The evaluation of progress reports and review by a radiologist will be mandatory covered by health plans. Requested by the Brazilian College of Radiology and Image Diagnosis (CBR), the inclusion of these procedures in the List of the National Supplementary Health Agency (ANS) was confirmed in March and is already in force: from now on, the specialist doctor will be remunerated by evaluation and comparison with previous exams, as well as issuing the document. This victory, the result of more than two years of work by CBR, guarantees the doctor's correct remuneration and the patient's right and expectation to receive diagnosis and treatment safely.
“This achievement is very important for the radiologist, who now has preserved his right to remuneration for providing this service. Comparison between exams is frequent and has become increasingly complex, demanding time and high qualifications from the specialist”, says Juliana Tapajós, director of Professional Defense at CBR. “The main beneficiary of this decision is the patient, who will be able to count on increasingly consistent reports for the correct identification of improvement, worsening or stability of injuries, contributing to a more accurate diagnosis, as well as better follow-up and follow-up”, he highlights.
She clarifies that the CBR's claim led to the introduction of the procedures in the Brazilian Hierarchical Classification of Medical Procedures (CBHPM), in 2022, and in the Unified Supplementary Health Terminology table (TUSS), in 2023. The inclusion in the ANS List completes the standardization. The codes are defined and the Brazilian College of Radiology will carry out communication actions to inform and guide the specialist doctor. “CBR will continue to support the specialty and its members in the search for the best working conditions and excellent service to the population”, argues the entity’s president, Cibele Carvalho.
Detailed logging – In the case of evolutionary report procedures, the work of the radiologist will be paid in situations where it is necessary to analyze images from the patient's previous exams to prepare the current exam report, without a medical request being necessary. This document aims to evaluate the evolution of the disease or the effectiveness of the treatment.
To guide the specialist, the CBR recommends that the use and collection of evolutionary report codes be done when the patient presents, in physical or electronic form,, the images from the previous exam. The current procedure and data from such exams must be recorded in the progress report, with the date, clinic or service and identification of the doctor who performed the previous procedure.
The CBR highlights that follow-up exams are indicated in several situations, such as monitoring response to treatment of neoplastic, inflammatory or infectious lesions; the control of inflammatory and infectious collections; checking the stability of injuries of an uncertain nature; resolution and monitoring of potentially serious illnesses; control after therapies; screening and risk stratification of neoplasms; control of diagnosed injuries; among others.
In the case of the review report, clarifies the CBR, the creation of the procedures will remunerate the medical work when images are made available by the patient and a doctor requests a review of the exam and issuance of a new report, with the character of a second opinion.
“A dedicated second opinion interpretation of medical images performed by radiologists with expertise can increase the accuracy of detecting lesions, which could influence patient care”, comments Juliana.
