Whitney Palmer

Healthcare. Politics. Family.

How To Be The Perfect Radiology Group

Published on the DiagnosticImaging.com website on Feb. 19, 2015

By Whitney L.J. Howell

You have reimbursement woes. You worry about your billing practices. You wonder if you’re doing the right things to demonstrate your value to partner hospitals. The daily stresses can be nearly overwhelming – but, if you were a perfect radiology group, these worries wouldn’t exist.

The perfect radiology group has tweaked its day-to-day activities. Their streamlined coding process ensures proper payment. Their targeted marketing attracts more referring physicians, and personnel tactics secure a seat at the administrative decision-making table. Every day, for the perfect radiology group, operations are smooth.

But, is the perfect radiology group really attainable? Not really, industry experts acknowledge, but it’s possible for you to get close. Later this year, the American College of Radiology (ACR) will release a road map for creating your “optimal” radiology practice or department. In it, according to Mark Bernardy, MD, chair of the ACR Managed Care Committee, you’ll find a list of best practices that were tested at the ground level, and can help you on your way. Consider it an expansion of ACR’s Imaging 3.0.

“Imaging 3.0 has laudable big picture ideas. Everyone nods their head that it sounds good and right. But, then, exactly what is it that you want me to do?” said Bernardy, who is also a practicing Georgia-based radiologist. “There’s a big gap. I thought it would be useful to go through the exercise of writing down what it is we mean when we say, ‘This is what the perfect radiology group looks like.’”

As a compilation of best practices gathered from large medical centers and small private practices nationwide, it will be a living document, open to modification with new, effective ideas, he said.

Read the remainder of the story at its original location: http://www.diagnosticimaging.com/practice-management/how-be-perfect-radiology-group?cid=tophero


February 23, 2015 Posted by | Healthcare | , , , , , , , | Leave a comment

Radiology Data Registries: Know How to Comply

Published on the March 14, 2013, DiagnosticImaging.com website

By Whitney L.J. Howell

The number of radiology practices and departments looking to benchmark themselves against their peers through data registries is growing. But many still need guidance on what these databases are and how they can correctly participate.

For years, your practice or department has likely followed its own protocol for diagnostic scans, using what you felt were best practices for radiation doses, for example. According to industry experts, data registries are pathways to double-check yourself and ensure what you’re doing provides the best care to your patients.

“These registries are effective in the promotion of quality improvement changes and changes in high-quality health,” said Cynthia Moran, assistant executive director of government relations, economics, and health policy at the American College of Radiology (ACR). “The use of registries is so that people can see where they are in the performance metric.”

Although the ACR Dose Index Registry has received the most attention recently, seven additional registries exist — CT colonography, general radiology improvement, IV contrast extravasation, mammography, oncologic PET, night coverage, and quality improvement for CT scans in children. Together, these registries comprise the ACR National Radiology Data Registry (NRDR).

By providing data to a registry, you’re contributing to the body of information that will be used to craft future best practices guidelines. According to Moran, these registries also make it easy for you to compare yourself to your peers.

“If you provide data to a group or registry, you periodically get a report to see where you stand respective to your other colleagues,” she said. “If your numbers are far off from the performance of others, you can create a process to see what’s wrong and how you can do better for your patients.”

While data registries are most often lauded for improving the quality of care available to patients,  they do make a more direct impact on radiology practices, said Judy Burleson, ACR’s director of quality and safety metrics.

“When quality improvement and quality reporting programs are used in combination with reimbursement mechanics, it enables payers — private or Medicare — to pay for services for their beneficiaries based on quality rather than fee-for service,” she said. “When you integrate a quality program within payment structures, you’re inserting and element of value there.”

Ensuring Compliance

To participate in any registry within the NRDR, your practice must complete a participation agreement. Not only does this document outline the specific registry or registries in which you want to enroll — it isn’t required that you participate in all registries — but it also mandates that you have the proper privacy protocols in place to protect the patient data you collect and submit.

There are also other rules you must follow, Burleson said.

“To be in compliance with a clinical data registry like the ACR registries or specialty society registries, practices just need to submit specific data elements in the format that’s required,” she said. “This could be problematic for some sites that must figure out the best way to get this data and from where to find it.”

To read the remainder of the story at its original location: http://www.diagnosticimaging.com/articles/radiology-data-registries-know-how-comply-0

March 18, 2013 Posted by | Healthcare | , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

MRI Safety Still a Concern, But National Guidance Lacking

Published on the July 27, 2012, DiagnosticImaging.com website

By Whitney L.J. Howell

Last October, the U.S. Food and Drug Administration (FDA) held a meeting to examine the biggest MRI safety concerns and outline best practices to reduce injuries associated with the scans. So far, however, the industry has received no national guidance on how to accomplish this goal.

But the lack of official instruction at the federal level doesn’t mean the push toward greater MRI safety — being recognized this week during MRI Safety Week — has stalled. Advancements are underway at the state level and in the accreditation process to prevent another tragedy, such as the 2001 Colombini case when a 6-year-old boy died when an oxygen tank flew across the room and struck him during the imaging process.

“Any protection that is implemented will benefit the 30 million Americans who get MRIs on an annual basis,” said Tobias Gilk, president and MRI safety director at Mednovus and senior vice president at the design and architecture firm Rad-Planning. “People are beginning to look harder at MRI risk factors as the power of our magnets continue to increase.”

State Regulations

Many states and the Joint Commission have implemented new regulations that strictly govern the design and construction of new MRI suites. These requirements do not mandate retrofitting existing installations.

“There are a growing number of states that are adopting this building code,” Gilk said. “Anyone who does MRI suite work — renovation, upgrade, equipment replacements, anything with a building permit — in virtually every jurisdiction must follow these state standards.”

