The U.S. Centers for Medicare and Medicaid Services (CMS) has proposed a 54% cut to the technical compensation rate for the use of computer-aided detection (CAD) with digital and analog mammography, according to an analysis by the Stanford Washington Research Group in Washington, DC.
CMS has recommended an 8.8% reduction in 2007 to CPT codes 76082 and 76083, the technical component codes for diagnostic and screening mammography CAD, according to the Stanford Washington Research Group (Medical Technology Bulletin, June 21, 2006). The current reimbursement rate is $15.92, which would drop to $14.02 in 2007 before falling to $7.20 in 2010, a 54.77% decrease,.
According to CMS, the suggested revisions are based on the relative amount of physician work that is required to perform mammography CAD. But the proposal does not differentiate between the use of CAD software integrated with full-field digital mammography (FFDM) and the use of CAD software with film-screen mammography (FSM), which requires digitizing before processing and is a more labor-intensive, time-consuming process.
The recommended reduction is proposed in Five Year Review of Work Relative Value Units Under the Physician Fee Schedule and Proposed Changes to the Practice Expense Methodology (CMS-1512-PN) . The deadline for public comment about this 675-page document is 5:00 p.m. on August 21, 2006.
As of August 14, only a dozen U.S. physicians had submitted comments to the CMS Web site about the proposed changes. The American College of Radiology (ACR) has said it will submit its opinion prior to the August 21st deadline.
An additional 700+ page document , (CMS-1321-P), includes additions and modifications to recommended changes proposed in CMS-1512-PN, and is expected to be published in the Federal Register on August 22, 2006. A 90-day response window will also be provided for public comment.
Comments to CMS may be submitted online or by mailing an original statement and two copies to: CMS/Department of Health and Human Services, Attn: (CMS-1512-PN or CMS-1321-P), P.O. Box 8014, Baltimore, MD, 21244-8014. Overnight mail should be sent to 7500 Security Boulevard, Mail Stop C4-26-05.
The ACR reports that the number of FFDM systems registered in the past 10 months has increased by 32%, and since the results of the DMIST trial were announced last year, the total number of facilities with FFDM in the U.S. has gone up by 4%. However, not all these facilities are 100% digital and continue to use FSM as well.
By Cynthia Keen
AuntMinnie.com staff writer
August 15, 2006
Related Reading
CMS scales back contiguous body part cut, modifies outpatient cap, August 9, 2006
Take care when coding for digital mammography and CAD, July 13, 2006
Digital mammography: Can your facility afford to make the leap? May 11, 2006
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