Logomarca CBR Brazilian College of Radiology and Imaging Diagnosis
2020-11-11 14:50:08 - 11

Participate in Public Consultation #81 on the ANS website

Public Consultation No. 81 for Updating the List of Procedures and Events in Health Cycle 2019/2020 is on the air from October 8 to November 21, 2020. Check it out here The objective at this moment is only to receive contributions according to the evaluations that have already been made by the National Supplementary Health Agency (ANS) and made available for Public Consultation (CP) the Preliminary Recommendations (RP) for the List Update Proposals (PAR) of the cycle in effect, where we can choose “I agree with the preliminary recommendation”; “I disagree with the preliminary recommendation” and “I agree/partially disagree with the preliminary recommendation”. After preliminary analysis by the ANS, we identified in the Public Consultation the list of procedures below, Radiology and Diagnostic Imaging, which we understand that we should position ourselves on each TAU (Technical Analysis Unit). Click here to check out a simple step-by-step guide to help you participate in the Public Consultation and, below, the suggested content for each UAT. Remembering that clinics and doctors can participate individually.  
    1. 114_MAGNETIC RESONANCE_KNEE (I agree with the preliminary recommendation. Justification: (I agree with the preliminary recommendation, because the claims presented in the document for the elaboration of a knee MRI DUT lack scientific evidence to support them. The indications for the use of Magnetic Resonance as a method of investigating pathological conditions of the knee are so many and so varied, depending on the anatomical compartment involved, the associated clinical picture, that there is no document in the medical literature even similar to the one presented. Therefore, I strongly oppose the inclusion of this DUT.)
    2. 115_MAGNETIC RESONANCE_SPEAKER (I agree with the preliminary recommendation). Justification: (I agree with the preliminary recommendation, because the claims presented in the document for the elaboration of a Spine Magnetic Resonance DUT lack scientific evidence to support them. The indications for the use of Magnetic Resonance as a method of investigating the pathological conditions of the spine are so many and so variable depending on the compartment involved, neuro and axis and its peripheral structures or bone structures, the associated clinical picture, that there is no document in the medical literature even similar to the one presented. Therefore, I strongly oppose the inclusion of this DUT.)
    3. 504_OBSTETRIC ULTRASONOGRAPHY WITH NUCHAL TRANSLUCENCY (I disagree with the preliminary recommendation). Justification: (I disagree with the preliminary recommendation, because First Trimester Morphological Ultrasound is a much more complex exam than Obstetric Ultrasound with Nuchal Translucency. The First Trimester Morphological Ultrasound includes a detailed study of the anatomy such as the following items: ossification of the bones of the skull, cerebral ventricles and choroid plexuses, sickle of the brain, eyes and nasal bone, facial bones, lips, vertebral column in longitudinal and axial sections , lungs and their symmetry, fetal heart with four-chamber section, presence of stomach and its location, bladder, kidneys, cord and its insertion, integrity of the abdominal wall and skin, upper and lower limbs with their segments. Nuchal Translucency is included in the evaluation of the fetal cervical region. Reference: ISUOG practice guidelines: performance of first-trimestrer fetal ultrasound scanner. Thus, the First Trimester Morphological Ultrasound must be distinct from the Obstetric Ultrasound with Nuchal Translucency, with a specific code and different pricing.)
    4. 508_PERCUTANEOUS VACUUM BIOPSY GUIDED BY X-RAY OR ULTRASONOGRAPHY - US (MAMOTOMY) (I partially agree/disagree with the preliminary recommendation). Justification: (I do not agree with changing the DUT on ultrasound-guided percutaneous vacuum biopsy (item II), which propose mandatory coverage in nodules smaller than 2 cm, categories 4 or 5 of BIRADS, in cases where doubt remains after Ultrasonography-guided Core Biopsy. This is because there are several clinical situations in which it is not possible or necessary to perform Core Biopsy prior to percutaneous vacuum biopsy, which may even increase costs, delay diagnosis and patient anxiety. An example is lesions close to implants or the chest wall, or even in the context of determining complete pathological response after neoadjuvant chemotherapy treatment of breast cancer. On the other hand, I agree with changing the description of the procedure for the inclusion of the “Magnetic Resonance”, as well as agreeing with the changes proposed for item I of the DUT (a,b,c).