CT Compliance. Date Created: February 17, 2016 Date Closed: March 9, 2016

Transcription

1 CT Compliance Date Created: February 17, 2016 Date Closed: March 9, 2016 Total Responses (# individual members): 426 Total Responses (# member facilities) : 420 Member Facility Response Rate: 24% Powered by

2 Q1: Facility Bed Size Answered: Number of Beds n/a > > > > Number of Facilities

3 Q2: How many CT scanners does your facility/system have? If you are part of a system and/or manage multiple facilities, please provide the total number of CT scanners across all. Answered: Number of Scanners Ten or more Five to Nine Two to Four 115 One Number of Facilities

4 Q3: Were you compliant on January 1, 2016 for the MITA Smart Dose CT standard? Answered: 425 Partially 28.2% (n=120) Yes 58.6% (n=249) No 13.2% (n=56)

5 [For those who answered Yes they were compliant.] How did you comply? (Check all that apply.) Answered: % 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% Replaced scanner(s) OEM vendor upgrade Third party vendor upgrade Do not use for Medicare outpatients Other (please specify)

6 [For those who answered Yes they were compliant.] Do you have your certification letter? Answered: 222 No 18.9% (n=42) Yes 81.1% (n=180)

7 [For those who answered Yes they were compliant.] When did you get it? Answered: % (n= % (n=24) 72.5% (n=158) Before January 1, After January 1, Haven't received it yet.

8 [For those who answered No they were not compliant.] If you're not compliant, who is applying the modifier for billing? (Check all that apply.) Answered: % 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% Finance Radiology Coders IT Not sure Other (please specify)

9 [For those who answered No they were not compliant.] What type of process must you use to accomplish this task? Answered: 52 Completely Automated. We are able to leverage existing systems to identify patients and procedures without human intervention. 24.5% 10.2% 16.3% 14.3% Partially Automated/Partially Manual completely within the Imaging Department. We are able to run reports off our system, but a staff member must review and make appropriate adjustments/modifications to ensure the modifier is appended. Partially Automated/Partially Manual between the Imaging Department and Finance (or other department). We are able to run reports off our system, but a staff member must review and make appropriate adjustments/modifications to ensure the modifier is appen Completely Manual within Imaging Department only. We have to manually track what procedures were performed on the non-compliant system and a staff member from the Imaging Department applies the modifier. 10.2% 24.5% Completely Manual utilizing staff in addition to Imaging Department. We have to manually track what procedures were performed on the non-compliant system and a staff member outside the department applies the modifier. Other (please specify)

10 [For those who answered No they were not compliant.] Will you be compliant by January 1, 2017? Answered: 48 No 33.3% (n=16) Yes 66.7% (n=32)

11 [For those who answered they were Partially Compliant. ] On scanners that were not compliant, how did you comply? (Check all that apply.) Answered: % 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% Replaced scanner(s) OEM vendor upgrade Third party vendor upgrade Do not use for Medicare outpatients Other (please specify)

