Important Compliance Information

Document that 3-D imaging was done:

When we bill for a CTA or MRA, we must document that 3-D images were created. Our macros must have a phrase such as:

"3-D Maximum Intensity Pixel (MIP) images were created and reviewed."

Document Administration of IV contrast:

We must also document the amount and type of contrast given, e.g.:

"100 ml of Isovue 300 was given IV." rate information may be useful, but is not required for billing purposes.

CTA and MRA reports must comply with MIPS/MACRA

All studies of the carotid (CTA, MRA, US) must describe the degree of stenosis using the distal carotid as a reference (as per the NASCET trial)

Studies must refer to the diameter of the distal (cervical) ICAs

e.g. if there is 76% stenosis of the right ICA:

Severe stenosis of the right ICA.

Note:

Internal carotid artery stenosis reported are based on the distal internal carotid artery as a reference as used in the 1998 NASCET study.

Mild stenosis <50 %

Moderate stenosis 50-69 %

Severe stenosis 70-99 %

please go to :

https://sites.google.com/site/neuroradiologyprimer/neuroradiology/head-and-neck/g-vascular/iv-oral-cavity-pharynx-supra--and-infrahyoid-neck/carotid-stenosis

to review the reason for this measure