Medicare Administrative Contractors exploring coverage of cerebral perfusion analysis using CT

Three of the seven Medicare Administrative Contractors are exploring local coverage of cerebral perfusion analysis using CT imaging, the American College of Radiology advised its members Tuesday.

MACs are currently seeking comment from radiologists and other subject matter experts on the “local coverage determination,” as it’s called. ACR noted that the payment change would mean that clinicians could receive Medicare payment for CT imaging guidance to aid in the removal of a blood clot under certain conditions.

“The American College of Radiology Contractor Advisory Committee (CAC) representatives will track this topic and submit written comments to the appropriate contractor. If your local MAC does not have [a local coverage determination] on this topic and deems this as a noncovered service, a request should be sent to reverse this decision,” ACR advised in its July 14 news post. “CAC representatives are vital to influence decisions related to reimbursement at the local level, but this cannot be done without the engagement of subject matter experts in neuroradiology.”

ACR said this would be the first proposed local coverage determination for this code category. Along with CT perfusion with contrast, it would also cover post-processing of parametric maps with determination of brain blood flow and volume, and mean transit time. The college expects MACs to allow 45 days for the radiology field to provide testimony through open meetings and the public comment period.

“…There is an opportunity to make your voice heard,” ACR wrote.

Read more about the coverage determination and how to comment in the ACR post below.

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

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