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  Latest News

CA's Breast Density Legislation Extended Through 2025
9/14/2018
Legislation to extend California’s breast density reporting bill has been signed by California Gov. Jerry Brown, ensuring the law will remain in place through 2025. 
Read more at Radiology Business.

2019 HOPPS Proposed Rule Summary
8/15/2018
The proposed rule for the 2019 Hospital Outpatient Prospective Payment System (OPPS) was released by CMS on July 25. This article highlights two aspects of particular interest to the AHRA community: 1) Updates to the Site Neutral Payment Policy; and 2) Cost Center Calculation Updates for MRI and CT. 
Read more in Link.

2019 Proposed PFS: AUC Summary
7/13/2018
On July 12, CMS released the proposed rule for the 2019 Physician Fee Schedule. Here are a few quick takeaways from the primary AUC section.
Read more in Link.

AHRA CDSM/AUC Stakeholder Update
4/18/2018
In February, 2018, AHRA brought together stakeholder groups with an interest or authority over how information will be generated by the Clinical Decision Support Mechanisms, coded and transmitted through the imaging operational system (i.e., ordering professional to imaging department to radiologist), and the placement of the CDSM code on the Medicare claim (both technical and professional).
Click here to read more.

CMS Clarifies CR to DR Policy (Modifier FY)
3/9/2018
CMS recently released their quarterly update of the Hospital Outpatient Prospective System and clarified their policy regarding the applicability of modifier FY when images were performed using both CR and DR technology (multiple views). Modifier FY is to be reported when CR technology is the only technology used to perform the imaging service. If an imaging service has both CR and DR views, then the payment adjustment does not apply and modifier FY does not need to be used. AHRA urged CMS to provide clarification on these types of scenarios and we are pleased to see that they have clarified the policy. Here is the relevant language from the quarterly update (emphasis added):

CMS notes that section 1833(t)(16)(F)(ii) refers to an imaging service that is an X-ray taken using computed radiography technology. Where the imaging service is comprised of multiple images that include both X-rays taken using computed radiography technology and images taken using digital radiography, CMS does not believe the payment reduction would apply to that service. Instead, the payment adjustment applies to an imaging service that is an X-ray taken using computed radiography technology where the X-ray taken using computed radiography technology is not combined with digital radiography in the same imaging service.

This “CR to DR” policy was created by the Consolidated Appropriations Act of 2016 and it reduces Medicare reimbursement for X-rays taken using computed radiography technology by 7% until 2022 and 10% thereafter. The intent is to incentivize a transition to digital radiography technology and save Medicare money. The Consolidated Appropriations Act of 2016 also reduced Medicare reimbursement for film X-rays by 20%. If you perform an X-ray with film, you must use modifier FX.
 
CMS Creates Modifier QQ for Voluntary AUC Reporting
3/7/2018
CMS announced on Friday that they were creating a new modifier, QQ, for voluntary Appropriate Use Criteria (AUC) reporting. The modifier may be used on claims with dates of service on or after July 1, 2018. 
Read more in Link.

AHRA Organizes First AUC Stakeholder Summit
2/20/2018
AHRA organized and hosted a multi-stakeholder summit on February 20, 2018 to discuss the development of a coordinated series of recommendations on implementing the statutory requirement in which ordering physicians must consult a Clinical Decision Support Mechanism (CDSM)/Appropriate Use Criteria (AUC) as a condition of payment for certain advanced imaging services.
Read more.

Patient Relationship Categories and Codes
2/16/2018
The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 instructed CMS to create Patient Relationship Categories and Codes as a tool to more accurately attribute resource use and care episodes to clinicians who serve patients in different roles as part of the assessment of the cost of care. This report from the ACR, AHRA Regulatory Affairs committee, and RBMA provides their recommendation for using these codes in 2018.
Click here to read the report.

Breast Density Legislation Introduced in Congress
11/21/2017
The Breast Density and Mammography Reporting Act of 2017 (HR 4122, S 2006) has now been introduced in both the House of Representatives and the Senate with bipartisan support. The bill would set a minimum standard for dense breast tissue notification after mammograms and recommend women discuss options with their physician to see if additional breast cancer screening is needed.
Read more at Radiology Business.

2018 MPFS Final Rule Summary
11/14/2017
CMS released the 2018 Physician Fee Schedule Final Rule last week. The following is a summary of the AHRA-related policies written by the AHRA Regulatory Affairs committee.
Click here to read more.

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