ACR, ASNR Urged CMS to Accept Physicians Advice on New and Revised CPT Codes

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In August, the American College of Radiology (ACR) and the American Society of Neuroradiology (ASNR) met with CMS officials to “reiterate and provide additional information” as to why they should accept the advice of the physician experts on Relative Value Scale Update Committee (RUC) when updating Current Procedural Terminology (CPT) codes that relate to radiology, stated the ACR yesterday.

The RUC is organized by the American Medical Association and committee members are nominated from various specialty organizations, including the ACR. However, while the ACR gathers cost data that are then supplied to the RUC to help in its decision making, Geraldine B. McGinty, MD, chair of the ACR’s Commission on Economics and the college’s member of the RUC abstains from voting on recommendations that could affect radiology to ensure there is no possibility of bias. It is a practice all committee members follow, she told ImagingBiz in July.

“As a member of the RUC, I act as an expert and not an advocate for my specialty,” McGinty said. “That is the first thing they drum into you.”

To help the RUC in advising CMS on codes for the 2014 Medicare Physician Fee Schedule (MPFS) Final Rule (scheduled to be released in November), the ACR surveyed and presented more than 50 CPT codes to the RUC, the College stated.

The CPT codes covered 15 different code families and although CMS is under no obligation to follow the advice of the RUC, not doing so may mean that data from real radiologists on work relative value units (RVUs) and practice expenses is ignored.

The ACR is making an effort to be “more proactive in our communications with CMS” at a time when there is strong political pressure to reduce government spending in all areas, including health care. In addition, CMS developed the 2014 MPFS at a time when the objectivity of the RUC is being questioned by both the media and at least one legislator.

One high-level media example of this was the Washington Post article “How a Secretive Panel uses Data that Distort Doctors’ Pay” — which was even endorsed by Brian Klepper and Paul Fischer of Health Affairs. In addition, in July, Rep. Jim McDermott (D-Wash.), a ranking member of the House Ways and Means Subcommittee on Health, introduced H.R.2545, which seeks to create an alternative advisory committee to the RUC and reduce its influence.

A list of the 15 code families for which new and revised CPT codes were presented is posted in the news section of the ACR’s website.