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Accreditation for Medicare-covered advanced diagnostic imaging

Washington—Providers submitting claims for the technical component of advanced diagnostic imaging services for Medicare beneficiaries must be accredited by Jan. 1, 2012, to be reimbursed for the claim if the service is performed on or after that date, the Centers for Medicare & Medicaid Services said.

CMS has approved three national accreditation organizations to provide accreditation services for suppliers of the technical component of advanced diagnostic imaging procedures: The American College of Radiology, The Intersocietal Accreditation Commission and The Joint Commission.

On November, 17, 2011, CMS announced “important new information about these accreditation requirements.” The notice says that “providers need not submit their ADI data on their 855 enrollment forms or via the PECOS enrollment system. CMS receives that data from the accrediting organizations.” PECOS is the Medicare Internet-based Provider, Enrollment, Chain and Ownership System.

The announcement may be of interest to certain oral surgeons or other dental specialists who provide ADI services covered by Medicare but is unlikely to affect most dentists. The accreditation will apply only to the suppliers of the images themselves and not to the physician’s interpretation of the image, the notice says. Accreditation applies only to providers who are paid under the Medicare physician fee schedule.