decisionhealth Newsletters, Coder Pink Sheets - 2010 Issue 6 (June)
Look out for deeper TC cuts on many contiguous MRI, CT and ultrasounds
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Article Overview
This article explains a Medicare payment update affecting the technical component of certain high-priced diagnostic imaging services when multiple scans are performed in the same session and belong to related imaging families. It is relevant to orthopedic, radiology, and other practices that bill MRI, CT, and ultrasound studies under the Medicare Physician Fee Schedule, and it references CMS guidance, imaging-family indicators, and a fee-schedule table of affected services.
Why This Topic Matters
Providers that perform multiple imaging studies in one session need to understand how Medicare’s technical-component payment changes may affect reimbursement and fee schedule review. The article helps readers identify which broad imaging categories and official Medicare resources are involved.
Article Sections
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Payment change overview
Introduces the Medicare update, the effective date, and the broad imaging categories involved. Summarizes the scope of the technical-component change and the role of contiguous imaging families.
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Example of the reduction in practice
Uses a spinal MRI scenario to illustrate how the policy affects multiple studies performed in one session. The example is limited to payment impact and family grouping context.
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How to identify affected imaging codes
Explains where the affected services appear in the Medicare Physician Fee Schedule Relative Value File and which column indicators are used to flag them. Also notes the imaging-family reference information available in the file.
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Key to Medicare’s diagnostic imaging family indicators
Lists the imaging-family indicator categories for CT, MRI, MRA, and ultrasound. This section serves as a reference for interpreting the family classifications used by Medicare.
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Shrinking tech components for ortho MRI, CT scans
Presents a table of common imaging services used by orthopedic practices and shows how the technical component is affected under the updated reduction schedule. The section focuses on reimbursement comparison data and family classifications.
What You Will Learn
- How the Medicare imaging payment update is organized and when it takes effect
- Which general imaging modalities and technical-component claims are involved
- How Medicare imaging-family indicators are presented in the fee schedule file
- What kinds of official CMS and fee schedule resources are referenced for review
- How the update is illustrated using common orthopedic imaging services
Who Should Read This
- Medical coders
- Radiology billers
- Orthopedic practice managers
- Revenue cycle staff
- Compliance staff
Codes Discussed
Modifiers Discussed
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