|
CT Colonography Breakthrough | PET Payment Unbound
July 11, 2024
|
|
|
|
|
Together with
|
|
|
|
“For the sake of our patients, I am delighted to see that CTC will finally take its rightful place as a preferred CRC screening option (in truth, the best option for most).”
|
|
Perry Pickhardt, MD, commenting on CMS’ proposal to begin covering CT colonography.
|
|
|
Imaging news doesn’t happen in a vacuum. That’s why we’re excited to announce the launch of The Imaging Wire’s new “Industry Wire” section, which provides a quick snapshot of the major healthcare stories that are happening outside of medical imaging. You can find the Industry Wire at the bottom of each newsletter issue going forward, so scroll on down and get caught up.
|
|
|
|
In a major news development this week, CMS proposed to begin Medicare coverage of CT colonography screening – also known as virtual colonoscopy – starting in 2025. The move will give radiology an entree into another of the major cancer screening tests.
CT colonography has been around for over 30 years as an imaging-based alternative to optical colonoscopy for colorectal cancer screening that produces a virtual fly-through of a patient’s colon that can detect pre-cancerous polyps.
- CTC has a number of advantages over traditional colonoscopy: patients don’t need to be sedated, and there is lower risk of complications such as bowel perforation.
But CTC has struggled to gain wider acceptance in the face of fierce resistance from gastroenterologists.
- Gastroenterologists typically prefer to steer their patients to optical colonoscopy for cancer screening rather than refer them out for imaging exams.
The USPSTF in 2016 added CT colonography to its list of recommended cancer screening exams.
- This led to a 50% jump in virtual colonoscopy exams performed for privately insured patients.
But as anyone who follows the US healthcare system knows, Medicare is the big enchilada when it comes to reimbursement, and the gastroenterology community has successfully fought off efforts to secure broader payment.
- This comes in spite of clinical studies showing CT colonography’s effectiveness, and even the widely reported case of President Barack Obama undergoing a CTC screening exam in 2010 as part of his annual physical because it didn’t require sedation.
But enough ancient history, on to this week’s news. In a proposed rule for the 2025 HOPPS issued on July 10, CMS proposed the following:
- Remove coverage for barium enema for colorectal cancer screening, as it “no longer meets modern clinical standards”
- Add coverage for CT colonography, creating Ambulatory Payment Classification (APC) 74261 for CTC without contrast and 74262 for CTC with contrast
- Reassign CPT code 74263 for CTC/VC from “not payable” to “payable” status
The Takeaway
This week’s news is a huge win for radiology and indicates that gastroenterology’s stranglehold on colorectal cancer screening is finally beginning to crack. Imaging facilities should begin preparing to offer CT colonography as a less invasive option to optical colonoscopy for Medicare beneficiaries.
|
|
|
Next-Generation Enterprise Imaging
US healthcare organizations are making a definitive pivot to cloud technology. In this white paper from AGFA HealthCare and HIMSS, learn about the benefits of cloud-based enterprise imaging. Download the white paper today.
|
|
AI-Empowered CT Workflow
CT systems from United Imaging are designed for high image quality and low dose, and their AI-empowered workflow enables fast and reproducible positioning, helping you image patients with confidence. Learn more on this page.
|
|
- PET Payment Unbound: In another big development in the 2025 HOPPS proposal, CMS proposed unbundling payments for specialized diagnostic radiopharmaceuticals, including PET. Long on the nuclear medicine community’s wish list, the change would undo reimbursement policy in which radiotracer payments are bundled with imaging exams, a policy that tends to depress reimbursement. The change would apply to radiotracers with a per-day cost higher than $630. CMS also proposed a $10 add-on payment for US-produced technetium-99m, commonly used for nuclear cardiology tests.
- AI Directs Supplemental Breast MRI: Another research study validates the use of the AISmartDensity score for directing breast MRI to women with suspicious lesions on mammography screening. In the ScreenTrustMRI study, Swedish researchers used their homegrown AI algorithm to select 559 women for breast MRI, finding a cancer detection rate of 64 cancers per 1k MRI exams, a CDR nearly 4X higher than the density-based method used in the DENSE trial. The study builds on findings in April in which AISmartDensity predicted short-term breast cancer risk. Check out radiologist Laura Heacock, MD’s analysis on LinkedIn.
