Reading and billing MRIs

[deathmerchant]

Do you guys know neurologists who read their own MRIs/CTH etc and bill for them? In the past you could get boarded without any kind of fellowship or training and I know few neurologists who are doing that. What about anyone without a board certification? I personally feel pretty comfortable reading basic Dementia or MS follow up or stroke MRIs.

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[Postictal Raiden]

I don't have an answer to your question

But I feel that reading and billing neuroimages can be extremely risky. What happens if you miss subcutaneous/boney lesion, a thyroid mass, an esophageal abnormalities, a dental abscess, etc?
In neurology we get very good training on reading CNS imaging, but we almost never pay attention to the other stuff

Radiologists are held accountable for everything on the scan. Literally, everything.

 

[deathmerchant]

I don't have an answer to your question

But I feel that reading and billing neuroimages can be extremely risky. What happens if you miss subcutaneous/boney lesion, a thyroid mass, an esophageal abnormalities, a dental abscess, etc?
In neurology we get very good training on reading CNS imaging, but we almost never pay attention to the other stuff

Radiologists are held accountable for everything on the scan. Literally, everything.

Yes I understand that. there's always a risk. Im talking about very basic follow up MRIs, like MS, stroke, Dementia etc. Esp if you have a radiologist you can ask if you have doubts about a lesion. I know some neurologists who have been doing it for a while. i was just curious how common it is.

 

[sharkbaitwhohaha]

Yes I understand that. there's always a risk. Im talking about very basic follow up MRIs, like MS, stroke, Dementia etc. Esp if you have a radiologist you can ask if you have doubts about a lesion. I know some neurologists who have been doing it for a while. i was just curious how common it is.

Reading them and interpreting them for clinical reasoning is not the same as billing for them and holding all the liability.

The former is very common, the latter is not at all

 

[xenotype]

Yes I understand that. there's always a risk. Im talking about very basic follow up MRIs, like MS, stroke, Dementia etc. Esp if you have a radiologist you can ask if you have doubts about a lesion. I know some neurologists who have been doing it for a while. i was just curious how common it is.

A) Good luck getting insurers to pay you without being a radiologist.
B) I personally don't want to be responsible for that small pharyngeal cyst that later became a squamous cell carcinoma at the bottom of the MRI or the orbital fracture that was missed on the CT when the patient was admitted after a fall. Radiologists get sued for these all the time and you have no defense at all. I doubt your malpractice company would even cover this, but you absolutely should ask before signing any reports.

 

[deathmerchant]

A) Good luck getting insurers to pay you without being a radiologist.
B) I personally don't want to be responsible for that small pharyngeal cyst that later became a squamous cell carcinoma at the bottom of the MRI or the orbital fracture that was missed on the CT when the patient was admitted after a fall. Radiologists get sued for these all the time and you have no defense at all. I doubt your malpractice company would even cover this, but you absolutely should ask before signing any reports.

Yes I agree with you and that's why i wanted to ask the hivemind. Like i mentioned I know few neurologists in the community who do read MRIs, and get paid for it. But I think they might have been boarded back when you get take the boards without fellowship. I think it was changed in the past 7-8 years. Im not sure. Although I do think there is way to get UCNS neuro-imaging certification without fellowship. Ill look into that.
Also im not talking about reading acute MRIs or trauma. May be like MS f/u in patients who get it every 6months-1year etc. Or Dementia/Stroke/Meningioma follow ups.

But I get it and I agree with the general consensus here- its not common and it is high risk. I am reconsidering. Thank you.

 

[Telamir]

I have a friend who did that fellowship/certification.

It's neat for when he has to interpret imaging studies but to be honest functionally useless. No one is going to hire him to be a "radiologist" and no imaging center is just going to do the image and send it out without a radiologist interpreting so you can do it and bill for it.

Most of us are comfortable interpreting MRIs and CTs, in my case I'm relatively comfortable with hospital cases, too. Do I occasionally catch stuff radiologists miss? Sure; but they occasionally catch stuff I miss and it'd be a little scary if I was the only one looking at the images. It's an extra set of eyes.

I certainly wouldn't want to find myself being deposed and asked for my credentials to be interpreting images. I'd look pretty bad pretty quick, even with a certificate.