Modified on: Tue, 9 Nov, 2021 at 6:02 PM
Medicare requires data submission to an approved clinical practice registry as a condition for reimbursement for lung cancer screening exams. The ACR Lung Cancer Screening Registry (LCSR) is approved by CMS for this purpose.
As a CMS-approved lung cancer screening clinical practice registry, we require data to be submitted on all patients who undergo screening at your facility. We will provide participating facilities with facility-level and physician-level reports that contain comparisons between you and your peers on measures of interpretive quality. We will submit data to CMS data requested by them to validate registry participation.
Yes. The new facility registration form can be used by facilities, physician groups or other entities to register the locations at which you practice. If this is the first time your group is registering any of the sites where it practices, will first apply for a corporate account ID and then register each physical location within that account. See The Application Process for details.
Lung Cancer Screening Registry
ACR Lung Cancer Screening Center Designation
Required for CMS reimbursement
Available to all facilities
Registration starting May 2015
Data submission: Summer 2015
Available to all facilities that have achieved ACR CT
Accreditation in at least the chest module
Dependent upon number of radiologists and sites involved
$400 per facility
Collect required data elements for submission to the registry interface
Mail or fax application, signed attestation, completed clinical data form with lung cancer screening protocol (based on average-size patient study) and fee
The ACR Lung Cancer Screening Registry is approved by the Center for Medicare and Medicaid Services to enable providers to meet quality reporting requirements to receive Medicare CT lung cancer screening payment.
The ACR Lung Cancer Screening Center Designation makes your site notable as a provider of safe, effective diagnostic care for those considered at high risk for lung cancer.
No. We do, however, require a patient ID that uniquely identifies each patient within your facility. It is important to note that without the Medicare beneficiary ID, we will be unable to document your compliance with the CMS reimbursement requirement to submit low-dose CT lung cancer screening data to a registry.
Yes. Documenting compliance with CMS reimbursement requirements is only one of the purposes of the LCSR. It primarily serves as a quality improvement tool for studying the benefits of low-dose CT lung cancer screening. By signing the LCSR participation agreement, you agree to report all low-dose CT lung cancer screening exams. However, you should not report data on participants of studies or clinical trials whose Institutional Review Board (IRB) has expressly prohibited such reporting.
In order for CMS to approve the LCSR for meeting quality reporting requirements for reimbursement, the ACR submitted an application demonstrating the LCSR’s value for the assessment of quality of low-dose CT lung cancer screening. A panel of experts from the LCSR Committee determined which data elements would be essential for monitoring the quality of low-dose CT lung cancer screening. Because screening is performed on an asymptomatic population, there is an added responsibility for the medical community to ensure that risks and benefits are adequately measured and monitored. The additional data elements are essential for monitoring quality and ensuring that the benefits of screening in clinical practice meet or exceed the benefits found in research.
You can submit data to the LCSR according to your schedule; however, we suggest that you submit data monthly.
The time at which you bill for either component is entirely up to your workflow; however, it is assumed that you have submitted the low-dose CT exam data to the registry first.
We send quarterly reports to CMS that detail the exam information provided to us during your data submission.
For the purposes of reporting to the LCSR data registry, your facility or group of radiologists should provide Lung-RADS Assessment Categories to the registry. We strongly recommend including the Lung-RADS Assessment in the radiologist’s final report, so it can be provided to the registry.
Yes, provided the treating physician clears the patient for a screening. Usually patients remain in a surveillance program rather than a screening program. However, if the physician clears the patient for a screening, the ACR would like to have the data for the new screening exam.
Yes, you should still enter the data into the registry. The registry is for collecting information on all exams for which the purpose of the exam was screening. Ideally, it would be done with low dose. But if it is done at full dose, you should just enter the exam and the CTDIvol and DLP that were associated with that particular exam.
Make sure you are selecting the correct facility in the drop down in order to perform the export. If you’re not transmitting data it may be because you have the corporate account selected in the facility picker in the upper right corner, rather than the facility that is associated with the data.
It’s likely the patient has already been entered into the system from a previous exam. In order to check, once you’ve logged in to NRDR select the Manage Patients tab from the menu on the left side of the page. Use the filter to search for the patient in question (please use the Manage Patients tab to determine which identifier was used). If you are trying to enter an annual exam, select Register New Exam from the NRDR page and use the purple search bar to search for your existing patient.
