HAP Radiology Billing and Coding Blog

The Contrast Media Shortage’s Impact on Radiology on June 1, 2022

The shutdown of GE Healthcare’s Shanghai, China plant that began in April has caused a global shortage of the iodinated contrast media iohexol (GE’s Omnipaque TM). GE reports that it has returned to a 50% production rate, and they have shifted some production to a plant in Ireland, but they expect an 80% reduction in supplies through June. Alternative contrast agents such as iodixanol (GE’s Vispaque TM) and ioversol (Optiray[1]) are becoming scarce as practices have shifted to using those products instead of iohexol. As of May 31, Omnipaque, Vispaque, and Ultravist (Bayer’s iopromide) have been added to the FDA’s list of drug shortages.

Categories: radiology, contrast media shortage

When Will Programs and Policies Enacted During the Pandemic End? on May 10, 2022

With our first article posted in March 2020, we began a series designed to help you stay abreast of the many regulatory changes and funding opportunities that would help you get through the COVID-19 Public Health Emergency (PHE). The PHE is now scheduled to end on July 15, 2022, unless it is extended for another 90 days, but regardless of exactly when the PHE ends you will need to know what to expect. Some policies will end immediately, and others will end in some number of days later.

Categories: medicare, HHS PRF, Public Health Emergency, PHE, telehealth, medicaid

Appropriate Use Criteria (AUC) Penalty Phase Set to Begin on April 29, 2022

Will the requirement to use Clinical Decision Support (CDS) finally become a reality? The current timetable for the penalty phase of the AUC/CDS rule calls for it to begin on the later of January 1, 2023, or the January 1 following the end of the COVID-19 public health emergency (PHE). The PHE has just been extended another 90 days into July 2022, with no end in sight although there are some indications that it could end this year. One source reports that the Administration will give 60 days’ notice before ending the PHE. With this uncertainty, it would be wise for practices to be ready just in case!

Categories: interventional radiology, clinical decision support, CDS, radiology, appropriate use criteria, AUC

Provider Relief Fund Reporting Extensions Are Available For Extenuating Circumstances on April 22, 2022

This article was updated on
May 3, 2022. 

 

By now, practices that received grants under the Provider Relief Funds (PRF) program are familiar with the process of reporting on those funds. Reporting on the initial round of funding that came in April – June 2020 (Period 1) was due by November 30, 2021. The second reporting period, for funds received July – December 2020 (Period 2), ended on March 31, 2022. However, the Health Resources & Services Administration (HRSA) recently announced that providers will be able to submit a request to report late due to extenuating circumstances for any reporting period. The request deadline for Period 1 was April 22, 2022. A request for Period 2 must be made online by May 13, 2022.

Categories: HHS, HHS PRF, Provider Relief Fund

United Healthcare is Moving to a Designated Diagnostic Provider Program on April 6, 2022

On July 1, 2022, United Healthcare will begin to implement its Designated Diagnostic Provider (DDP) program for imaging facilities in certain states. According to United’s FAQ document, outpatient MRI/MRA, CT, PET, and nuclear medicine scans must be performed by a Designated Diagnostic Provider in order for members to have the lowest out-of-pocket cost. A member will pay more for services provided by non-DDP imaging facilities.

Categories: radiology, DDP, Designated Diagnostic Provider

Medical Debt Credit Reporting Policy Changes Will Impact Radiology Practices on March 29, 2022

One of the tools available to assist with the collection of unpaid patient balances is to report the debt to a credit reporting bureau. While typically used as a last resort, it has had the effect of ultimately achieving collection when the patient applies for a loan that requires them to clear up the open balances shown on the credit report. While most physician groups are compassionate and are willing to work with their patients to avoid credit bureau reporting, they are required by insurance laws to pursue collection of patient co-payments and coinsurance. With patient deductibles, copayments and coinsurance increasing in many plans, loss of revenue to the practice through non-collection has become a bigger concern over recent years.

Categories: patient collections, radiology, medical debt

When & How to Bill For Locum Tenens Services In The Radiology Practice on March 22, 2022

The workload of a radiology practice doesn’t diminish when one of the physicians is away, either on leave or due to termination, and one way to cope with the shortfall of staff is to use a temporary physician service. Knowing how to properly bill for those services is essential to maintaining cash flow in compliance with the regulations.

Categories: radiology billing, radiology, locum tenens

Legal Win Forces a Change to the No Surprises Act on March 3, 2022

The decision by a US District Court in a lawsuit brought by the Texas Medical Association has invalidated a portion of the No Surprises Act (NSA). While other similar suits are still pending, this ruling will immediately impact some of the methodology to be used in settling disputes that arise under the NSA.

Categories: No Surprises Act

Strengthening Congressional Support Addresses Medicare Interventional Radiology Cuts on February 25, 2022

Interventional radiology is among those specialties hit hard by the clinical labor practice expense cuts in the 2022 Medicare Physician Fee Schedule (MPFS). The proposed Physician Fee Schedule for 2022 contained an estimated 9% cut to interventional radiology (IR), due primarily to the revision of the practice expense component of the RVU calculation. The MPFS final rule brought the IR cut down to an estimated 5% after reconsideration of some of the methodology employed in calculating clinical labor costs. However, this is a blended figure that ignores the much larger effect on the global reimbursement for office procedures than on the professional component for hospital-based procedures.

Categories: interventional radiology, interventional radiology billing, Medicare Physician Fee Schedule

Coverage is Expanded for Lung Cancer Screening Using LDCT on February 16, 2022

The Centers for Medicare and Medicaid Services (CMS) has announced a shift in its eligibility criteria for coverage of lung cancer screening using low-dose CT (LDCT), thus joining other payers in adopting recommendations made by the US Preventive Services Task Force (USPSTF).  In addition, CMS made other modifications to its eligibility criteria that will increase the ability of more people to obtain access to screening, effective February 10, 2022 with the posting of its Decision Memo.

Categories: low dose CT, radiology, lung cancer screening

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