- Displaying items by tag: radiology practice management
ImagineSoftware, a leading provider of healthcare billing software, today announced that cloud-based medical and professional billing software solutions provider, CPU Medical Management Systems (CPUMMS) joins the Imagine team. The combined company will be the market leader with the single largest footprint of radiology billing software, with an expanded presence across multiple healthcare specialties
If you're wondering what the world will look like with the full implementation of ICD-10, it might be something like the following:
Yours truly was in a car accident. Fortunately, it was not fatal, but it did leave me with some injuries. My physician sends me to my favorite radiology group imaging center for an MRI. I am well cared for and the mandatory social media customer satisfaction survey process allowed me to confirm so. When billing for my services, the practice is denied because sufficient information is not provided by my referring physician to the radiology group and I, as the patient, did not know the importance. Specifically, the radiology group was not informed that I was a passenger (versus the driver) and the vehicle had three wheels (verses four).
This is a fictitious, future example for what could be in store for us.
This month, the 1500 was revised to accommodate the new ICD-10. Field 21 will allow the practice to communicate if it is using ICD-9 or ICD-10 diagnosis coding. Additionally, the allowed number of diagnosis will grow from the current four (4) to twelve (12). A screenshot is provided below:
Also, there are changes to identify the role of the provider reported in Item Number 17 (Referring = DN, Ordering = DK, or Supervising Provider = DQ (in that order)).
When filling in this field it is recommended that you do not use periods or commas. The field allows for 26 characters. A hyphen can be used for hyphenated names. See the screenshot below:
I am pleased to let you know that not only is IMAGINE aware of this change, but is in the process of updating software to accommodate this expansion and help make the transition to ICD-10 an easier and more managable reality for all IMAGINE clients.
Healthcare reform ups the ante in terms of expectations, attempting to measure (and pay) in a world of quality, where patients are “cured” the first time around and the effectiveness of their physicians determined by whether they accomplish that goal. Value-based compensation models, while still functionally vague, are the intended mandate and represent a quantum change from current fee-for-service models.
The “new” model of healthcare comes on the heels of recent reimbursement cuts, the implementation of “5010” (the new format for standard electronic Health Insurance Portability and Accountability Act transactions), the threat of penalty for failure to submit quality data codes compliant with Physician Quality Reporting System (PQRS) measures to the Centers for Medicare and Medicaid (CMS), confusion regarding changing Meaningful Use requirements, an often hostile environment of Recovery Audit Contractor (RAC) audits and even more confusion over how to function with future payment systems. In our new world, the quality of healthcare will improve based on objective measurement and the “value” of the patient experience, all at lower cost for those paying the bill.
Better healthcare for less cost? The demand for more service, higher standards of accountability (while at the same time simplifying administration), and increased levels of compliance reporting usually go hand in hand with higher costs. Practices are rapidly facing the need to upgrade technology and personnel skills, with perhaps a greater reliance on support from consultants and professional organizations to help them navigate the waters.
This type of contradictory, disruptive messaging tips the balance of certainty and stability, puts us on high alert, and allows for fear, uncertainty, and doubt to set in. Some of the credible surveys conducted in 2011/2012 show physician morale at an all-time low, with many providers considering the safety of employment over practice ownership and others even considering a change in career.While this should come as no surprise given an increasingly hostile business environment, it would be unfortunate and further add to the predicted physician shortage in the future. In fact, solutions to this crisis are actually within reach.
Radiology is usually viewed as a “behind the scenes” specialty, where contribution to the patient’s circle of care is consultative and supports those physicians with direct patient contact. While radiologists could in theory support the concept of “value” in medicine, they in fact have little control over how their interpretations are used to drive improved outcomes. At the same time, as quality becomes the watchword, insurance companies in some parts of the country are attempting to steer patients to lower cost providers without consideration of quality. How does radiology move then from the perception of being a “passive” specialty in regard to patients, potentially treated as a low-cost commodity and therefore, able to maintain some level of control over its destiny?
Alan C.Kay stated, “The best way to predict the future is to create it.” What can this look like for radiology?
This week, the U.S. Preventive Services Task Force published an improved rating for Ankle–Brachial Index (ABI) screening for in adults at risk for Peripheral Arterial Disease (PAD). Their September 3, 2013 "I statement" recommendation for ABI Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment With the Ankle–Brachial Index in Adults has improved since their last "D Recommendation" Statement in 2005. This is good news for those radiology practices with active Interventional Radiology (IR sections). It reinforces the need for more clinical research in this area.
This improved recommendation helps support The American College of Cardiology Foundation and the American Heart Association released joint practice guidelines recommending the use of resting ABI for detecting PAD in patients at increased risk.
According to the Society of Interventional Radiology (SIR):
"Peripheral arterial disease (PAD), also known as peripheral vascular disease (PVD), is a very common condition affecting 20 percent of Americans age 65 and older. PAD develops most commonly as a result of atherosclerosis, or hardening of the arteries, which occurs when cholesterol and scar tissue build up, forming a substance called plaque inside the arteries. This is a very serious condition. The clogged arteries cause decreased blood flow to the legs, which can result in pain when walking, and eventually gangrene and amputation.
Because atherosclerosis is a systemic disease (that is, affects the body as a whole), individuals with PAD are likely to have blocked arteries in other areas of the body. Thus, those with PAD are at increased risk for heart disease, aortic aneurysms and stroke. PAD is also a marker for diabetes, hypertension and other conditions.
PAD may also be caused by blood clots."
Those who are at highest risk for PAD are: