by MBMS | December 5, 2024

According to factors specified in the law, average payment rates under the Physician Fee Schedule (PFS) will be reduced by 2.93% in CY 2025, compared to the average amount these services were paid for most of CY 2024. The change to the PFS Conversion Factor (CF) incorporates the zero percent overall update required by statute, the expiration of the temporary 2.93% increase in payment for… Read More

by MBMS | December 5, 2024

The Centers for Medicare & Medicaid Services (CMS) released the 2025 Medicare Physician Fee Schedule (PFS) Final rule on November 1, 2024, which includes proposed changes to the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) participation options and requirements for 2025. Read More

by MBMS | November 6, 2024

Note from the author, Niki Tracey: This update is in reference to the April 2024 newsletter article I published regarding CTP exams. Additional coverage updates have been released. Read More

by MBMS | September 6, 2024

A new Anthem policy has been released related to inaccurate laterality and diagnosis combinations, which radiology practices across the country should be made aware of.  This new policy applies to all Anthem Blue Cross and Blue Shield plans and its affiliated plans. Continue reading full article below… Read More

by MBMS | July 2, 2024

Cyberattacks are a reoccurring security issue in the world today. The target/victim can range from an individual or small business up to a major corporation (UnitedHealth Group) and software system (CDK). A cyberattack is a malicious, unwelcome, and deliberate attempt by an individual or organization to breach the information system of another individual or organization. Continue reading full article below… Read More

by MBMS | June 5, 2024

The increase in utilization and hiring of radiology physician extenders by facilities and radiology groups makes it crucial to understand the impact physician extenders have on healthcare billing. Continue reading full article below… Read More

by MBMS | June 5, 2024

Nurse practitioners (NP) and physician assistants (PA) are also known as non-physician practitioners (NPP). These providers are not physicians but practice in collaboration or under the supervision of a physician. Continue reading full article below… Read More

by MBMS | May 3, 2024

A future update to the Palmetto LCD (Local Coverage Determination) policy brings good news for providers that perform computed tomography cerebral perfusion analysis studies with CPT code 0042T. Continue reading full article below… Read More

by MBMS | May 3, 2024

Measure QMM26 (previously measure MSN16) is reported for all patients age 50 or older undergoing a screening ultrasound for an abdominal aortic aneurysm (AAA). Continue reading full article below… Read More

by MBMS | April 4, 2024

On March 9, President Biden signed the Consolidated Appropriations Act 2024 (CAA 2024), avoiding a looming partial government shutdown. In CAA 2024, Congress applied several short-term fixes rather than making any significant changes to existing programs. The new law includes the following provisions impacting healthcare providers. Continue reading full article below… Read More

by MBMS | March 5, 2024

The Centers for Medicare & Medicaid Services (CMS) announced increased participation in CMS’ accountable care organization (ACO) initiatives in 2024, which will increase the quality of care for more people with Medicare. Continue reading full article below… Read More

by MBMS | March 5, 2024

CMS on January 17th issued a final rule requiring health plans to streamline their PA processes.The rule was initially proposed in December 2022, and public comments on the rule werecollected until March 2023. Continue reading full article below… Read More

by MBMS | February 14, 2024

As previously reported in the February Radiology Trends Newsletter, MBMS has been following updates regarding the appeal of NCCI edit for CPT code 76937. We are happy to share that the CMS decision has been overturned and we will begin coding and reporting CPT code 76937when documented appropriately. Continue reading full article below… Read More

by MBMS | February 2, 2024

Measure MSN13 will be reported for all patients, regardless of age, undergoing a Coronary Calcium Scoring screening study with a CACS score greater than zero. This measure applies to CPT code 75571. Continue reading full article below… Read More

by MBMS | February 2, 2024

Beginning this year, the following instruction was released pertaining to CPT code 76937 (Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent real-time ultrasound visualization of vascular needle entry, with permanent recording and reporting [list separately in addition to code for primary procedure]). Continue reading full article below… Read More

by MBMS | January 5, 2024

Writing for Modern Healthcare, Caroline Hudson outlines five key factors that will impact hospitals’financial performance in 2024. Continue reading full article below… Read More

by MBMS | December 21, 2023

Quality Payment Program The Centers for Medicare & Medicaid Services (CMS) released the 2024 Medicare Physician Fee Schedule (PFS) Final rule on November 2, 2023, which includes proposed changes to the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) participation options and requirements for 2024. Continue reading full article below… Read More

by MBMS | December 8, 2023

CMS has finalized the Medicare Physician Fee Schedule (MPFS) for 2024, issued November 2, 2023. Continue reading full article below… Read More

by MBMS | December 5, 2023

Certified electronic health record technology (CEHRT) is a health IT product that has successfully passed testing on specific standards and criteria selected by the Centers for Medicare and Medicaid Services (CMS) for use in specific programs. CEHRT can be achieved through the use of a single system or a combination of modules that can be used together. Continue reading full article below… Read More

by MBMS | November 6, 2023

CMS (Centers for Medicare and Medicaid Services) has proposed to remove three Radiology Quality Measures for the 2024 Performance Year. The confirmation of these quality measures being removed for the 2024 Performance Year will be published in the MPFS (Medicare Physician Fee Schedule) Final Rule, to be released later this month. Continue reading full article below… Read More

