The ACR has commented extensively on the new Hospital
Outpatient Prospective Payment System (HOPPS) and its
relative weights known as Ambulatory Payment
Classifications (APCs) effective August 1, 2000. The ACR
will continue to monitor the groupings of radiology
procedures into APCs and the values assigned for the
technical component of outpatient procedures.
In addition, the ACR commented extensively on the new
"units of service" edits implemented by HCFA on July 1,
2000. These edits limit the frequency by which any
radiology or radiation oncology procedure may be coded
for a patient in one day even with the use of a
The ACR Practice Expense Committee was formed with
representatives from each of the subspecialty economic
committees. This committee will formalize a mechanism
for making recommendations through collection and
evaluation of expense data and the comparison of that
data to the existing Clinical Practice Expert Panel (CPEP)
The ACR met with HCFA personnel to request their
assistance in clarifying the "ordering of diagnostic
tests rule" (HCFA regulation 410.23) and the "ICD-9
coding guidelines". HCFA has agreed to formalize, in
writing, the intent and interpretation of the regulation
to eliminate any ambiguity.
The CPT Editorial Panel accepted the addition of 26 new
and the revision of 58 existing CPT codes as proposed by
the ACR at its February 2000 meeting in Chicago.
As part of the CPT V Project, the ACR CPT Advisor and
the Coding & Nomenclature Committee have reviewed and
made recommendations for editorial revision to CPT to
further standardize and enhance the CPT descriptors.
In addition to the standard RUC (Relative Value Update
Committee) cycle, the ACR is working on the second
congressionally mandated "Five Year Review" of all CPT
codes. This review is limited to reassessment of the
physician work value component.
The ACR's CAC (Carrier Advisory Committee) Network is
made up of approximately 200 radiology and radiation
oncology volunteers who spend countless hours attending
Medicare Carrier Advisory Committee meetings, drafting
and commenting on radiology and radiation oncology
policies. These policies, known as local medical review
policies (LMRP), affect radiologists' and radiation
oncologists' reimbursement for procedures at the state
level. The unique relationships that the ACR CAC
representatives have with their Carrier Medical
Directors (CMDs) have been successful in negotiating
fair reimbursement policy at the local level as well as
acceptance of ACR accreditation programs in many of
ACR staff has confirmed all 50 liaison nominations to
the Managed Care Network. The Network will determine
needs to effectively deal with Managed Care
Organizations (MCO) utilizing the newly created on-line
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V. Resident Support
To further support the transition of residents into
practice the ACR and APDR began the development of a
7-part video series. The videos focus on non-clinical
skills development and practice issues. The first six
videos have been sent to all program directors and ACR
The annual ACR In-Training Examinations (Diagnostic and
Radiation Oncology) are intended to improve insight into
the overall effectiveness of the resident in-training
program, both to the participating resident and the
program director. The Diagnostic examination is held in
February and the Radiation Oncology examination is in
March. Starting January 1, 2000, the College drastically
reduced its member fees for members transitioning from
training to practice.
The ACR Education Department, under the direction of the
Commission on Education, awards CME credits through a
broad array of educational symposia and products
(available in print, video, and CD-ROM formats).
Included among these are the National Conference on
Breast Cancer, the recently developed Cardiovascular
Imaging Conferences, and the ACR Mammography Symposium.
Also offered are self-evaluation programs such as the
Mammography Interpretive Skill Assessment Examination
and the Continual Professional Improvement (CPI)
subscription series. A new feature launched in the July
1999 issue of the ACR Bulletin is the "Knowledge
Challenge", aimed at enhancing knowledge and skill areas
concerning complex cases in radiology. The Education
Department also grants CME credit for jointly sponsored
and co-sponsored radiology educational activities with
other academic institutions.
The ACR initiated ACRIN, the American College of
Radiology Imaging Network, the first standing
collaborative clinical trials group in diagnostic
radiology. ACRIN will permit more rapid and extensive
conduct of high quality, multi-center clinical trials
than has previously been possible. Nine protocols are in
various stages of development.
TASAP, a program to enhance clinical research by
providing to individual investigators without charge
assistance they require in statistical analysis, data
management, and study design for important research
studies, was initiated.
As part of the ACR's mission of providing information
important to the profession, in the last year the
research staff published 10 major papers in leading
diagnostic radiology and radiation oncology journals.
A study of radiologists' workload measured in RVUs was
completed and published in Radiology.
Its data answers the question the ACR research
department is most frequently asked, "What is the
workload of a radiologist?" A study of practice costs in
diagnostic radiology practices will appear shortly in
Radiology; a similar study of radiation oncology
practices has been completed and submitted to for
In response to growing legislative activity related to
self-referral, the ACR stepped up research activity in
this field. The past year saw ACR involvement in
multiple self-referral research studies. Three were
published in AJR or Radiology and several others are
scheduled for presentation at RSNA in 2000.
The ACR conducted a large-scale survey of radiology
practices in 1999 designed to address issues of
importance to the profession. Data analysis and
publications of results are underway.
The ACR completed a study of the use throughout the
American health care system of quantitative standards
for procedure volumes and the sources of these
standards. Results are used to guide ACR's
The future of radiology rests with those willing to make
an investment. Invest in the ACR. It will be one of the
wisest decisions you will ever make.