Medical Community Braces for Algorithm to Reduce Unnecessary Imaging Orders

Eventually, algorithms will be broadly used to assess the appropriateness of diagnostic imaging orders by clinicians, but not by January 2020. That's the date CMS has mandated that such algorithms will be deployed as part ofPAMA (Protecting Access to Medicare Act). This topic was discussed in a recent article (see:Docs Brace for Medicare'Appropriate' Imaging Rule). It's long so link to it if you are vitally interested. Below is a short excerpt from it:As the medical community braces for implementation of theProtecting Access to Medicare Act (PAMA) by the Jan. 1, 2020 deadline, some wonder if it's even feasible or if another program delay is on the horizon.The policy, aimed at reducing unnecessary testing, mandates that all advanced diagnostic imaging orders go through an algorithm that provides key confirmation codes required when Medicare is billed later on for the service. Dubbed a"clinical decision support mechanism" (CDSM), this software processes each CT, MRI, nuclear medicine, and PET order before spitting out its verdict to the ordering professional:"appropriate,""maybe appropriate," or"rarely appropriate".... Eventually, Medicare will not pay claims or advanced imaging without these codes.The program has been delayed several times, and the 2020 deadline equates to a"soft launch," as improper imaging claims won't be rejected until the following year, with no firm deadline for addition...
Source: Lab Soft News - Category: Laboratory Medicine Authors: Tags: Cost of Healthcare Diagnostics Healthcare Information Technology Healthcare Innovations Medical Research Predictive Analytics Radiology Source Type: blogs