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…

The Department of Veterans Affairs has an amazing resource, the National Center for Patient Safety, which has access to detailed accident evaluations that, by law, are kept confidential within the VA. What NCPS has done over the years, however, is to evaluate and distil the data, providing useful pictures of complex risk profiles.

Late last year, the NCPS updated their previously published ‘MR Hazard Summary‘ in which they quantified, for the first time, the average cost of one MRI missile accident at $43,172.

What isn’t included in the VA’s cost average, because they don’t operate on a per procedure reimbursement rate, is the lost revenue from MRI downtime. This 5-figure cost average does include magnet system damage, cost of care for injury accidents, costs associated with farming-out MRI patients to other providers, but not the overhead expenses and lost revenue that would be critical components of commercial providers’ costs.

Even though revenue for an efficient MRI provider should be on the order of $1,000 per hour and overhead costs are several thousand dollars per business day, let’s assume, for the sake of argument, that the VA’s number is equally true for the per-procedure payees.

• If a box of donuts will entice staff to a lunch-hour meeting, you could provide over 19 years of daily MRI safety updates to your staff for the cost of a single accident.
• Or, if MRI safety conferences cost $2,000 to attend, $43,172 would provide for 21 conferences (plus a little extra for the bar tabs) for a site’s Technologists.
• Or, for less than half of the cost of a single accident you could buy, have installed, and provide regular training for a pass-through Mednovus MRI Sentinel® ferromagnetic detector.
• Or you could provide the hand-held Mednovus SAFESCAN Target Scanner™ and have more than $40,000 left over!

When people assert that ferromagnetic screening tools are simply ‘too expensive,’ it must be because nobody has shown them the real business costs of just a single MRI missile accident. It’s not ferromagnetic detection that’s expensive, it’s the accidents that they help prevent!

Yes, every business must balance their books and money doesn’t materialize in the bank account simply because there is a need. But when substantial help with MRI safety for patients and staff is so cost-effective as compared to projectile accidents, and the ROI requires only grade school math, why wouldn’t every MRI provider provide ferromagnetic detection screening for patients, staff and equipment?

So here’s your call to action… if you haven’t already done so, finagle ferromagnetic detection into this year’s budgetary priorities. Avoid the unplanned $40,000+ ‘hit’ with a fiscally-wise, planned deployment of a ferromagnetic screening system.

Here’s a perfect example that made the local news in Seattle a few years ago…

$200,000! And that was probably just the repair bill and didn’t count the ongoing expenses such as the scheduled staff’s salaries, the cost of the machine and the service contract (which, by the way, wouldn’t cover this type of accident), and the $1,000 per hour that the hospital failed to bring in by performing MRI scans.

“Uhh, Mr. Jones we could probably squeeze you in if you don’t mind if we cover your body in Crisco so that we can slide you past the floor polisher that’s wedged in the front of the opening to the MRI scanner.”

And at $10,000 – $15,000 per day in lost revenue (and probably something approaching that for ongoing operational expenses) the immediate indirect costs probably start to rival the direct repair costs. Then add on the fact that the accident made the evening news. How many patients over the next several days and weeks canceled their appointments (or worse, simply didn’t show up) out of a fear that the MRI at the hospital was unsafe??

The shocking truth is that these sorts of accidents occur all the time. MRI providers can be faced with up to a half-million dollars in costs just from one overzealous housekeeper with a floor polisher.

Why do floor polishers and oxygen cylinders (and a whole laundry list of other items) repeatedly get sucked into magnets and cause so much damage? It’s usually because people are either unaware of the fact that there is a risk from these super-strong magnets, or because they mistakenly think that the object that they’re carrying is safe in the MRI room. In either case, a ferromagnetic detector could provide the feedback needed to alert the patient, support staff or physician that they have something on their person that may prove to be a major threat to the MRI scanner.