REIMBURSEMENT REDUCTION 2017

Congress on Dec. 18, 2015 included changes affecting Medicare and the PATIENT Protection and Affordable Care Act. (ACA). Section 502 of the bill which begins on page 1950 line 14, includes elements designed to incentivize the transition from traditional X-ray imaging to digital radiography. Currently this is a 20% reduction starting in 2017.

Film continues to escalate in cost as do the costs of regulatory compliance for those providers using film. Reimbursement decreases probably aren’t going to stop with 20%. Costs certainly are not going to go down. You should consider how you can be filmless and completely Digital before these reductions are implemented.

Reimbursement Reduction begins January 2017 for Film and Film Processor users and 2018 for CR users. If you are considering switching to a filmless DR now, we have various solutions depending upon modalities.

DEFINITIONS (from Wikipedia):

CR (Computed Radiography): Analog with a digital format. The CR cassette is used much like a film cassette however it contains an imaging plate (IP) with a photostimulable storage phosphor layer (typically 0.1 to 0.3 mm thick). A plate reader typically opens the cassette, removes and reads the plate and renders the image. Finally, the plate is “erased” and returned to the cassette. The process is much faster than film but still has no validation of image quality until it has been processed.

DR (Direct Radiography): Digital system. In a DR system, various wired or wireless detectors such as a flat panel detector are used depending upon the modality and may be placed in a bucky or table top configuration. The image is typically rendered within seconds.

1. Indirect detectors contain a layer of scintillator material either Gadolinium Oxysulfide or Cesium Iodide , which converts the x-rays into light.  Directly behind the scintillator layer is an amorphous silicon-on glass detector array manufactured using a process very similar to that used to make LCD televisions and computer monitors. Like a TFT-LCD display, millions of roughly 0.2 mm pixels each containing a thin-film transistor form a grid patterned in amorphous silicon on the glass substrate. Unlike an LCD, but similar to a digital camera's image sensor chip, each pixel also contains a photodiode which generates an electrical signal in proportion to the light produced by the portion of scintillator layer in front of the pixel. The signals from the photodiodes are amplified and encoded by additional electronics positioned at the edges or behind the sensor array in order to produce an accurate and sensitive digital representation of the x-ray image.
2. Direct FPDs (Flat Plate Detector) - Amorphous selenium (a-Se) FPDs are known as “direct” detectors because X-ray photons are converted directly into charge.  The outer layer of the flat panel in this design is typically a high-voltage bias electrode. X-ray photons create electron-hole pairs in a-Se, and the transit of these electrons and holes depends on the potential of the bias voltage charge. The charge pattern is then read by a TFT array in the same way images produced by indirect detectors are read. 

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