Radiology Coding Alert

Medicare legislation raises conversion factor by 1.5 percent

CMS offered radiologists an early holiday gift this year: Despite earlier reports of a 4.5 percent conversion factor decrease, CMS announced a last-minute increase, raising the conversion factor by 1.5 percent for both 2004 and 2005. Thanks to the Medicare Prescription Drug and Improvement Act, approved by Congress on Nov. 25, the conversion factor, which was 36.7856 in 2003, will rise to about 37.3373 (CMS has not released the new rate's exact amount).
 
This is particularly good news for radiologists, because CMS did not increase relative value units (RVUs) for most radiology and radiation oncology procedures. In fact, Medicare decreased the RVUs for many services, and did not change the RVUs for most others.
 
"It is disheartening that the reimbursement for radiation oncology will decrease in 2004," says Deborah I. Churchill, RTT, president of Churchill Consulting Inc., a Killingworth, Conn., consulting firm that offers audits, seminars and electronic coding applications. "We have seen great technological strides in the past few years, such as 3-D and IMRT planning. The cost of these technologies is extremely high, and the staff expenditures have increased exponentially to meet the requirements of these technologies. It seems inappropriate that as the level and quality of care increases, the reimbursement decreases."
 
The chart can help you determine the work RVUs for some commonly billed radiology procedures.