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Orthopedic Practices: Update Imaging Accreditation or Face Medicare Denials in 2012

Written by  Sabrina Rodak | Monday, 31 October 2011 15:58
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Physicians, non-physician practitioners and independent diagnostic testing facilities that provide the technical component of advanced diagnostic imaging services must be accredited by Jan. 1, 2012 to bill Medicare for these services, according to a CMS report.
Advanced diagnostic imaging procedures include MRI, CT and nuclear medicine imaging such as PET; they exclude X-ray, ultrasound, fluoroscopy procedures and diagnostic and screening mammography that are subject to quality oversight by the FDA. The technical component is the equipment and technician performing the test.

The accreditation will apply only to the suppliers of the images, not to the physician's interpretation (professional component) of the image. In addition, only suppliers of ADI paid under the Medicare Physician Fee Schedule must be accredited; hospitals are thus exempt from the requirement. ADI services furnished in a hospital outpatient setting are also exempt.

The American College of Radiology, the Intersocietal Accreditation Commission and The Joint Commission are the approved accreditation organizations. Suppliers of the TC for ADI must be accredited by only one of these organizations by Jan. 1 to avoid claim denials by Medicare. Requirements for accreditation include meeting quality standards for medical personnel, equipment and images, among others.

The accreditation process may take up to five months and the average cost for one location and one modality is approximately $3,500 every three years, according to the report.

Related Articles on Imaging Services:

Changes for CMS Imaging Reimbursement: 6 Things for Orthopedic and Spine Providers to Know
Trends and Insights Into Orthopedic Teleradiology: Q&A With Radiologist Dr. Douglas Smith

iPad-Based Radiology Interface for Orthopedic and Spine Surgeons: Virtual Viewbox From Musculoskeletal Imaging Consultants








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