Blind epidurals not really useful

[lobelsteve]

http://m.painmedicine.oxfordjournal...91.abstract?ijkey=ZiKVPewEHdMzAXZ&keytype=ref

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[Extralong]

+1 fluoroscopy guided injections.

Would you ever blindly inject your own mama? Cause I wouldn't.

 

[epidural man]

I agree they may not be useful, but the question is - why inject blind?

I think we should all start injecting blind. Perhaps unethical, but how else can we fight the ridiculous medicare. When they bundle a prodecure reimbursement, they are essentially saying - that the "guided" part is not needed. They are saying - we will pay you regardless if you use guided or not. They are also saying, it doesn't take experience, training, etc - to use guided. Because if they understood this, they would reward/reimburse for doing something that takes more skill, and ultimately - is more effective.

 

[Ducttape]

how are you coming to your conclusion?

bundled means "we wont pay you unless you are using fluoro"; "its not an epidural unless fluoro is used - payment will not be proessed."

 

[ampaphb]

Could have also been accomplished by requiring that the fluoro code accompany the procedure code. Bundling the two under one code was a cost cutting measure

 

[Ducttape]

yes, important in the overall scheme of things, but a side point of my response to epidural man.

CMS makes fluoroscopy an integral and mandatory part of the procedure by bundling. blind epidurals are not considered epidurals at all and Medicare wont pay for them.

 

[lobelsteve]

We should ask the authors of the study.

 

[ampaphb]

showoff

 

[Taus]

I'd love to see you and Yakov get into it


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[lobelsteve]

I'd love to see you and Yakov get into it


Sent from my iPhone using SDN mobile app

I am the least senior guy on the label, and they were all running circles around me in EBM when we were on teleconference. I need my EBM 2 course to just keep pace.

 

[epidural man]

how are you coming to your conclusion?

bundled means "we wont pay you unless you are using fluoro"; "its not an epidural unless fluoro is used - payment will not be proessed."

People get paid to do labor epidurals - they are not with fluoro - and it uses the same code for placement.

 

[pastafan]

People get paid to do labor epidurals - they are not with fluoro - and it uses the same code for placement.

Not exactly:

Code Description
01960 Anesthesia for vaginal delivery only. [Note: Anesthesia via epidural catheter should be billed using CPT code 01967.]
01961 Anesthesia for cesarean delivery only.
01967 Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor).
01968 Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia. (List separately in addition to code for primary procedure.)

 

[epidural man]

Not exactly:

Code Description
01960 Anesthesia for vaginal delivery only. [Note: Anesthesia via epidural catheter should be billed using CPT code 01967.]
01961 Anesthesia for cesarean delivery only.
01967 Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor).
01968 Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia. (List separately in addition to code for primary procedure.)

oh...I thought they where the same CPT.