Experts blast JAMA chest pain paper; more code bundling? And, MBI and dense tissue

Dear AuntMinnie Member,

Should low-risk individuals presenting to the emergency department with chest pain be sent home without imaging? That's the conclusion of a new study in the Journal of the American Medical Association that is critical of the role that imaging plays in triaging low-risk patients.

After analyzing insurance claims of more than 400,000 people with chest pain, researchers from Pennsylvania concluded that low-risk individuals who didn't get any imaging had no more heart attacks than those who did get scanned as part of their evaluation. The authors concluded that imaging probably isn't helpful and might be harmful in the workup of low-risk people.

But radiologists are pointing out what they believe are serious flaws in the JAMA paper. For example, the patients who received imaging were older and sicker than those who were sent home without it. Imaging experts were also aghast at the authors' decision to exclude key populations of patients -- including anyone who was determined to have had a heart attack when they presented to the emergency department.

Read more by clicking here, or visit our CT Community at ct.auntminnie.com.

More coding bundling?

Having two previously separate medical procedures subjected to "code bundling" is kind of like having your birthday present and your Christmas present rolled into one: Somehow the single gift just isn't quite as good as two separate ones would have been.

That's why radiology administrators can be forgiven for looking warily at the American Medical Association's latest announcement that it's planning to bundle certain CPT codes for imaging guidance into surgical codes.

The change will also include radiological supervision and interpretation (S&I), according to a new column by Jeff Majchrzak of Panacea Healthcare Solutions. Find out how the new code bundling might affect your practice by clicking here, or visit our Imaging Leaders Community at leaders.auntminnie.com.

MBI and dense tissue

Finally, visit our Women's Imaging Community for a new article on how adding molecular breast imaging (MBI) to mammography can improve the accuracy of screening in women with dense breast tissue, traditionally a difficult area for conventional mammography. Researchers from the Mayo Clinic in Rochester, MN, developed a low-dose protocol designed to sharply reduce radiation from MBI studies and found that it worked well. Learn more by clicking here, or visit the community at women.auntminnie.com.