- Thomas to Lead Lunit Screening Group: Fresh off its acquisition of Volpara Health Technologies, Lunit has tapped Volpara CEO Teri Thomas to lead its Cancer Screening Group. Thomas will spearhead sales and marketing activities for both Lunit and Volpara, with an emphasis on growing Lunit’s business in the US and EMEA region in 2024, and further geographic expansion in 2025. Thomas will remain CEO of Volpara.
- Chest X-Ray AI Estimates Lung Function: A homegrown AI algorithm that analyzed chest X-rays provided estimates of lung function correlating well with traditional spirometry measures like FVC and FEV1. In a paper in Lancet Digital Health, Japanese researchers used their AI model to analyze chest X-rays of 6.4k patients, finding that it had a Pearson’s correlation coefficient (r) with FVC and FEV1 of more than 0.90, indicating a high level of agreement and showing the AI technique could be used in place of spirometry.
- Predicting Patient No-Shows: Nothing disrupts an imaging facility’s operations more than patients who don’t show up for their appointments. A new study in Clinical Imaging sheds light on the factors leading to no-shows in a survey of 282 patients who missed appointments. UC Irvine researchers found that the highest no-show rates were in patients with either financial hardship (44%) or health-related social needs (33%), but only 13% said they were screened for these factors before their appointment. Better screening could identify at-risk patients who could be targeted for interventions.
- NIBIB Targeted by NIH Reform Proposal: The US National Institute of Biomedical Imaging and Bioengineering (NIBIB) would be eliminated under an NIH reform proposal in the US House of Representatives. The proposal would consolidate NIH institutes from 27 to 15, with NIBIB functions moved into a new National Institute on Innovation and Advanced Research that would include other centers. NIBIB was established in 2000 and has a fiscal 2024 budget of $441M; it’s not clear whether the proposal has enough bipartisan support to get passed in an election year.
- 4DMedical Signs Imaging Network: Respiratory imaging company 4DMedical will be providing its lung ventilation imaging technology to an imaging center operator in Australia. Jones Radiology runs 29 clinics in South Australia and signed the deal after piloting 4DMedical’s CT LVAS solution at three sites. The new contract will mostly involve referrals to CT LVAS, which creates lung ventilation studies from existing CT scans, but Jones Radiology sites will also have access to the company’s XV LVAS fluoroscopy solution.
- AIRS Medical Raises $20M: South Korean AI developer AIRS Medical has raised $20M in a Series C funding from institutional investors that the company will use to expand international distribution of its SwiftMR software. SwiftMR reduces MRI scan speeds as much as 50% and can increase patient throughput up to 38%. AIRS launched the application in South Korea in 2021 and entered the US and European markets in 2023.
- CT Lung Screening’s Early Adopters: A new study in Preventive Medicine Reports found variations among those most likely to get CT lung cancer screening within 24 months after being found eligible. Among 2.4k people screened from 2015 to 2022 at Thomas Jefferson University in Philadelphia, higher adjusted odds ratios for early completion were found among African Americans and people who currently smoke (aOR=1.428 and 1.514, respectively). The findings could indicate that the 2021 expansion of eligibility criteria is working to reduce disparities in screening access.
- Bracco Makes Changes to Barium Portfolio: Contrast agent company Bracco Diagnostics is tweaking its portfolio of barium contrast agents for abdominal imaging. The company said it is discontinuing three non-FDA-approved barium agents due to “a significant decline in product usage.” Simultaneously, the company announced several upcoming offerings, including the CitraClear filling beverage, mini-packaging for its Varibar barium sulfate product, and a new flavor in its CT barium line to be launched in 2025.