by MBMS | June 1, 2021

Radiology billing has become increasingly more challenging, and success hinges on a proven process guided by industry experts that understand the day-to-day revenue cycle intricacies and nuances. Read More

by MBMS | November 6, 2023

After losing her aunt at age 49 to interval breast cancer, Canan Dagdeviren, Ph.D. and associate professor at Massachusetts Institute of Technology (MIT), designed a flexible patch using 3-D printing to create a more “user-friendly” screening method. The patch is attached to a bra using magnets. This forms an interface between the 1D array and breast tissue that can easily be slotted into pre-determined imaging… Read More

by MBMS | October 4, 2023

The Centers for Medicare & Medicaid Services (CMS) has released the Final Performance Feedback for the 2022 Merit-Based Incentive Payment System (MIPS) Performance period. The 2022 MIPS Performance Feedback reflects all the MIPS data submitted or calculated for an individual clinician, group, or APM Entity participating in MIPS. It includes final MIPS scores and payment adjustment information associated with the 2022 reporting period in the… Read More

by MBMS | October 4, 2023

According to a study published in Academic Radiology the US health system was responsible for 10% of the total greenhouse gas emissions in 2013.  Beyond the obvious use of electricity and solid waste generation, gadolinium-based contrast is contaminating drinking water due to patient voiding and the methods used in water treatment. Continue reading article below… Read More

by MBMS | September 5, 2023

At the start of the pandemic, Congress enacted the Families First Coronavirus Response Act (FFCRA), which included a requirement that Medicaid programs keep people continuously enrolled through the end of the COVID-19 public health emergency (PHE) in exchange for enhanced federal funding. As part of the Consolidated Appropriations Act 2023, signed into law on Dec. 29, 2022, Congress delinked the continuous enrollment provision from the… Read More

by MBMS | September 5, 2023

Flow Medical has received a $1.0M investment of the $3.0M necessary to market its catheter specifically used to diagnose and treat pulmonary emboli. Flow Medical, a start-up from the University of Chicago, plans to use the funds for development and testing prior to applying for 510(k) clearance from the Food and Drug Administration (FDA). The start-up company used a grant from the Small Business InnovationResearch… Read More

by MBMS | July 31, 2023

The Centers for Medicare & Medicaid Services (CMS) released the proposed 2024 Medicare Physician Fee Schedule (PFS) rule on Thursday, July 13, which includes proposed changes to the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) participation options and requirements for 2024. Continue reading article below… Read More

by MBMS | May 23, 2022

Accurate radiology coding is one of the essential parts of a healthy revenue cycle as it sets the course for a seamless claims process in order to achieve the highest clean claim rates. Read More

by MBMS | June 27, 2023

Measure MSN16 is reported for all patients age 50 or older who have had a positive screening for abdominal aortic aneurysm (AAA). The measure applies to CPT Code 76706, ultrasound of the abdominal aorta, and screening for abdominal aortic aneurysm. Continue reading full article below… Read More

by MBMS | June 27, 2023

Starting July 1st, 2023, the use of one of these modifiers will be required on the HCPCS code for any single-use vials of drugs/ biologicals. Continue reading full article below… Read More

by MBMS | June 26, 2023

The increase in utilization and hiring of Radiology Physician Extenders by facilities and Radiology groups makes it crucial to understand physician extenders’ impact on healthcare billing. It is important to remember that even though a person is clinically able to perform a service, it does not make it a billable service. This document will provide the information required to determine how the provider group will… Read More

by MBMS | June 23, 2023

On Jan. 30, 2023, the Biden Administration announced its plans to end the COVID-19 Public Health Emergency (PHE). While the PHE officially ended on May 11, 2023, it is important to note its potential effect on radiology operations. During the pandemic, various flexibility waiver provisions were granted to help healthcare providers serve patients. While some of these changes will be permanent or extended due to… Read More

by MBMS | June 16, 2023

COVID long-haulers are patients whose COVID-19 symptoms are sustained or recurring. Their symptoms may include chest and joint pain, arrhythmias, brain “fog,” headache, loss of taste or smell, and sore throat. In an Italian study, 87.4 % of patients had at least one lingering symptom. Continue reading full article below… Lori M. Shore, CPC, RCC, RCCIR, FRBMA Vice President, Coding Education and Compliance MBMS, LLC… Read More

by MBMS | June 7, 2023

The Centers for Medicare & Medicaid Services (CMS) began implementing the appropriate use criteria (AUC) program on Jan. 1, 2020, beginning with an education and operations testing period. This program impacts all physicians and practitioners that order and render advanced diagnostic imaging services. Continue reading full article below… Article Provided By:Clarissa King-Houseal, CCMA, CPPMIndustry Research and Relations Senior Analystcking-houseal@mbms.net Read More

by MBMS | November 30, 2021

Radiology practices, regardless of how they handle their billing, all have the same goal in mind: to create a claim and have the insurance company process it as quickly as possible and receive the appropriate reimbursement per their contract. Read More