HAP Radiology Billing and Coding Blog

Radiologists at NYU Langone Medical Center have been creating video radiology reports in addition to their traditional text-based reports. The videos are intended for the patient, not the referring physician, and they are uploaded to the patient portal as they are completed. A team headed by Michael P. Recht, MD, studied the results, which became available online April 20 at the American Journal of Roentgenology. An example of a video report is included in NYU Langone’s NewsHub.

The use of teleradiology services was originally framed around the need for a better lifestyle, usually to supplement a radiology group for its call obligation. Teleradiology reading was almost always ‘preliminary,’ with final reports generated by the regular staff, and it was always an expense to the practice that was deemed worthwhile to avoid having to provide night and weekend coverage by the regular staff. Today, the picture has changed to the point where teleradiology services are providing final reports and they have become an indispensable part of the practice that has shifted from a cost center to a profit center.

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.

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.

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!

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.

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.

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.

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.

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.