The American College of Radiology said it has lost a dispute with the Centers for Medicare & Medicaid Services over restrictions around payment for certain ultrasound exams, Radiology Business reports.
ACR filed the appeal in October, hoping to overturn a determination that providers would only receive payment for one duplex scan of extremity veins per beneficiary in a single visit. CMS would likely deem any such imaging beyond that amount “medically unlikely” and deny the claim, the college said in a March 24 update.
“Our CPT Advisors (physician volunteers representing multiple radiology societies) believe there are many clinical scenarios where it would be reasonable to perform a bilateral upper extremity deep vein thrombosis exam on the same day as a bilateral lower extremity DVT exam, or a unilateral DVT exam of an arm on the same day as a unilateral DVT exam of a leg,” ACR said.
However, CMS denied the initial appeal and stuck with the decision after a recent face-to-face meeting, the college reported. Read more.
