Billing and collection for peripheral IV with US?

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caligas

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doing this more and more for as a gesture of goodwill (often pre or postpartum) but would like to get paid if possible. Anybody having luck?

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doing this more and more for as a gesture of goodwill (often pre or postpartum) but would like to get paid if possible. Anybody having luck?


Good question. I submit this procedure to our billers most of the time but am not sure how the payment has been..

It's a complete pain in the @ss at off hours though.
 
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If I get called to place an iv my standard response is 'I'm not very good at ivs you guys should get a nurse who does them every day to help you. I do an iv once a month, if that.'


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I'm sure it doesn't reimburse worth a crap, and I try to avoid calling y'all, but we greatly appreciate your assistance when we're 6 attempts deep on a kid and we've already pulled nicu / ultrasound trained nurses to attempt. You have magic eyes and fingers
 
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Good question. I submit this procedure to our billers most of the time but am not sure how the payment has been..

It's a complete pain in the @ss at off hours though.

Why do you do them off hours? Our standard reply is that we are not an IV starting service. If someone is around and available, sure we'll do it; otherwise forget it.
 
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Why do you do them off hours? Our standard reply is that we are not an IV starting service. If someone is around and available, sure we'll do it; otherwise forget it.
We defer to our hospital IV service. If those nurses can't do it, we're doing a central line.

For a non-surgical/OB patient, perhaps bill it as an anesthesia consult. :)
 
We defer to our hospital IV service. If those nurses can't do it, we're doing a central line.

For a non-surgical/OB patient, perhaps bill it as an anesthesia consult. :)

If the nurses can't get an IV, you're putting in a central line?? I can't tell you how many times nurses/whoever has failed on a kid or put some crappy 24g in the AC and then we pop in something bigger first stick.
 
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If the nurses can't get an IV, you're putting in a central line?? I can't tell you how many times nurses/whoever has failed on a kid or put some crappy 24g in the AC and then we pop in something bigger first stick.

You don't necessarily have to put in a central line. But if they're going to consult anesthesia for an IV, they've got to understand that what they're really consulting us for is vascular access. If we make the trip and don't get a peripheral IV, the patient is going to get a central line. If they don't want a central line under those circumstances then either the patient doesn't really need an IV at all, or the service they meant to consult in the first place wasn't us, but the PICC line folks.


(Any minute now someone is going to pop in and say that expanding PIV services and becoming IV and lab draw monkeys is how an anesthesia group can "show value" to the hospital in this day and age.)
 
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You don't necessarily have to put in a central line. But if they're going to consult anesthesia for an IV, they've got to understand that what they're really consulting us for is vascular access. If we make the trip and don't get a peripheral IV, the patient is going to get a central line. If they don't want a central line under those circumstances then either the patient doesn't really need an IV at all, or the service they meant to consult in the first place wasn't us, but the PICC line folks.


(Any minute now someone is going to pop in and say that expanding PIV services and becoming IV and lab draw monkeys is how an anesthesia group can "show value" to the hospital in this day and age.)

I assume jwk's post was about adults. In 5 years of peds I've never seen a kid that someone from anesthesia wasn't able to get access on (without resorting to central access) including super chubby 8 month olds, cardiac kids who've had a million previous lines etc. Some of our staff are wizards with ultrasound IV placement.
 
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You don't necessarily have to put in a central line. But if they're going to consult anesthesia for an IV, they've got to understand that what they're really consulting us for is vascular access. If we make the trip and don't get a peripheral IV, the patient is going to get a central line. If they don't want a central line under those circumstances then either the patient doesn't really need an IV at all, or the service they meant to consult in the first place wasn't us, but the PICC line folks.

Except many times the PICC service isn't as easy to commandeer as the in-house anesthesiologist.
 
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I assume jwk's post was about adults. In 5 years of peds I've never seen a kid that someone from anesthesia wasn't able to get access on (without resorting to central access) including super chubby 8 month olds, cardiac kids who've had a million previous lines etc. Some of our staff are wizards with ultrasound IV placement.
Remember that there's a difference in working in academia than there is private practice. Ever since our hospital IV team started using ultrasound, we simply aren't the go-to guys for peripheral IVs anymore. Fine with me. It's not an educational exercise for our department. Translate the time it takes for a hard-to-stick peripheral IV that nets zero reimbursement and compare it to the other things we have occupying our time. It's different if it's a patient going to surgery or OB, but honestly, if our IV team can't get it with ultrasound, and it's something that they do multiple times a day (and I don't), then more than likely we'll be looking at a central line. I think most patients would prefer that to repeated sticks over and over.
 
How many of you folks are placing IO's in non emergent circumstances when access becomes a flog but you're not convinced that central access is warranted?


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How many of you folks are placing IO's in non emergent circumstances when access becomes a flog but you're not convinced that central access is warranted?


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Never seen one placed in/for elective surgery.
 
How many of you folks are placing IO's in non emergent circumstances when access becomes a flog but you're not convinced that central access is warranted?

We are not but it isn't a bad idea.

Every now and then we get an absolute flog where an IO would be beneficial.
 
How many of you folks are placing IO's in non emergent circumstances when access becomes a flog but you're not convinced that central access is warranted?


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It crossed my mind overnight recently in a baby with improving sepsis / bacterial meningitis, but thanks to anesthesia it didn't come to that :D
 
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How many of you folks are placing IO's in non emergent circumstances when access becomes a flog but you're not convinced that central access is warranted?


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In the ER they will, but we never do.
 
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