Awareness : Newsletter Articles

Use of Modifier “FY”

As stated in the CY 2018 OPPS/ASC final rule, section 502 of Division O, title V of the Consolidated Appropriations Act, 2016 (Pub. L. 114-113), which was enacted on December 18, 2015, contains provisions to incentivize the transition from traditional X-ray imaging to digital radiography. As permitted by section 1833(t)(16)(F)(iv) of the Social Security Act (the Act), CMS implemented modifier “FY” (X-ray taken using computed radiography technology/cassette-based imaging) to enable providers under the OPPS to appropriately report computed radiography services. Effective January 1, 2018, hospital outpatient facilities are required to use this modifier with the applicable HCPCS code(s) to describe an imaging service that is an X-ray taken using computed radiography technology.

In this same final rule, CMS also stated that section 1833(t)(16)(F)(ii) of the Act provides for a phased-in reduction in payment in the case of an imaging service that is an X-ray taken using computed radiography technology (as defined in section 1848(b)(9)(C) of the Act). Payment for such a service (including the X-ray component of a packaged service) furnished during CY 2018, 2019, 2020, 2021, or 2022, that would otherwise be determined under section 1833(t) of the Act (without application of subparagraph (F)(ii) and before application of any other adjustment), will be reduced by 7 percent, and if such a service is furnished during CY 2023 or a subsequent year, by 10 percent. For purposes of this reduction, computed radiography technology is defined in section 1848(b)(9)(C) of the Act as cassette-based imaging which utilizes an imaging plate to create the image involved. CMS notes that section 1833(t)(16)(F)(ii) refers to an imaging service that is an X-ray taken using computed radiography technology. Where the imaging service is comprised of multiple images that include both X-rays taken using computed radiography technology and images taken using digital radiography, CMS does not believe the payment reduction would apply to that service. Instead, the payment adjustment applies to an imaging service that is an X-ray taken using computed radiography technology where the X-ray taken using computed radiography technology is not combined with digital radiography in the same imaging service.