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Support accurate reimbursement amid ever-changing regulations

Keeping up with radiology reimbursement is tough. Amid the cycle of annual Medicare Physician Fee Schedule (MPFS) updates, regulatory changes and legislation, the future of reimbursement can feel uncertain.

As the landscape shifts again, radiology departments and imaging centers can benefit from a sharp focus on accurate documentation and coding to receive the reimbursement due to them.

The 2023 landscape

The Centers for Medicare & Medicaid Services (CMS) expect radiology reimbursement to dip in 2023.

Estimated impact of MPFS for CY 2023¹

  • Hand holding an x-ray

    Diagnostic radiology
    2% decrease

  • Brain

    Nuclear medicine
    2% decrease

  • Person undergoing an x-ray scan

    Interventional radiology
    3% decrease

  • Building

    Radiation oncology and therapy centers
    1% decrease

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With multiple factors affecting reimbursement — including the MPFS, conversion factor and other regulations — it can seem almost impossible to understand the holistic impact.
Even when government funding softens the blow, any reimbursement cuts can feel significant for teams that are already lean. The impact also adds up over time.

Coins coming out of a broken piggy bank

44% reduction in Medicare reimbursement for diagnostic radiology in the past decade  when adjusted for inflation, according to a recent study of the 50 most common imaging exams.²

Strengthen documentation and coding to support accurate reimbursement. With the power of artificial intelligence (AI), 3M™ M*Modal Fluency for Imaging can help improve accuracy, increase efficiency and close gaps in clinical documentation through:

  • Person using the voice-to-text feature on a mobile phone
    Speech recognition

    Help improve radiology reporting accuracy using embedded natural language understanding (NLU) technology

  • Hand holding a medical chart
    Computer-assisted physician documentation (CAPD)

    Address the top 10 most common radiology billing errors with real time CAPD coding

  • Templated document
    Templates

    Boost efficiency and simplify the user experience with customizable smart templates

Physician with a first-aid kit

Case highlight: Radiologists rely on 3M M*Modal reporting technology

Here’s one radiology group’s experience.

Tennessee-based outpatient facility Abercrombie Radiology made major improvements and avoided possible downcoding for three coding concepts using:

  • Person using the voice-to-text feature on a mobile phone
    speech recognition
  • A laptop with the EHR open and a speech bubble above it
    real time CAPD nudges
  • Template on a computer
    structured templates

With 3M Fluency for Imaging, radiologists were able to:

  • A crossed out edit symbol
    avoid addendums
  • A document with an ex over it and a down arrow next to it
    reduce administrative waste
  • A crossed out gear
    avoid inefficiencies

Implementing these changes allowed for greater documentation specificity in the 160,000+ reports that Abercrombie Radiology creates using 3M Fluency for Imaging each year.

A circular arrow going around a dollar sign

This helped Abercrombie Radiology achieve a projected annualized financial impact of
$165,000 in increased reimbursement.

  • Speech bubble with a heart in it

    “We are thrilled with our relationship with 3M. Combining speech recognition along with flexible templates has created some real efficiencies that help us improve quality and improve fixes down the line.”

    Shannon Hampson
    Chief executive officer
    Abercrombie Radiology


  • As with any case study, results, outcomes and/or financial improvements should not be interpreted as a guarantee or warranty of similar results. Individual results may vary depending on a facility’s circumstances.
     

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References

¹Coffta, S. (2022, November 15). The Medicare Final Rule Confirms Big Payment Reduction For 2023. Healthcare Administrative Partners Radiology Billing and Coding Blog. https://info.hapusa.com/blog-0/the-medicare-final-rule-confirms-big-payment-reduction-for-2023

²Schartz, E., Manganaro, M., & Schartz, D. (2022). Declining Medicare Reimbursement for Diagnostic Radiology: A 10-Year Analysis Across 50 Imaging Studies. Current Problems in Diagnostic Radiology. https://doi.org/10.1067/j.cpradiol.2022.01.007

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