12 [For those who answered they were Partially Compliant. ] On scanners that were not compliant, how did you comply? (Answer: Other) Answered: 56 - added modifiers - Take penalty reduction - use scanner & take medicare cut - planned OEM vendor upgrade - add CT modifier to non compliant exams - apply modifier - looking to replace but havent yet - vendor has not upgraded yet so we are taking the financial hit - billing code used to document non compliant scanner - Take 5% reduction - one machine is not yet compliant and only used for biopsies at this time - In the process of replacing 2 scanners, vendor is behind in completing all upgrades. - Waiting for Philips to release upgrade. - Use code for payment reduction - Waiting on vendor upgrade this month, having to put modifier on all medicare pts - we took the 5% reduction - sending accountng patient info on all medicare for 5%reduction in reimbursement - Taking the deduction, and working toward the upgrade - use CT modifier on Medicare patients - taking penalty until replaced mid The vendor was not able to meet the order promptly enough to satisfy the deadline; however, upon further investigation, it was found that compliance was not did not apply to IP scans. The scanner not in compliance was IP driven. - Our scanner meets three of the 4 requirements - Adding modifier to charge to identify - Not compliant: Incurring reimbursment reduction - attach modifier on all exams that are non-compliant - placing the modifier on all patients scanned on this scanner and taking the penalty - Taking the reduction in medicare reimbursement - 5% hit - We were in the process of adding a new CT scanner so that we would be compliant. We will only use the one that is not compliant if the new one is down. - Replacement of scanner to take place this year, meanwhile we use the billing modifier for medicare outpatients - Limit the use for medicare patients as much as possible - Replaced one out of two with the second one due to be replacedone mid coordinate w/ billing for the 5% reduction - Code those patients that must be done on non compliant CT - Accepted 5% reduction - Replacement in the queue for next fiscal year, choosing to not be XR29 compliant with one off-site scanner, extremely LOW volume. - Still waiting for vendor to release update so we can comply on one of our units - CT portion of PET/CT is not compliant. We are using it but will replace later this year. - did not upgrade - Trying to not use for Medicare pts; for those we do, have to add modifier. Have an upgrade scheduled, but on a waiting list. - use XR29 modifiers - Installed in 2015 xr-29 compliant - we only use that scanner for special procedures - Are not compliant and will be hit with reimbursement penatly - use of modifier - In the process of looking to replace, perform intervention procedures only on system - Hold billing using a log for noncompliant scanners, ensure accuracy of modifiers, then submit. On at least one scanner, do not do MC patients. - Not possible to comply - too old - We are taking the cut on the one scanner that is not compliant. - 5% penalty- 2 PET/CT and 1 CT ENT - will be replacing 4th quarter fy 16 - If has to be used, attaching modifier - ONLY USE AS BACK UP IF #1 CT IS DOWN - Notified Medicare procedure was done on a noncompliant scanner and took the 5% hit - Apply modifier that reduces by the 5%. - Took the 5% hit

13 [For those who answered they were Partially Compliant. ] Do you have your certification letter? Answered: 113 No 43.4% (n=49) Yes 56.6% (n=64)

14 [For those who answered they were Partially Compliant. ] When did you get it? Answered: % (n-44) 45.0% (n=49) Before January 1, After January 1, Haven't received it yet. 14.7% (n=16)

15 [For those who answered they were Partially Compliant. ] How many scanners are still not compliant? Answered: Number of Scanners Number of Facilities

16 [For those who answered they were Partially Compliant. ] Where you're not compliant, who is applying the modifier for billing? (Check all that apply.) Answered: % 35.0% 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% Finance Radiology Coders IT Not sure Other (please specify) Number of Facilities

17 [For those who answered they were Partially Compliant. ] Where you're not compliant, who is applying the modifier for billing? (Answer: Other) Answered: 20 - Programmed into system - inpatient scanner, doesn't apply - only use for IR procedures - we are not usiong scanner for diagnostic CT work - we built separate procedures for these patients with modifiers - na - I believe, know its being done but not sure who is doing it. - N/A - na - billing - Registration, Radiology then IT - We added it to our charge master since none of the imaging scanners are compliant. Inly the new CT simulator that was just installed is compliant and we are still waiting for the XR 29 letter. - billing dept - Business office - Not scanning Medicare patients on the non-compliant scanner - We only scan patients on our compliant scanner. The other is used only for PET/CT scans. - hardwired modifier to resource - No scheduled Medicare OP for those reduced payment scans - We have hard coded the modifier in EPIC by scanner. - patient accts

18 [For those who answered they were Partially Compliant. ] What type of process must you use to accomplish this task? Answered: 111 Completely Automated. We are able to leverage existing systems to identify patients and procedures without human intervention. 20.7% 16.2% 19.8% 16.2% Partially Automated/Partially Manual completely within the Imaging Department. We are able to run reports off our system, but a staff member must review and make appropriate adjustments/modifications to ensure the modifier is appended. Partially Automated/Partially Manual between the Imaging Department and Finance (or other department). We are able to run reports off our system, but a staff member must review and make appropriate adjustments/modifications to ensure the modifier is appen Completely Manual within Imaging Department only. We have to manually track what procedures were performed on the non-compliant system and a staff member from the Imaging Department applies the modifier. 9.9% Number of Facilities 17.1% Completely Manual utilizing staff in addition to Imaging Department. We have to manually track what procedures were performed on the non-compliant system and a staff member outside the department applies the modifier. Other (please specify)

19 [For those who answered they were Partially Compliant. ] Will you be fully compliant by January 1, 2017? Answered: 113 No 23.9% (n=27) Yes 76.1% (n=86)