Diagnostic Imaging Tips

ACR Appropriateness Criteria® is evidence-based guidelines created to assist physicians in making the most appropriate imaging or treatment decision for a specific clinical condition. By employing these guidelines, providers can enhance the quality of care to their patients and contribute to the most efficacious use of radiology.

ACR Appropriateness Criteria is directly available to you at this link:  www.acr.org

Additional educational resources are available at:  radiologyinfo.org



 Members of the following organizations:

American College of Radiology                                                                                   www.acr.org                                 
American College of Osteopathic Radiology   www.aocr.org
American Osteopathic Association   www.osteopathic.org
American Society of Head and Neck Radiology  www.ashnr.org
American Roentgen Ray Society  www.arrs.org
Radiological Society of North American   www.rsna.org
Society of Interventional Radiology  www.sirweb.org
Society of Nuclear Medicine  www.snm.org
Society of Radiologists in Ultrasound  www.sru.org
Michigan State Medical Society  www.msms.org
Kent County Medical Society
Michigan Radiological Network

Medicare Guidelines

For your convenience we have provided Medicare's guidelines for various radiology procedures below as a quick reference to policies on medical necessity and frequency requirements.  Wisconsin Physicians Services (WPS) is the Medicare contractor for Michigan.  The links will allow you to view the policies, known as Local Coverage Determination (LCD).

Computerized Tomography (CT Scans)
http://wpsmedicare.com/part_b/policy/active/local/l28544_rad033.shtml (02/21/2011)  

Computed Coronary Tomography Angiography (CCTA)
http://wpsmedicare.com/part_b/policy/active/local/l30288_rad034.shtml (02/21/2011)

Bone Mass Measurements
http://wpsmedicare.com/part_b/policy/active/local/l31620_ms004.shtml  (03/21/2012)

Magnetic Resonance Imaging (MRI)
http://wpsmedicare.com/part_b/policy/active/local/l28723_rad024.shtml (03/01/2011)

Magnetic Resonance Angiography (MRA)
http://wpsmedicare.com/part_b/policy/active/local/l31355_rad023.shtml  (04/15/2011)

Vertebroplasty (Percutaneous) and Kyphoplasty
http://wpsmedicare.com/part_b/policy/active/local/l30516_rad032.shtml (02/21/2011)

Documentation Requirements:   Physician’s Services and diagnostic tests must be submitted with an ICD-9 code to support medical necessity and must be coded to the greatest level of accuracy and highest level of digit completeness. This means the precise ICD-9 code that fully explains the narrative description of the diagnosis contained in the medical record or test interpretation and report including the 4th or 5th digit sub classification for the diagnosis category.  

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