03/23/2016    Lawrence Kosova, DPM

Medicare X-Ray Reimbursement Cuts on the Horizon (Raymond F Posa, MBA)

Mr. Posa's post is full of misinformation. The
truth is that a CR image is still considered
closest to film quality, (especially an auto-
load CR) and the expense of having a DR system
is truly significant. Many doctors who have
purchased a DR have gradually seen their image
quality decrease with continued x-ray
radiation, requiring regular expensive annual
recalibration and finding themselves in a
situation where they again need to upgrade or
replace within as early as 5 years.

This recalibration process is done via software
where it is determined which sensors or pixels
have gone bad and blanks out the damaged area,
rather than having holes or unreadable
information, masking and smoothing it over
resulting in missing information.

A DR system is also much more costly with
expensive installation charges requiring
modification to your existing x-ray by a state
certified technician, annual calibration (with
annual support fees of $1000 - $2,000 per
year), and as mentioned…gradual image
degradation clearly noticeable within 5 years.

The only real expense of a CR would be where
the phosphor imaging plates used with manual
load CR systems can be damaged with
mishandling, depending on how careful the
technician is...however an auto-load CR system
eliminates this problem. The processing time
for an auto-load CR is about 30 seconds to
obtain an image, and about another 30 seconds
for erasure, resulting in a total processing
time of about 1 minute.

The 7% payment reduction only involves Medicare
going into effect next year, with 6 years later
in 2023 proposed to 10%. However the estimated
loss in revenue will in no way cover the
additional expense for a small office to
convert to DR for the reasons mentioned above.

The only other reason I can think why the
government has included CR in reimbursement
reduction, (other than from outside special
interests) might be the disposal of used plates
containing Phosphor, but they can be recycled.

This is just another way the small office
practitioner is being hit with continuous
government reduction in income. Hopefully, when
the new regime takes office next year, and
pressure from medical organizations....smarter
minds will persevere.

Lawrence Kosova, DPM, Chicago, IL

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