Acute Pain Service

[halflife94]

Advertisement - Members don't see this ad

Does your hospital have an anesthesia acute pain service who manages patients on the floor ie. medical management or maintainence of PNC or epidurals? How much do you get paid for a consult? Do they have any particular qualifications or just completion of anesthesia residency? Thanks

 

[halflife94]

any good acute pain textbooks?

 

[jwk]

We have a very busy acute pain service that manages both epidurals and PCA pumps. Most of those patients are post-op, but there are some that are done for non-surgical or patients that may not be coming to the OR for a few days still. As with most anesthesia fees, most things we do are assigned a unit value from the RVG.

If they're post-op patients, most of the time you can only charge for management. If I remember correctly, that charge is 1-3 units per day. It doesn't sound like a huge amount, but if you're doing that on 50+ patients a day, it easily covers the cost of personnel. However, if you use general anesthesia for the procedure and place an epidural to be used for post-op pain control, you can also charge for epidural placement in addition to the daily management charge.

For laboring C-Sections, three separate fees may be generated. Placement and management of the epidural for labor, C-Section anesthesia, and then daily management for post op pain. All of these items have RVG values and CPT codes attached to them.

Some insurance companies are better than others at reimbursement of course. Most will reimburse for PCEA management, but some will not for straight IV PCA's.

 

[Tuohy]

This is a good textbook for acute pain-

http://www.borders.com.au/book/acute-pain-management/426744/

 

[epidural man]

Does your hospital have an anesthesia acute pain service who manages patients on the floor ie. medical management or maintainence of PNC or epidurals? How much do you get paid for a consult? Do they have any particular qualifications or just completion of anesthesia residency? Thanks

That is a great question for private practice folks. Most academic centers have it. I'm curious if it is economically feasible in the private sector.

PP guys?

 

[Tuohy]

Can an Acute Pain Service Be Cost-Effective?
Anesth Analg October 2010 111:841-844;

 

[2ndyear]

That is a great question for private practice folks. Most academic centers have it. I'm curious if it is economically feasible in the private sector.

PP guys?

I would say it's necessary if you do most any larger case. Post op epidurals for thoracotomies, big abdominal cases, etc. It is an expectation of the hospital and many times the surgeon. Residency training is just fine to handle acute pain issues that come up, as well as the acute on chronic pain stuff. As for economics, depends on how much time is spent rounding and dealing with acute pain. I would say not feasible in my hospital for a dedicated employee, but we generally round during any down time. But like I said, it is an expectation so you do it whether or not the money is there.

 

[Frank Rizzo]

That is a great question for private practice folks. Most academic centers have it. I'm curious if it is economically feasible in the private sector.

PP guys?

Yes, its basically the on-call docs responsibility to round on these patients in the AM. Economically, we don't make much, if any, money on it, but it is expected by the surgeons/hospital.