Is Diagnostic Radiology Coding Really Easy?

Ok, I’ll just come out and say it–many times in coding discussions, I’ve heard people say that diagnostic radiology coding is easy. That it’s a good place for new coders to start. I’m not really sure how I feel about that. Not that it’s not a good place for new coders to start (it is) but that it’s so easy– anyone can do it. I’ll admit it’s much easier that interventional radiology coding, and some of the other specialties out there…but diagnostic radiology is it’s own specialty. It has it’s own set of rules and if you’re not a radiology coder–you won’t be familiar with it. I mean, yes, you could learn it–that’s why I started this website–to help new coders learn–but does it sound weird if I feel bad that people think it’s very easy to code?

For starters, here are some of the little idiosyncrasies that a diagnostic radiology coder knows off the top of her/his head:

*Understands modifier 26 and TC

*When to use modifiers 59/76/77/52/53

*How many organs are in a complete abdominal ultrasound vs limited

*The difference between all of the different types of OB ultrasounds

*The documentation requirements for spectral Doppler (now if we can teach radiologists how to document this right, we’ll really be in good shape).

*The different contrast codes for mri’s and ct scans

*Understand the difference between an mri, mra, ct, cta and pet scan

*Difference between a screening and diagnostic mammogram

*The physician ordering rule

*All the different cpt codes for x-rays

*The different types of x-ray views

*Knows the codes in the 7000 series without looking in the cpt book

*All of the different PQRS codes that may be required and the documentation requirements for each

*Understands that “initial encounter” for fractures/injuries does not mean first encounter.

*The whole ICD-10-CM book because codes are used from every section!


Another part of diagnostic radiology coding that is specific to it, is the speed at which you’re expected to code. On average, a coder should do 60 reports an hour at 97% accuracy. Many coders can do more, but this is the expected rate. There are short cuts–like different encoders that can help coders keep up the pace, but ideally I think a radiology should be able to code 60 an hour without much help. It’s a specialty where there always is a lot to code, so you have to hit the ground running.

The only way to work your way up to that speed is by practicing! There are no short cuts. I once had a teacher that said “the more you practice, the better you get.” That still holds true years and years later (Thank you Mrs. Jaffe). Here is a free diagnostic radiology coding test if you’re looking for more practice.

Anyway, with all that being said–I love diagnostic radiology coding and I know I’m biased, but I just think it’s the best and I can’t help but feel bad if people put the specialty down without fully understanding it.

All of the above topics (and more) are things I plan to talk/write about at some point, so if you’re interested in learning–keep following this blog and facebook page 🙂




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