In November 2011, Blue Cross and Blue Shield of Minnesota and Blue Plus (Blue Cross) announced a requirement that ordering clinicians and imaging providers use HTDI automated decision support — RadPort (Nuance) or an alternative. This program included the Minnesota service area and providers in surrounding counties in Wisconsin, South Dakota, North Dakota and Iowa.
On July 26, 2012, the Institute for Clinical Systems Improvement (ICSI) announced that the software vendor for RadPort will discontinue the product, and broad-scale implementation by ICSI of RadPort decision support was being discontinued effective July 26, 2012.
Because of these developments, Blue Cross is no longer requiring the use of RadPort software or alternatives, either in an Electronic Medical Record (EMR) integrated version or a web-based version. Blue Cross is no longer requiring the submission of HTDI decision support numbers with claims. These changes are effective immediately.
At this time, Blue Cross is not requiring or recommending any specific software tool to replace RadPort.
Blue Cross is committed to judicious, evidence-based use of diagnostic imaging and efficient, timely delivery of care. Blue Cross will be closely monitoring the use of imaging.
Medical and Behavioral Health Policies relating to HTDI
All providers must continue to follow current pre-certification/pre-authorization and investigative policies in the Medical and Behavioral Health Policy Manual for commercial products. The following procedures have coverage criteria, are subject to medical review and where applicable, continue to require the standard pre-certification/pre-authorization process:
Minnesota Government Programs:
All providers must continue to follow current pre-certification/pre-authorization and investigative policies in the Medical and Behavioral Health Policy Manual for Minnesota Health Care Programs (MHCP) as defined in the Provider Service Agreement. The following procedures require pre-certification/pre-authorization:
These procedures are not covered for either commercial or Minnesota Government Programs members:
Previous provider bulletin
This announcement supersedes and replaces Provider Bulletin P15-11 entitled “High-Technology Diagnostic Imaging (HTDI) program” that was published on July 27, 2011.
For questions regarding provider contracts, please contact your Blue Cross contract representative or call provider services at (651) 662-5200 or toll free at 1-800-262-0820.
For questions regarding the ICSI HTDI initiative, please contact ICSI at (952) 814-7067.