In a word, ‘Yes,’ but not by the conventional ways that imaging providers are accustomed to...
Would using ferromagnetic detection (FMD), to add a new and effective layer of pre-MRI screening, be reimbursed? What I mean is, is there a CPT code to get paid back for providing this additional service?
No, but the lack of a CPT code has little to do with the fact that using FMD can contribute, directly, to an MRI provider’s bottom-line. In fact, there are two concrete ways, off of the top of my head, that I know have provided financial ‘payback’ to users of ferromagnetic detection systems.
First, the indirect. If you owned a million-dollar house on the Florida coast, don’t you think you’d spring for hurricane insurance? What if there was an insurance policy that didn’t pay you back a proportion of your loss, leaving you to start all over, but instead offered the promise of making it less likely that the hurricane would even hit you in the first place?
This is what ferromagnetic detection does… when used correctly it reduces the risks of unplanned maintenance for shim disturbances, interrupted throughput for incomplete patient screenings, downtime associated with extracting cell phones, jewelry, furniture, etc… from the bore, or worse, damage to your MRI system.
What is this preventative effect worth? Well, the Veterans Administration published their average cost for an MRI projectile accident at $43,172 per incident. This average included a number of lesser projectile accidents, such as cell phones, indicating that some of these accidents are likely into the 6-figure range. Plus, because the VA doesn’t operate on a per-procedure reimbursement rate, the $43,172 cost does not include lost patient revenue.
The published VA data does not give frequency information, so if we turn to the only peer reviewed publication that does (Chaljub, Cramer, et. al.), and extrapolate the frequency they give for only medical gas cylinder accidents and assume that the same frequency of once every 6 years applies to all projectile events, even the smaller projectiles (it would, in reality, be far more frequent), the annualized cost of projectile accidents is roughly $7,200 (this is the VA’s $43,172 cost per projectile accident, divided by the Chaljub frequency determination of 1 medical gas cylinder accident every 6 years of MRI operation).
This is a hyper-conservative number, given that it doesn’t include lost scan-time reimbursement from projectile accidents, is based on data that is approaching 10 years old (indications are that accident rates have been on a steady increase year-over-year), and doesn’t include smaller projectiles in the frequency determination. The above figure also doesn’t take into account unplanned shim-correction or lost throughput from patient re-screening. Based on expert information from a former co-director of the VA’s National Center for Patient Safety, the annualized cost of projectile accidents exceeds $20,000 per year per MRI.
Anybody who claims to be able to drive that cost to $0 is selling snake oil. Accidents will continue to happen because MRI is just too dynamic and complicated an environment to assure 100% effectiveness in managing all the variables, all the time. But what if ferromagnetic detection could help cut that cost in half? What if we could help slash that annualized cost to just 10% of what it was, would that be worthwhile?
The second way that I know of that FMD has paid for itself is through a reduction in linen costs. One of Mednovus’ clients went from requiring all outpatients to gown (at a laundry cost of about $3 per patient) to only having about 1/4 of their patients gown (who was gowned was a function of the type of exam and the degree to which the staff felt comfortable with the patient’s ability to comply with screening instructions). All patients were screened with a hand-held ferromagnetic detector. This client reduced ongoing laundry costs, reduced average patient prep time, and improved screening effectiveness.
In a way, this provider found a way to get automatic reimbursement for using ferromagnetic detection pre-screening. It isn’t a CPT code, but the savings for linen service drops to the bottom line, just as a per-procedure reimbursement would.
So if we set aside the entire question of safety for patients and staff in the MRI environment and look at ferromagnetic detection solely though a lens of cost effectiveness, smartly deployed FMD systems can have very rapid return on investment (ROI) periods, in some cases only a matter of months!
Whether you look at ferromagnetic detection systems as something of a risk-management ‘insurance policy’, or a throughput management tool, or cost-containment for laundry services, or any of the other creative and constructive ‘revenue-positive’ solutions, a serious look comes away with the assessment that, “Yes, ferromagnetic detection is cost effective.”
And this is just the financial aspect, we haven’t even touched on the safety, best practice and accreditation parts of the equation…Tobias Gilk, President & MRI Safety Director Mednovus, Inc. Tobias.Gilk@Mednovus.com www.MEDNOVUS.com