HANK CODES codes interventional radiology (IR) reports as well as diagnostic radiology reports. The autocoder reads each radiology report and decides whether the report describes an interventional procedure. You do not tag or route the case yourself.

## How the autocoder recognizes an IR case

The autocoder looks for procedural language in the radiology report. It looks for therapeutic work such as embolization, angioplasty, thrombectomy, stent placement, atherectomy, vertebroplasty and sclerotherapy. It also looks for catheter and wire work, for drainage and access work such as nephrostomy, cholecystostomy, gastrostomy and abscess drainage, and for device placement such as a PICC, a port or an IVC filter. It also looks for procedure-suite language, for example prep and drape, sedation and hemostasis.

The autocoder needs more than one of these signals before it treats the report as interventional. A diagnostic interpretation that only recommends a drainage does not become an IR case.

## What changes when a case codes as IR

IR cases get IR-specific checks that diagnostic radiology cases do not get.

**Add-on code integrity.** The autocoder compares each add-on code on the claim against the CMS add-on code edit data. When CMS lists specific acceptable primary codes for that add-on, and none of those primaries is on the claim, the autocoder raises the `ir_addon_without_primary` alert. The alert names the acceptable primaries. This alert is FINANCIAL with a default severity of 6. The check is data-driven, so it covers only CMS-defined (Type 1) add-ons.

**Bundled work reported twice.** The autocoder raises `ir_combined_sni_conflict` when a combined interventional code sits on the claim next to a separate code for catheterization, imaging supervision and interpretation, or guidance that the combined code already includes. Shipped families cover cervicocerebral angiography, renal angiography, the dialysis circuit, vascular embolization, lung core biopsy, image-guided breast biopsy, bone and lung ablation, and imaging-inclusive drainage. The autocoder raises `ir_picc_bundled_imaging_conflict` when a PICC code that bundles all imaging guidance (36572, 36573 or 36584) appears with 76937 or 77001. Both alerts are COMPLIANCE with a default severity of 6.

**Documentation reminders.** The autocoder raises `ir_us_guidance_documentation` when 76937 is billed, and `ir_moderate_sedation_documentation` when a moderate sedation code (99151-99153 or 99155-99157) is billed. Both alerts are COMPLIANCE with a default severity of 5. Each alert lists the documentation elements a coder must confirm.

Full trigger and action detail for every alert is in the alert reference.

## What a coder verifies on an IR claim

1. The procedure codes match the interventional work in the report.
2. Each add-on code has its primary procedure on the claim.
3. No separately reported code duplicates work that a combined code already includes.
4. Guidance and sedation documentation supports the codes on the claim.
5. Laterality modifiers and the diagnosis codes agree with the report.

## Configuration

Your facility configuration controls whether IR coding is active, through the `irCoding` setting. The shipped default is on. With IR coding off, the autocoder codes radiology reports as diagnostic radiology only, and it raises the `radiology_ir_not_supported` alert on codes outside the diagnostic range. Your facility configuration also controls each IR processing rule (`ir_picc_bundled_imaging_conflict`, the `ir_combined_sni_*` family, `ir_us_guidance_documentation` and `ir_moderate_sedation_documentation`), so you can change a severity or disable a rule. Contact your Hank representative to change any of this.

## How this reaches you

What happens next depends on how your organization consumes HANK CODES. In HANK Claim Maker, a COMPLIANCE alert flags the claim for the compliance team your administrators configured for it. Organizations that consume the coding API directly decide in their own workflow which alerts pause a claim, who reviews them, and when a claim is released.