Radiology Billing and Coding Audit Checklist Form
Use this checklist to review coding accuracy, documentation support, charge integrity, and follow-up actions for radiology billing and coding audits.
Audit Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Auditor Name
*
Audit Type
*
Please Select
Coding Accuracy
Documentation Support
Charge Integrity
Comprehensive Audit
Coding Accuracy Checklist
All codes selected are appropriate for the documented procedures
Modifiers are used correctly
No unbundling or upcoding detected
Documentation Support Checklist
Documentation supports all billed codes
Signatures and dates are present where required
No missing or ambiguous information
Charge Integrity Checklist
All charges are supported by documentation
No duplicate or missing charges
Charge amounts are accurate
Overall Audit Score
1
2
3
4
5
Audit Findings / Notes
Follow-Up Actions Required
Audit Follow-Up Completed
Yes
No
Submit Audit
Should be Empty: