Re: Doppler for office u/s. Was: ?hetertopic pregnancy

From: Mark Perloe (mperloe@ivf.com)
Wed Feb 28 16:42:27 2001


At 08:59 AM 2/28/01 -0600, you wrote:

>Do you know the price? Can you increase reimbursement for 3D images? I
>know it is emerging technology, but what benefit does 3D have in the hands
>of a generalist?

Should be about $50k they are not firm yet. Medison will actually put the machine in the office for free and only take the first $100 of what you actually collect for the 3D fee, not the doppler or transvaginal fee. I don't like their machine though as it puts off a lot of heat.

The 3D is fun and not that helpful. As for reimbursements, that is yet to be seen. But at $50k, it is not much more than average doppler flow, which I am still not certain of the value. Mark Perloe

>
>Richard Chudacoff, MD
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Mark Perloe
>Sent: Tuesday, February 27, 2001 8:38 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Doppler for office u/s. Was: ?hetertopic pregnancy
>
>Richard,
>
>Please look at the new Shimadzu 3D doppler. They are quite cost effective.
>I have three of there non-doppler machines and hope to have one soon. The
>use of 3D for new OB scans, uterine malformations, fibroids is helpful.
>
>The value of doppler flow studies outside of a research setting for
>infertility is still up for grabs, but this machine should be very affordable.
>Mark Perloe
>
>At 03:01 PM 2/27/01 -0600, you wrote:
>
>I'm looking to purchase a new ultrasound for my office. The ole Ultramark IV
>is on its last legs. I've considered getting Doppler but just don't see that
>reimbursements are going to offset the extra cost of the machine. The way I
>look at it, it is kind of expensive just to hear fetal heart motion in the
>first trimester.
>
>Any thoughts on whether Doppler is a must for a small solo-practice with a
>diagnostic center right next-door?
>
>Richard Chudacoff, MD
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of art
>fougner, md
>Sent: Tuesday, February 27, 2001 7:57 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: ?hetertopic pregnancy
>
>Paul
>
>"ring of fire" often either absent or incomplete in some ectopics
>fizzling out. of course these could be managed expectantly, which is
>what might be the prudent course of action here. Mark, had a case
>recently featuring a healthy growing IUG sac, risiing Betas, pain and an
>adnexal mass separate from the ovary and consistent with thickened tube.
>increasing pain prompted laparoscopy, revealing torsion of the fallopian
>tube.
>
>art
>
>At Mon, 26 Feb 2001, Paul Prior MD wrote:
> >
> >On Mon, 26 Feb 2001 18:22:58 -0600, Mark Perloe <mperloe@ivf.com>
> >wrote:
> >
> >>KA is a 32 yo G3 ectopic 2 female s/p right salpingectomy. She conceived
> >>after ovulation induction and IUI (3 mature follicles with E2 384pg/ml
> >>peak). An intrauterine gestational sac with fetal pole and FHT is seen.
>She
> >>complains of left adnexal pain. The left ovary is enlarged suggesting mild
> >>hyperstimulation. A small 1cm saclike structure on the edge of the
> >>ovary. Over the past week it has not changed in size. It appears to be
> >>attached (moves with) the ovary. She is now 6W4D.
> >
> >Doppler on the ovary? I'm sure you are more experience in this than
> >I, Mark, but did you turn on the doppler in this area? I have found
> >the "ring of fire" to be very helpful for ectopics.
> >
> >--
> >Paul Prior MD
> >Coshocton, OH
> >Solo Practice
> >OB/GYN, FACOG
> >
>
>--
>art fougner, md
>
>A series of 1000 cases begins with but a single anecdote.
>
>Mark Perloe, M.D. http://grs.ivf.com 404-843-2229
>5445 Meridian Mark Rd, Suite 270, Atlanta, GA 30342

--
Mark Perloe, M.D.   http://grs.ivf.com 404-843-2229
5445 Meridian Mark Rd, Suite 270, Atlanta, GA 30342




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