Radiology & MIPS Reporting: Everything You Need to Know

Which quality measures will specifically help radiologists secure the most amount of points and avoid penalties?

Am I a non patient-facing clinician? What does that mean for my reporting requirements?

Should I report at the organization TIN or individual NPI level?

These are questions we hear often from radiology groups as they scramble to put together a plan for the 2017 Merit-based Incentive Payment System (MIPS) reporting year and prepare for 2018. But fear not! We are going to cover all of these questions here to ensure your radiology practice is set up for success.

As a primer, know that in 2017 you may be subject to report on three categories of MIPS: Quality, Advancing Care Information (ACI), and Improvement Activities. In 2018, a fourth category will be added: cost. Each category makes up the following percentages toward your overall total composite score, the final score that will affect your Medicare Part B reimbursements in future years.

What if I am a non-patient facing clinician?

If you provide a minimal amount of patient-facing services, you may be designated as a non-patient facing clinicians and may not have to report on Advancing Care Information. The Advancing Care Information category is primarily used to demonstrate your meaningful use of a Certified EHR Technology (CEHRT), making up 25% of your total composite score. If you are offering a patient-facing service, you will be subject to the requirements of this category. A non-patient facing MIPS-eligible clinician is clinician who bills 100 or fewer patient facing encounters annually. A non-patient facing MIPS-eligible group is a group in which at least 75% of eligible providers are designated as non-patient facing clinicians. If you are non-patient facing, you are not subject to report on the ACI category requirements and instead the 25% from your ACI category will be reweighted to the Quality category

Which measures should my radiology practice choose?

There are 243 quality measures available to providers to select and report to CMS for MIPS. How will you decide the best measure set for your organization? Below are the most commonly selected quality measures amongst the radiology providers using Able Health for MIPS reporting:

QDC MIPS Measure # Description
G9340 362 MIPS 362 Optimizing Patient Exposure to Ionizing Radiation: Computed Tomography (CT) Images Available for Patient Follow-up and Comparison Purposes
G9318 359 MIPS Quality 359: Optimizing Patient Exposure to Ionizing Radiation: Utilization of a Standardized Nomenclature for Computed Tomography (CT) Imaging Description
G9500 145 MIPS Quality 145: Radiology: Exposure Dose or Time Reported for Procedures Using Fluoroscopy
3340F, 3341F, 3342F, 3344F, 3345F, 3350F 146 MIPS 146 Radiology: Inappropriate Use of “Probably Benign” Assessment Category in Screening Mammograms
7025F 225 MIPS 225 Radiology: Reminder System for Screening Mammograms
G9556 406 MIPS 406 Appropriate Follow-up Imaging for Incidental Thyroid Nodules in Patients
G9550 405 MIPS 405 Appropriate Follow-up Imaging for Incidental Abdominal Lesions
3100F 195 MIPS 195 Radiology: Stenosis Measurement in Carotid Imaging Reports
G9321 360 MIPS 360 Optimizing Patient Exposure to Ionizing Radiation: Count of Potential High Dose Radiation Imaging Studies: Computed Tomography (CT) and Cardiac Nuclear Medicine Studies
7025F 225 MIPS 225 Radiology: Reminder System for Screening Mammograms
G8783, G8950 317 MIPS 317 Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

Should we report at the Group Level (TIN) or at the Individual Provider Level (NPI)? And when must I decide?

Good news, unlike for PQRS, under MIPS you do not need to let CMS know ahead of submission whether you are reporting as an individual or a group (unless you are reporting via the CMS Web Interface or participating in CAHPS for MIPS). In the Able Health platform, you can track both individual and group performance all year long, and decide at submission time which route you want to go.

So, what next?

Submission time for 2017 is around the corner, and the Quality Payment Program is ramping up in 2018. The Quality category must be reported for 12 month in 2018 in order to achieve full performance. Whether you want to get set up for 2017 submission quickly, or get ahead of the game for 2018, Able Health can help. Schedule a demo here, or sign up for our newsletter to stay up to date on the QPP.

 

About Able Health: We give provider groups the tools they need to track and report quality metrics across multiple quality programs, helping healthcare professionals focus less on reporting and more on providing good healthcare. Our QCDR and Qualified Registry supports all 243 MIPS registry measures, plus many other measures such as HEDIS, ACO, custom measures and more. Our simple, easy-to-use MIPS dashboard allows practices to view, improve, and submit their quality measures performance results to CMS in real-time.


Further reading:
The 2018 QPP Final Rule Has Arrived
Help! I can’t find six relevant MIPS measures for my specialty

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