Radiology Coding Alert

Plus: Radiology RVUs could see 10 percent drop.

Another season of nail-biting is under way, waiting to find out whether your Medicare payments will be slashed. As most practices know, last June Congress voted not only to stave off a 21 percent cut to your Medicare pay, but also to increase your revenue by 2.2 percent. However, that vote only kept the cuts at bay through November 30. Effective December 1, your Medicare pay was set to drop by over 23 percent, unless Congress intervened to reverse the cuts.

As of publication time, the Senate and House had passed a measure to delay Medicare's 23 percent cut to the fee schedule conversion factor due to take effect Dec. 1. The delay pushes the cut until Dec. 31. The President was expected to sign the bill into law.

Still looming is a possible cut to 2011 payments starting January 1. There are rumblings that another one-year patch to keep rates up is under consideration by Congress. Some newly-elected Senators and House members will be in place in 2011, and it's unclear whether the current Congress will make changes affecting 2011 pay before January, or whether they'll leave the issues for the new Congress to handle, says Michael A. Ferragamo, MD, FACS, clinical assistant professor at the State University of New York at Stony Brook.

If those fixes don't pass, here's what's in store: "The calendar year 2011 Physician Fee Schedule conversion factor is $25.5217," notes the 2011 Medicare Physician fee schedule Final Rule (with comment period), printed in the Federal Register published on Nov. 29. This amounts to a dismal 30 percent cut compared to the current rate of $36.8729.

All of this leaves Part B practices in the dark about the future of payments yet again. "While Congress has provided temporary relief from these reductions every year since 2003, a long-term solution is critical," the Fee Schedule notes. "We are committed to permanently reforming the Medicare payment formula."

Radiology Hit Hard by RVU Cuts, Too

In addition to dealing with conversion factor fluctuations, radiology will be among the hardest hit by additional cuts to relative value units (RVUs) and other factors influencing payment. These cuts will have a significant impact on specialty practices that are already financially stretched:

• Diagnostic testing facility: 15 percent cut
• Radiology: 10 percent cut
• Interventional radiology: 5 percent cut
• Nuclear medicine: 4 percent cut
• Radiation oncology: 1 percent cut.

Resource: You can search the Federal Register here: www.gpoaccess.gov/fr/.

"The rule is written under current law, which means that it takesinto account the schedule of negative updates to the SGR," said CMS's Amy Bassano during a Nov. 16 CMS Open Door Forum. "If the law were to change, we would put out revised files and rates to reflect any changes in the law," she noted.