To conform to the building regulations, health care engineers must meet eight standards, Gilk said. They must follow the American College of Radiology’s (ACR) 4-Zone Principles that addresse integrated access controls and screening practices. There must also be a clear line-of-sight between the operator’s console and patient inside the MRI machine, and designers must include demarcation lines to keep individuals with implantable medical devices far enough away. The presence of ferromagnetic-only detectors is required, and new MRI suites must also have exhaust fans and other protective measures to eliminate any cryogen that escapes into the imaging area.They must include an always-illuminated sign to remind staff that the MRI magnetic field is always active even without a patient.

These new design codes also require a clearly marked safe zone in which staff can use MR conditional equipment. Most importantly, Gilk said, designers and engineers must remember there is no cookie-cutter model for MRI suites. Each site is different and requires individual planning.


In a switch from years past, Gilk said, the Joint Commission is requiring far more documentation to prove you are making your MRI suite as safe as possible for patients. As part of the ACR’s 4-Zone Principles, the Commission now requires proof that you have established access control and provide proper staff supervision. You must also produce documentation that you have adequately trained your MRI personnel in safety procedures and protocols, he said.

“The Joint Commission wants to see evidence of screening protocols for implants and devices, clinical contraindications, and physical screenings,” Gilk said. “They want to see what you’re doing to make sure visitors aren’t carrying objects that will become dangers in the magnet room and what processes or tools are in place that accidents don’t occur.”

Requiring these measures — from an accreditation standpoint — is a giant step forward, he said.

To read the remainder of the story at its original location: http://www.diagnosticimaging.com/mri/content/article/113619/2092918

July 27, 2012 Posted by | Healthcare | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

New CT Abdomen/Pelvis CPT Code Changes Cut Reimbursement

Published in the April 26, 2011, DiagnosticImaging.com

By Whitney L.J. Howell

As of Jan. 1, 2011, the Centers for Medicare & Medicaid Services (CMS) changed the way you code for abdomen and pelvis CT scans performed together. The new combined-code requirement slices reimbursement for these services in half.

Each time you run these scans together, for the same reason and on the same service date, you lose between $200-400 in reimbursement, depending upon whether the test requires a contrast agent. That’s a 50 percent payment reduction each time you scan for tumors, cancer or other such problems.

Although the original codes for abdomen and pelvis CT scans conducted separately still exist, CMS now mandates that services performed together at least 75 percent of the time must use one CPT code. Assigning one code in these instances is the agency’s way of eliminating what it considers double payments for similar scans conducted at the same time.

The American College of Radiology (ACR) has opposed the move for the past five years, citing concerns over lost reimbursement, potential confusion over using new codes correctly, and frustration that consideration wasn’t given to the physician time needed to read scans.

To read the remainder of the article online: http://www.diagnosticimaging.com/practice-management/content/article/113619/1850806

April 28, 2011 Posted by | Healthcare | , , , , , , , , , , , | Leave a comment

Looking For Imaging in Stage 2 of Meaningful Use

Published on DiagnosticImaging.com on April 13, 2011

By Whitney L.J. Howell

Industry comments on the draft criteria for Stage 2 of the meaningful use program are in. Now specialty leaders and practices are waiting with bated breath see if Stage 2 recommendations offer any clarity on how radiologists will be required to implement electronic health record systems (EHRs).

As it stands now, specialty leaders aren’t holding out much hope the Stage 2 guidelines — which have no mention of imaging — will differ much from the uniform approach taken with Stage 1.

“The overall view is that the one-size-fits-all tactic will largely continue to be the case,” said Michael Peters, director of legislative and regulatory affairs for the American College of Radiology. “We’ve asked for specialty-specific paths because it’s the right thing to do, but we don’t anticipate that the federal agencies will have the time to noodle around and create pathways for all specialties.”

Without knowing the final recommendations from CMS, it’s impossible for radiology practices to effectively prepare for Stage 2 implementation, he said. Proposed rules are expected by late 2011 or early 2012.


To read the remainder of the article, visit: http://www.diagnosticimaging.com/meaningful-use/content/article/113619/1842692?cid=dlvr.it&CID=rss


April 14, 2011 Posted by | Healthcare | , , , , , , , | Leave a comment

Taking Steps to Improve Radiation Safety

Published on DiagnosticImaging.com on March 14, 2011

By Whitney L.J. Howell

Radiology currently has two buzzwords: safety and low dose. And, it’s a trend that’s been growing for the past five years.

Throughout the industry, radiologists and referring physicians are using a number of strategies to limit patient exposure to unneeded radiation. New programs, equipment, and contrast agents are being used together to drastically reduce the amount of radiation patients receive.

Safety and low-dose vigilance really kicked into high gear when the Biological Effects of Ionizing Radiation VII report came out in 2005. Media reports over the perceived dangers of radiation exposure prompted calls for measures that would protect patients, with the two main worries being accidental over-irradiation due to CT scan protocol errors and potential cancer risks associated with radiation.

The pendulum is now swinging toward limiting doses whenever possible. Through its Image Wisely and Image Gently campaigns, the American College of Radiology (ACR) and its partners have provided guidance and encouragement for reducing the amount of radiation used with both adults and children, respectively.

“The specialty is taking steps to improve safety. When it comes to doses, it’s all about ALARA — as low as reasonably achievable,” said James Thrall, MD, ACR President and Massachusetts General Hospital radiologist-in-chief. “The good news is that there are a tremendous number of technical innovations and clinical practices that are rapidly reducing exposure from CT scanning.”

To read the remainder of the article: http://bit.ly/haWvdn



March 17, 2011 Posted by | Healthcare, Science | , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment


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