Re: Ultrasound forum??! Help Me! Stir the pot!
From: James Smeltzer (James.Smeltzer@wellstar.org)
Sat Mar 8 13:38:30 2008
-- The Bible says that if we are rewarded on earth, we've been paid in full. I don't mind that particular deferred reimbursement up to a point, but it does not feed my family.
JimS
>>> art fougner, md <evsono@pipeline.com> 3/8/2008 2:20 PM >>>
Jim,
I'm sure you've discovered that the presence of a cpt code does not
guarantee reimbursement. It's just another one of many Stupid Managed
Care tricks.
Art
At Sat, 8 Mar 2008, James Smeltzer wrote:
>
>We DO have an "extra work" surcharge subcode that is sometimes used. We should all agree that it is sometimes warranted in the study of obese patients and use it. JSS
>
>--
>James S. Smeltzer, MD, FACOG, SMFM
>Consultant, Maternal Fetal Medicine
>Wellstar Physicians' Group
>Northwest Women's Care
>787 Campbell Hill St
>Marietta GA 30060
>James.Smeltzer@wellstar.org
>VM 678-290-3035
>Off 770-528-0260
>Page 404-318-3451
>
>>>> <jworrall@alaska.net> 3/7/2008 11:32 AM >>>
>
>OK, I shall stir a bit. I do NT but find it is very time consuming. As our
>patients become more obese, it becomes more and more difficult. I have not
>bothered becoming certified in the nasal bone, because I did not think it
>was worth the money and effort, and it would just make scans all the more
>time consuming. And while I am at it, let me ask a question. Do you
>recognize that 76813 and 76817 are different? If a patient is sent to you
>for "nuchal translucency", or "first trimester genetic screen", do you do
>anything besides CRL and NT? Do you ever charge both 76813 and 76817? If we
>are not allowed to discuss these things, then do not respond.
>
>I do not check all cervices at 18-32 weeks. I do not require a full bladder
>for transabdominal obstetrical scans and I do not see the cervix well
>transabdominally in most patients. I am of the school that the only way to
>look at the cervix is transvaginally. I also am of the feeling that I should
>not charge for exams that were not formally requested by the referring
>provider. I do not want to do a transvaginal scan routinely, without
>compensation of some sort. It is quite a bit of work and time for my nurse
>to sterilize the transvaginal probe. I agree that the cervix should be
>checked, but isn't it up to the obstetrical provider to order that? I guess
>if one has all obstetrical patients arrive with a very full bladder, you
>will be able to evaluate the cervix transabdominally in many patients. Then
>it is not a problem. Still, there is hardly a week goes by that I do not
>have to scan at least one patient that weighs 250-300 lbs. The vast majority
>of pregnant patients I see weigh more than I do. It is becoming a huge
>problem.
>
>I have missed your always-significant contributions, Jim. Please do not give
>up on this forum. Another forum to look at is Yahoo Group's Medical Imaging
>forum. http://health.groups.yahoo.com/group/medicalimaging/?yguid=7595043
>
>Allen
>
>--------------------------------------------------
>From: "James Smeltzer" <James.Smeltzer@wellstar.org>
>--------------------------------------------------
>--------------------------------------------------
>--------------------------------------------------
>Sent: Friday, March 07, 2008 5:48 AM
>--------------------------------------------------
>To: "Multiple recipients of list ULTRASOUND" <ultrasound@mail.obgyn.net>
>--------------------------------------------------
>Subject: Ultrasound forum??! Help Me! Stir the pot!
>--------------------------------------------------
>
>> This used to be a place I loved to go to. Things got very busy. Personal
>> issues intervened. Too many emails from someone hunting a job & Pfft?!
>> Resurrection!?
>>
>> Maybe this pot needs stirring!
>>
>> Hop y'all are doing NTs and nose bones at 10-14 weeks, and checking
>> cervixes at all 18 to 32 week studies!
>>
>> If not, then I would love to hear why not?
>>
>> Is anybody back there?!
>>
>> ;^) Jim S
>>
>> James S. Smeltzer, MD, FACOG, SMFM
>> Consultant, Maternal Fetal Medicine
>> Wellstar Physicians' Group
>> Northwest Women's Care
>> 787 Campbell Hill St
>> Marietta GA 30060
>> James.Smeltzer@wellstar.org
>> VM 678-290-3035
>> Off 770-528-0260
>> Page 404-318-3451
>>
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--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
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