strategic about when and how to advance new code change proposals to assure that its creation doesn’t harm reimbursement for the specialty as a whole,” Dr. Swan said.
The SIR member value For over 30 years, SIR has had a presence in the RUC and CPT process. Currently, there are three SIR members serving in leadership roles in the space: Dr. Swan serves alongside Daniel Picus, MD, FSIR, on the CPT Editorial Panel Executive Committee, and Ezequiel Silva III, MD, FSIR, serves as the RUC Chair.
This is not only a testament to the value that IR brings to the process, but the impact that IR has had in shaping interventional medicine over the years as well.
“Think about how much IR has changed medicine over 30 years. Our ability to contribute to that evolution at both the CPT and RUC level has truly been benefi cial to medicine as a whole,” said Dr. Silva.
Dr. Silva fi rst became involved in CPT creation in the mid-2000s when he helped create a code for placing a fi ducial marker in the chest. Dr. Silva has since gone on to be appointed as the RUC Chair twice and gave the 2024 Charles T. Dotter Lecture on IR and public policy advocacy.
“For example, think about even the most basic interventional procedures such as percutaneous image-guided biopsies, or think about even more complex work like a vascular stent or a TIPS procedure,” Dr. Silva said. “As interventional radiologists, we have to create codes and make sure they’re valued appropriately so those services can be provided, and for those services to grow in their clinical utility.”
These codes have become the backbone of member reimbursement, enabling members to continue to off er new and impactful therapies to patients.
In addition, the volunteers who work in the economic sphere off er another key benefi t to members.
“In my opinion, coding advice is probably one of the more important member-facing services the SIR
38 IRQ | SUMMER 2024
to learn on the job. So, the next step becomes, what’s your on-ramp for this?”
Dr. Silva recommends becoming engaged with the SIR Economics Committee. Within that committee, there are four workgroups: the CPT Editorial Panel and RUC workgroup, the Coding Application and Guidance workgroup, the Carrier Advocacy workgroup, and the soon-to-come Alternative Payment Model workgroup.
“Be forthright and say that you want to engage in this because you fi nd this interesting and you know you have a lot to learn. Show that you’re willing to learn,” Dr. Silva said.
Dr. Silva says he believes his involvement in the health policy space has not only provided a member benefi t, but a patient benefi t as well.
Economics Committee provides,” said Dr. Swan. “Procedure coding needs to be precise to avoid fraud and abuse. It is essential that the descriptor of the code reported matches the service provided. Close isn’t good enough.”
How to get involved However, even without an economic background, IRs are still able to play a key role in the CPT and valuation process.
The easiest way to be involved is to belong to a society like SIR.
When those initial surveys to determine the value of a code go out to determine the value of a particular procedure, they are sent only to SIR members—retired, nonpracticing or non-SIR members are not included in the outreach. Essentially, without membership to a society, a physician is unlikely to be involved in determining what they will be reimbursed.
Additional surveys then go out to determine experts and those interested in specifi c areas—and from this, members can be asked to serve as experts.
But for those who want to get in on the ground fl oor of the work, an economics degree or MBA isn’t necessary, Dr. Silva said. “What you do need, however, is a foundational interest and a willingness
“Sometimes my patients ask me about the fi nancial aspects of their care,” he said. “What does this therapy mean from a fi nancial perspective? Can you help with my explanation of benefi ts?”
According to Dr. Silva, this is an opportunity to further engage and support his patients.
“They want to feel like we’re in their corner, and we certainly and unquestionably are from the clinical perspective. But when you can go into their corner from an even deeper perspective that relates to their fi nancial circumstances and ability to pay for their procedure, I think it strengthens that relationship.”
In addition, he says his positions within the AMA have allowed him to see potential shortcomings in practice and then bring them to the policy space to improve.
“I’ve actually been able to see those changes come back to benefi t the patients I care for,” he said. “It’s a circumferential benefi t that starts with patient care, goes up the chain to the policy level and then comes back to patient care. It’s rewarding to see that benefi t and to see patients gaining from that experience.”
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