Ignore new imaging cost centers at your own financial peril

Radiology administrators who ignore a Centers for Medicare & Medicaid Services proposal to create new cost centers for CT and MR do so at their own financial peril, according to a coding and billing strategist who spoke Thursday at the American Healthcare Radiology Administrators' fall conference in Baltimore.

The proposed cost centers, said Melody Mulaik (pictured), president and co-founder of Powder Springs, Ga.-based Coding Strategies, will cause reimbursement decreases as high as 38 percent for CT. "It's a very big deal," she said. "You'll recall you already took a 25 percent hit this year on your CTs."

Mulaik also talked about the importance of accurate pricing and of radiology administrators' involvement in such matters with regard to proper coding.

"The problem is, if it doesn't accurately reflect what it costs you to provide a service, you're possibly telling Medicare that it didn't cost that much to perform a procedure," Mulaik said. "While you might be saying to yourselves, 'Well, finance does all of that, we don't really have any control,' you've got to have those conversations with your finance team."

Mulaik, who said AHRA has a new regulatory committee in place that is trying to work with the Healthcare Financial Management Association on these issues, also emphasized accuracy from a compliance standpoint. While the U.S. Department of Health & Human Services Office of Inspector General's primary focus is on auditing the electronic health record process as it pertains to Meaningful Use attestation, that doesn't mean medical imaging professionals aren't getting audited, as well, she said.

"Everybody undergoes an audit in some form or fashion," she said.

Last month, the American College of Radiology submitted comments to CMS on the Medicare Physician Fee Schedule, urging CMS not to adopt payment policies that would result in significant reimbursement cuts for radiologists and radiology oncology service providers. ACR also submitted a letter to CMS regarding the Hospital Outpatient Prospective Payment System (HOPPS) Proposed Rule requested, asking that CMS not implement the aforementioned data generated by the CT and MR cost centers. Instead, ACR wants CMS to continue to set hospital payment rates for CT and MR studies using the diagnostic radiology cost-to-charge ratio.

Data from the 2013 Medical Imaging Confidence Index (MICI) third-quarter survey, published in September, shows that radiology administrators continue to be skeptical about the level of compensation their facilities will receive from Medicare for diagnostic and interventional procedures.


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