by Jared Staheli
June 25th, 2015
The FDA furnishes data to CMS on a weekly basis, which specify the certification of facilities under the MQSA. This data are contained in a “MQSA file.”
Prior to April 1, 2003, the MQSA file showed all facilities that are certified to perform film screening and diagnostic mammograms. After April 1, 2003, the file shows a new Record Type with two indicators, “1” for film and “2” for digital to determine which mammograms the facility is certified to perform.
Section 104 of the Benefits Improvement and Protection Act (BIPA) of 2000, entitled “Modernization of Screening Mammography Benefit,” provided new payment methodologies for both diagnostic and screening mammograms that utilize digital technology. The new digital mammography codes have a higher payment rate. In order for Medicare to know whether the mammography facility is certified to perform digital mammography and, therefore, due a higher payment rate, CMS relies upon the FDA certification data contained in the MQSA file. The FDA sends an updated file via the CMS Mainframe Telecommunications System (CMSTS), formerly Network Data Mover, on a weekly basis.
Effective July 1, 2006, the MQSA file shows:
• Name of Facility,
• Certification number of the facility,
• Film certification obtained (Record-type =1) or digital certification obtained (Record- type = 2),
• Effective and Expiration dates of each certification,
• Letter “T” to designate the facility as terminated,
Some mammography facilities are certified to perform both film and digital mammography. In this case, the facility’s name and FDA certification number shows up on this file twice. One line will indicate film certification with effective date/expiration date while the other line will indicate digital certification with effective date/expiration date.
NOTE: The FDA does not issue printed certification which indicates film or/and digital. Refer to the MQSA file for proof of types of mammography the facility is certified to perform.
If the MQSA file appears to be in error, contact your regional office mammography coordinator. The coordinators will contact the FDA to research the apparent error.