PB Coder (Interventional Radiology Focused)

The PB Coder is responsible for reviewing, analyzing, and accurately coding Neurointerventional Radiology and Interventional Radiology procedures. This role requires advanced expertise in vascular anatomy, component coding, and specialized interventional radiology techniques across multiple vascular territories, including the head and neck, visceral (abdominal and pelvic), and peripheral (extremity) systems.

The PB Coder performs initial charge review and coding validation for complex interventional procedures within the Radiology and Neurosurgery specialties. Responsibilities include translating intricate diagnostic and therapeutic interventional procedures into the appropriate assignment of CPT, ICD-10-CM, HCPCS, and modifier for accurate reporting of physician professional services to third-party payers.

This role ensures coding accuracy, completeness, and compliance with established coding guidelines, regulatory requirements, payer-specific reimbursement policies, and industry best practices. The PB Coder serves as a subject matter expert in Neurointerventional and Interventional Radiology coding, supporting appropriate charge capture, compliance to ensure optimal reimbursement.

Essential Duties and Responsibilities:

• Review and analyze complex clinical documentation, including interventional radiology operative reports, procedural notes, consultation reports, diagnostic imaging results, and medical records for neurovascular, head and neck, visceral (abdominal/pelvic), peripheral vascular, and non-vascular interventional procedures.

• Accurately assign and sequence CPT, ICD-10-CM, HCPCS Level II, and modifier codes for a wide range of diagnostic and therapeutic interventional radiology and neurointerventional procedures, including but not limited to mechanical thrombectomy, embolization procedures (e.g., UFE, TACE, Y-90), angioplasty, stent placement, atherectomy, thrombolysis, dialysis access interventions, vertebral augmentation, biopsies, drainages, and vascular access procedures.

• Apply advanced knowledge of vascular anatomy and component coding principles to accurately capture selective and non-selective catheter placements, vascular access, imaging guidance, diagnostic angiography, intervention services, and Radiological Supervision and Interpretation (RS&I) components.

• Interpret outpatient consultation notes, office visits, hospital encounters, and inpatient consultation services to determine the appropriate professional services rendered and assign accurate CPT, ICD-10-CM, HCPCS, and modifier codes.

• Evaluate provider documentation for completeness, consistency, and coding specificity. Ensure diagnoses, procedures, and medical necessity are fully supported and accurately reflect the care and treatment provided.

• Apply appropriate modifiers and adhere to National Correct Coding Initiative (NCCI) edits, CMS regulations, Official Coding Guidelines, specialty-specific coding guidance, and payer-specific billing and reimbursement policies to promote compliant claim submission.

• Research and resolve complex coding scenarios involving bundled services, component coding, vascular families, hierarchical catheterization rules, and evolving interventional radiology coding guidance.

• Follows and adheres to all WWT policies such as Coding Audit Policy and Physician Coding Query In-Basket Policy
• Provide real time feedback to providers on all coding changes and trends via EPIC in basket message
• Regularly participate and engage in all coding meetings and other ad-hoc meetings as needed. Works in coordination with other members of the physician’s office/departments as necessary
• Collaborates with Coding Management Team for special coding and billing projects if assigned
• Resolving coding denials assigned by applying coding knowledge and skills. Apply coding knowledge and skills to resolve coding denials from payers and work with management and various departments
• Maintains active coding credentials and CEU’s required for coding roles
• Performs other related duties as required and assigned

  Knowledge, Skills & Abilities

• Specialized Experience: Minimum of 3-5 years of dedicated medical coding experience specifically within Interventional Radiology and Neuro-IR.

• Strong knowledge of vascular anatomy, catheterization hierarchies, component coding methodologies, Radiological Supervision and Interpretation (RS&I) coding, and payer-specific reimbursement.

• Analytical Precision: Superior ability to extract specific details from multi-page operative reports regarding access sites, catheter pathways, final device placement, and additional therapeutic steps.

• Communication - communicates clearly and concisely, verbally and in writing
• Persistence - comfortable pursuing, rebutting and escalating issues as appropriate
• Goal-oriented - holds him/herself accountable to achieving shared professional and personal goals.
• Customer Orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
• Interpersonal skills - establishing and maintaining effective working relationships with employees, and external parties.
• PC skills - demonstrates high proficiency in Microsoft Office applications, especially Microsoft Excel, and others as required
• Writing skills -advanced writing skills with ability to present a compelling argument, punctuate properly, spell correctly and transcribe accurately

 Education/Experience:

• Certified professional coder CCS-P, CPC, RHIT or RHIA through AAPC or AHIMA with a minimum of 3-5 years of dedicated medical coding experience specifically within Interventional Radiology.

• Responsibility for maintaining certification credentials and completing all continuing education requirements established by AAPC, AHIMA, or other applicable credentialing organizations.
• Clear understanding of protocols and procedures in a medical office including health information management, confidentiality, and safety
• Organize and prioritize responsibilities while remaining flexible to changing demands
• Excellent written and oral communication skills, with the ability to interact with patients, families, staff and others.
• Strong analytical skills and attention to detail
• Ability to establish priorities and work independently
• Must have high level of discretion and judgment