- Blue Earth Taps GE Vet as CEO: In other Bracco news, the company tapped a new CEO to lead its Blue Earth Diagnostics radiopharmaceutical business. Marco Campione is replacing David Gauden, PhD, who is moving over to become full-time CEO of Bracco subsidiary Blue Earth Therapeutics. Campione most recently served in senior executive roles in GE HealthCare’s contrast media business. Blue Earth develops and markets agents like its Posluma PET PSMA tracer for prostate imaging, which began shipping in 2023 after gaining FDA approval.
|
|
Image Sharing to Improve Patient Outcomes
In this case study, learn how AdventHealth improved treatment planning and delivery because of Nuance PowerShare’s immediate connection to other sites in the network for medical image sharing.
|
|
Imaging in the Cloud
The healthcare imaging market in the US is moving to the cloud. In this new report from KLAS Research, find out why companies like Merge by Merative are instilling confidence in customers thanks to their cloud approach.
|
|
AI’s Rapidly Growing Role in Medical Imaging
AI holds immense potential to drive productivity and efficiency gains for organizations, including healthcare. In this downloadable white paper from TeraRecon, learn about AI’s rapidly growing role in medical imaging.
|
|
- Women’s Health and AI: With new breast density reporting requirements coming in the US, there’s a need for objective density assessment and reporting. Check out this article from Blackford Analysis on the AI solutions that can help.
- Building a Brand in Radiology: Check out the next episode of Medality’s Radiology Report Podcast featuring Toronto Radiology’s Anish Kirpalani, MD, who talks to host Daniel Arnold about challenges and strategies in radiology, such as the importance of building a strong brand and proactive recruitment.
- Enhancing Patient Experience and Streamlining Operations: Jefferson County Health Center transformed their image exchange by eliminating the need for CDs, saving over 1,000 staff hours annually. This shift improved radiology patient satisfaction scores by 7.6%. Learn how JCHC enhanced patient care and operational efficiency with PocketHealth.
- Faster MRI Scans with No Compromise: What if you could speed up your MRI scans with no compromise on image quality? In this video, hear from SpinTech MRI how their STAGE software is making this vision a reality.
- Drivers of AI Usage in Radiology: Radiologists are being asked to read more, read faster, and with a higher degree of accuracy as imaging data grows in volume and complexity. In this video, listen to Bernardo Bizzo, MD, and Riverain CEO Steve Worrell explain how this is driving AI usage.
- An Update from Intelerad: Since joining Intelerad as CEO in 2023, Jordan Bazinsky has set the company on a course to address some of the major challenges facing radiology and healthcare today. Hear his thoughts in this episode of The Imaging Wire Show.
- Automated Weight-Bearing Foot Measurements: Learn how Gleamer’s BoneMetrics AI software was able to provide automated measurements on weight-bearing radiographs with high levels of accuracy in a paper published in Skeletal Radiology.
- Get to Know DeepHealth: DeepHealth offers a portfolio of AI solutions for clinical applications ranging from lung to prostate to brain indications. Learn more about DeepHealth and its AI-driven breakthroughs in care delivery.
- Re-Examining Radiology: A Look to the Future: What will the future of radiology look like? In this downloadable white paper from Optum, learn how a constellation of challenges and pressures have come together to change healthcare – and radiology.
- Imaging Workflows that Actually Work: Not a fan of medical image exchange on discs? Then check out Clearpath and find out how it’s removing obstacles to better radiology workflow. Request a demo today.
- Presenting Unboxing AI: Check out CARPL’s video series, Unboxing AI, featuring experts discussing AI and its future in radiology. The next episode on July 12 features Leonardo Bittencourt, MD, of University Hospitals – reserve your seat today.
- True TOF Technology Sets the Standard in PET/CT: True time-of-flight (TOF) PET/CT based on lutetium oxyorthosilicate (LSO) detectors offers numerous clinical advantages, such as better definition of small lesions and improved uniformity. Learn the other advantages in this article from Siemens Healthineers.
- AI-Automated Heart Failure Detection from EHRs: New research shows the feasibility of using Us2.ai’s echo AI solutions to automatically identify patients with heart failure from archived echo images in the EHR. Learn how it works in this study in European Journal of Heart Failure.
- Top 5 Benefits of Standardizing Medical Imaging Archives: Efficient data management is crucial for delivering quality patient care and achieving organizational goals. But data migration when transitioning to a new PACS can be daunting. Find out how solutions from Enlitic can streamline the process.
|
|
|
|
|
