Payers evaluate SPECT/CT on case-by-case basis
Early adopters educate insurers about value of each component of fusion imaging
As the diagnostic CT side of hybrid imaging adds new clinical potential for nuclear practices, some sites are facing questions about how to bill properly for the procedures. While practitioners in Germany and the Netherlands have encountered no problems with reimbursement, the situation outside of Europe is different.
Payment problems are likely to arise with applications in which CT was not previously requested, said Dr. Paul Shreve, a radiologist with PET Medical Imaging Center and Advanced Radiology Services in Grand Rapids, Michigan. Imaging with SPECT/CT prior to vertebroplasty, for instance, should be fully reimbursable because patients would have received a CT examination anyway. This may not necessarily be the case with other potential applications.
One useful strategy is to talk with individual insurers prior to scanning, if time allows, and explain the value of each part of the SPECT/CT examination, said Dr. Stephen Scharf, chief of nuclear medicine at Lenox Hill Hospital in New York City.
"Medicare needs to do the same thing for SPECT/CT that it did for PET/CT; that is, recognize that there are times when fusion imaging makes sense and come up with separate codes for those applications. For the moment, we can only bill for CT if we are interpreting both portions of the examination as separate tests," he said. -PG
Can Emerging AI Software Offer Detection of CAD on CCTA on Par with Radiologists?
May 14th 2025In a study involving over 1,000 patients who had coronary computed tomography angiography (CCTA) exams, AI software demonstrated a 90 percent AUC for assessments of cases > CAD-RADS 3 and 4A and had a 98 percent NPV for obstructive coronary artery disease.
Contrast-Enhanced Mammography Study Reveals 24 Percent Lower Sensitivity with Moderate/Marked BPE
April 30th 2025In comparison to minimal or mild background parenchymal enhancement on contrast-enhanced mammography (CEM), researchers found that moderate or marked BPE was associated with a 12 percent lower AUC for breast cancer detection.
Could AI-Powered Abbreviated MRI Reinvent Detection for Structural Abnormalities of the Knee?
April 24th 2025Employing deep learning image reconstruction, parallel imaging and multi-slice acceleration in a sub-five-minute 3T knee MRI, researchers noted 100 percent sensitivity and 99 percent specificity for anterior cruciate ligament (ACL) tears.
