What's New
Updated Accreditation Tool Kit
Because of the tremendous growth in diagnostic imaging and the associated quality issues, both Medicare and private payers have developed programs that will reward and pay for quality initiatives. By the third quarter in 2008, UnitedHealthcare will require all freestanding facilities and physician offices performing outpatient imaging studies that bill on CMS 1500 claim form to obtain accreditation as a condition for reimbursement. Now in addition, by 2012 all entities billing Medicare Part B will need to be accredited in order to bill for imaging services.
Visit our updated Accreditation Tool Kit to learn more about the new Medicare requirements and experience how other imaging centers have mastered the ICANL and ACR accreditation processes. Find information and resources to get you started, and guide you through the process.
Accreditation Tool Kit
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PETNET announces opening of new radiopharmacy
PETNET Solutions announces the opening of its newest radiopharmacy in Pensacola, Florida. The pharmacy is scheduled to open August 1, 2008. This is the first PETNET pharmacy to be dedicated exclusively to the compounding of general nuclear medicine and SPECT radiopharmaceuticals and will serve the nuclear medicine needs of the Pensacola area.
The new PETNET pharmacy will prepare a number of radiopharmaceuticals, including Tc99m labeled radiopharmaceuticals (i.e. Tc99m methylene diphosphonate, Tc99m sulfur colloid, and Tc99m macroaggregated albumin, etc.), I-131 and I-123 Iodine for imaging and therapy, TI-201 Thallous Chloride, Gallium-67 Gallium Citrate, Indium-111(labeled White Blood Cells) and Sr-89 Strontium Chloride, as well as a number of other, less often employed radiopharmaceuticals.
The new PETNET pharmacy will operate under PETNET Solutions Regional Director, Michael Mosley. Dean Bryant, RPh will serve as the pharmacy manager. When asked to comment on the new facility, Mosley said, “We’re bringing our expertise from our cyclotron and chemistry operations and applying them to traditional nuclear pharmacy practice.”
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Dose Credit Request
PETNET Solutions is pleased to announce on-line Dose Credit Request as part of PETNET Direct’s expanding portfolio of tools and services. PETNET Direct provides one convenient location to order your doses and now request credits! Not yet ordering on-line? No problem, Dose Credit Request is available to all PETNET customers!
Reduce phone calls, emails and faxes to the pharmacy. Dose Credit Request is convenient, fast, secure and easy. Simply select the patient/dose from the available list, select the reason code and submit to PETNET. It is as simple as 1, 2, 3!
Additional features include:
· Optional Email confirmations at every stage of the process
· On-line access to the status of your request
· On-line custom reports in HTML and Microsoft Excel
· Personal support from the PETNET Customer Care Center. Our knowledgeable Customer Care Specialists are available Monday – Friday, 8 am – 7 pm ET at 1-877 4PETNET (1-877-473-8638) or mi-lifenet@petnetsolutions.com.
Dose Credit Request available August 1, 2008
Preview
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Reimbursement News
Congress Overrides President’s Veto
Congress voted to override the President's veto of H.R 6331, the Medicare Improvements for Patients and Providers Act of 2008, which freezes physician payment cuts for 18 months and includes new provisions for accreditation and an appropriateness criteria pilot.
In terms of accreditation, by 2012, all entities billing Medicare Part B (physician practices and independent diagnostic testing facilities (IDTFs)) need to be accredited in order to bill Medicare for imaging services. There will be an appropriateness criteria pilot that examines whether appropriateness criteria developed by physician specialty societies will have an impact on utilization of imaging. These two items position the industry well for the larger debate next year over healthcare reform. The bill prohibits preauthorization as a tool to determine appropriate imaging within the pilot program.
HR 6331
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New 2008 Medicare Physician Fee Schedule Payment Rates
With the enactment of the Medicare Improvements for Patients and Providers Act of 2008 on July 15, 2008, the mid-year 2008 Medicare Physician Fee Schedule (MPFS) rate of -10.6 percent has been replaced with a 0.5 percent update, retroactive to July 1, 2008.
Read more
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Proposed Rule for 2009 Medicare Physician Fee Schedule Released
On June 30, 2008, the Centers for Medicare and Medicaid Services (CMS) posted on its website the proposed rule for Medicare payment for Medicare payments in the physician fee schedule for calendar year (CY) 2009.
Read more about important proposed changes for CY 2009.
View the Proposed 2009 MPFS Rule on the CMS website.
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Proposed Rule for 2009 Hospital Outpatient Services Released
On July 3, 2008, the Centers for Medicare and Medicaid Services (CMS) posted on its website the proposed rule for Medicare payment for hospital outpatient services and ambulatory surgical centers for calendar year (CY) 2009.
[FULL STORY]
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Billing for Claims as Part of the NOPR
As the SNM reported in January, all NOPR claims should be billed with the Q0 modifier. Furthermore, do not place any additional information in Item 23 (CMS-1500) or its electronic equivalent when billing NOPR claims. Adding information to this field for NOPR services billed with the Q0 modifier may result in incorrect denial of claims. Additional information should be placed in item19 or its electronic equivalent. If you have claims denied for this reason the claims can be corrected and resubmitted.
Read more on the SNM web site
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