Valuation of interventional radiologist remuneration

Professionals in our specialty have been treated unfairly in relation to the receipt of fees by health plans for decades. Due to the fact that our procedures are part of chapter IV of the Brazilian Hierarchical Classification of Medical Procedures (CBHPM), “Diagnostic and Therapeutic Procedures”, we were not contemplated with the increase of 100% in the medical fees for patients who have plans with superior hospital accommodations, foreseen in item 6 of the general instructions of the same table. In addition, the plans generally took advantage of this situation, claiming that we were part of the SADT package, in order not to pay the auxiliary fees in all codes and the addition of 30% to the amounts when the procedures were carried out at times of urgency . What has been happening is that, sometimes, we earn less than half of the fees received by specialists from other areas to perform the same procedure. Another distortion of the current table: there are the same procedures, but with different codes, performed by interventional radiologists and by professionals from other specialties. Invariably, the codes of other specialties had a larger surgical size or included a greater number of assistants. Sobrice, represented by me, director of Professional Defense, was at the headquarters of the Associação Médica Brasileira (AMB), in São Paulo (SP), on March 28th, requesting the correction of these historical injustices in the CBHPM table. All demands listed below were fully complied with and will be published in CBHPM 2018: Inclusion of the following note at the end of interventional procedures: 4.08.99.00-4 - Specific instructions for diagnostic and interventional imaging methods; 12. For hospitalized patients, the costs of Interventional Radiology procedures will comply with the provisions of item 6 of the General Instructions; this additional, however, does not apply to the operating cost. 13. The rules for the competition for surgical assistants must fully comply with item 5 of the General Instructions. 14. Urgent and emergency care will comply with the provisions of item 2 of the General Instructions. Equalization of postage/auxiliaries for the following procedures: 4.08.13.24-0 - Placement of an inferior vena cava (IVC) filter to prevent pulmonary thromboembolism (PTE): changed from one to two assistants; 4.08.13.87-8 - Percutaneous nephrostomy guided by X-rays, ultrasound, computed tomography or magnetic resonance: changed from 6B to 8B; 4.08.13.48-7 - Percutaneous biliary drainage: changed from 6A to 8B and changed from one to two auxiliaries; 4.08.13.41-0 - Percutaneous drainage of pleural collection: changed from 4C to 6B and inserted an auxiliary. This was a great achievement for our specialty and is part of a set of actions that are already underway to enhance the work of interventional radiologists. Also, so that, more and more, image-guided procedures can be regulated and widely offered to the population, both in the public and private systems. DR. RAPHAEL BRAZ LEVIGARD Director of Professional Defense at Sobrice – 2017-2018 Biennium