You must have your data submitted to the facility 30 days after the end of the quarter in order to have it incorporated in the current quarterly report cycle. If the last days falls on the weekend, then the data must be submitted by the following Monday. Any data not provided by the deadline will be incorporated in the next feedback report.
Q1 = Jan 1 – Mar 31. All data entry for Q1 is due no later than April 30.
Q2 = Apr 1 – June 30. All data entry for Q2 is due no later than July 31.
Q3 = July 1 – Sept 30. All data entry for Q3 is due no later than Oct 31.
Q4 = Oct 1 – Dec 31. All data entry for Q4 is due no later than Dec 31.
You should enter one of the other unique patient identifiers: Social Security Number or "other identification". "Other identification" is a unique patient identifier that you provide, such as MRN. Also, be sure to enter "Medicare" in the "Health insurance" field. If a record does not include a Medicare Beneficiary ID, and "Medicare" is not reported as the patient's health insurance, then the record will not be submitted to CMS.
If possible, please exclude it. The data elements should be focused on the actual CT scan itself.
Any follow-up imaging, biopsy, or surgical procedure performed specifically as a follow-up to a screening exam, if the procedure was performed within one year of the screening exam. If a procedure was not performed specifically as a follow-up to a screening exam, it should not be reported, except as noted under Exceptions below.
There can be multiple follow-up records for each patient during the same year. Please complete a follow-up record for each procedure, even if the procedures occur on the same day. These follow-up procedures should be added to Section B of the LCSR Exam Form that contains the screening exam data. To do so, click “Exam” on the LCSR menu to launch the “Search Exam” page. Use the search filter to locate the number of the exam for which you need to enter data. Click the red exam number to launch the exam form. Go to Section B within the exam form, click Add Follow-Up Record, and add the procedure data to the Exam form in the Follow-up Record. Go to the bottom of the Exam form and click Save.
An annual screening exam is not considered a follow-up procedure for the purposes of the LCSR. It should be added as a new screening exam, using the “Register New Exam” function. For returning patients, use the purple search bar in the “Register New Exam” form to locate the patient’s profile information. You can search for the patient using either the SSN, Medicare Beneficiary ID or the ‘Other ID’. Once the patient is found, the software will populate the form with the patient’s demographics. Complete the additional fields within the form, scroll to the bottom and click “Submit”.
If a procedure was not performed specifically as a follow-up to a screening exam, it should not be reported, except as follows:
These procedure should be reported, if performed within one year of a screening exam.
1. All lung biopsies.
2. Exams or procedures not performed specifically as a follow-up diagnostic to a screening exam but that provide diagnostic follow-up information that would be expected from a scheduled follow-up. Exams or procedures performed for patients in a lung cancer screening (LCS) program but not related to their LCS care should not be reported to the registry as a regular practice. They should only be reported when the clinician is aware or recognizes that the services provided could be reasonably recorded or used as appropriate LCS care for the patient. Clinicians should use their judgment as to what is in the best interest of the patient and submit data to the registry accordingly.
1. A patient has a screening exam with a normal result. Shortly after, the patient undergoes chest imaging for an unrelated reason, such as trauma. The additional chest imaging should not be reported as a follow-up procedure.
2. A patient has a percutaneous biopsy and a bronchoscopy, both recommended as follow-up to findings from a screening exam, and both within one year of the screening exam. Both procedures should be reported to the registry, each as a separate record, even if they occurred on the same day.
3. A patient has a screening exam with a result of Lung-RADS 2S. The S signifies additional clinically significant or potentially significant abnormalities. The S could possibly represent a liver mass that was an incidental finding on the screening exam. Even though an imaging procedure may be ordered by the provider to evaluate the liver mass, followed by a liver biopsy, this procedure and biopsy should not be entered into the registry, because they do not pertain to the lungs.
4. A patient has a screening with a suspicious finding, so a diagnostic follow-up CT #1 is performed. There is additionally still something suspicious, so a second diagnostic follow-up CT #2 is performed, still within a year of the original screening. CT#2 wasn't directly performed as a result of the screening exam, but was performed secondarily as result of the first follow-up to the screening, and therefore should be reported.
If a Lung-RADS category was assigned, then the exam should be reported, with Modality = Routine chest CT. If a Lung-RADS category was not assigned, then the exam should not be reported.
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