CoolRF

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painfree23

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experience with cool rf? Also, How do you bill for it?
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Too darn expensive. Can't get a facility or hospital to pay for the supplies and lesion generator.


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painfree23 said:
experience with cool rf? Also, How do you bill for it?
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unnecessary for anything but SIJ RF. If you know what you're doing, you can get any other nerve you need to with an 18G cannulae.

Also, cooled RF lesions are less predictable than discrete standard RF lesions. I reported earlier on this forum of a case of a patient who suffered paralysis of the femoral nerve after cooled hip RF.

And as mentioned, the costs are extreme and most hospitals/ASCs won't cover cooled RF cases anymore
 
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epidural man said:
Yes -

Lots of experience.

Horrible design. Very clunky.

I do it still.

Can't help with billing.
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Bill the same as you would conventional RF. I only use for SIJ, well actually I do some hip and knee cooled RF but try not to. Don't really enjoy those cases. The hip has scared me a little with bedrocks story and risk of puncturing the femoral artery. Had one patient who kept bleeding profusely after I removed the needle from the medial position (obturator branch). I thought for sure I'd hit the femoral artery and was gonna cause some huge hematoma with a subsequent compressive neuropathy or something. Fortunately all went well
 
clubdeac said:
Bill the same as you would conventional RF. I only use for SIJ, well actually I do some hip and knee cooled RF but try not to. Don't really enjoy those cases. The hip has scared me a little with bedrocks story and risk of puncturing the femoral artery. Had one patient who kept bleeding profusely after I removed the needle from the medial position (obturator branch). I thought for sure I'd hit the femoral artery and was gonna cause some huge hematoma with a subsequent compressive neuropathy or something. Fortunately all went well
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Totally agree -

By the way, I suggest you use the US and mark the lateral edge of the nerve and stay lateral to this - then you will never hit the big stuff.
 
Our hospital has one. Bought before I got there.
It kind of sucks. One lesion at a time.
Need to state in the note that there was tissue destruction of 80degrees at the lesion site. The Coolief rep says that even though the probe heats to 60-70degrees, the surrounding tissue hits 80degrees.
I only use it for lumbar RF and knees.
 
My understanding is the cost of the kit is about $600 per use, compared to the standard RF needles which are <$30 each.
 
Agast said:
My understanding is the cost of the kit is about $600 per use, compared to the standard RF needles which are <$30 each.
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Rep told me $ 700 for cooled but that was when it first came out, so maybe a bit cheaper now.

Regular RF needles shouldn't cost more than $ 10-12 each if you look around at different suppliers.
 
powermd said:
Any of you Stryker guys using Venom needles?
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Yes. Exclusively. They report a larger burn area...I do a single lesion per level about 75 percent of the time, never more than two, and I haven't noticed any issues with incomplete lesions yet. N=~100 in past 10 months.

Rep trying to sell coolief just quoted $700 for single and$1300 for three lesion kit. That's the disposables per case. Not to mention the machine is about twice the cost of the Stryker we got a year ago.
 
myrandom2003 said:
any updates on needle pricing for venom?
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ditto on this....patient begging me for hip RF. Plus one of my electrodes is bent too much so i need another one for my Bayliss machine. How much are these things now? I seem to remember them being very expensive.....somewhere around $1200 each is what i remember, but it's been almost 10 years since i bought one.
 
The Baylis cooled RF probe cost is $850 in my area, total impossibility. Baylis only cares about hospital service, hospitals are the only places that can afford this type of ripoff.
 
Do you have any links or pictures for lateral branch nerve blocks for SI joint pain?
 
So you can definitely get the reps from cosman/BoSci, Stryker, Abbott/Neurotherm to set up demo days where they bring in the RF machine for free for you to “try before you buy”. Your stim reps should be able to set this up.

Neurotherm will even put a free RF machine in your office provided you use a certain number of stim and needles. Stuff you would use anyway potentially.

Try that route first for the one off patient

I don’t know if the halyard company will do that though.
 
have had my baylis 4 electrode machine for 10 years....just need a source for new RF electrodes or whatever it is called
 
painfree23 said:
Do you have any links or pictures for lateral branch nerve blocks for SI joint pain?
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I block the sacral ala and then at approx 2 o'clock on the right side S1-4 foramens, and 10 o clock on the left. Sometimes in an especially big patient or challanging sacral foraminae visualization, I will block or burn along the medial edge of the SI joint itself.
 
myrandom2003 said:
So you can definitely get the reps from cosman/BoSci, Stryker, Abbott/Neurotherm to set up demo days where they bring in the RF machine for free for you to “try before you buy”. Your stim reps should be able to set this up.


I don’t know if the halyard company will do that though.
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Everyone does it including halyard. I think venom is around 50 per needle.
 
Paindude11 said:
I block the sacral ala and then at approx 2 o'clock on the right side S1-4 foramens, and 10 o clock on the left. Sometimes in an especially big patient or challanging sacral foraminae visualization, I will block or burn along the medial edge of the SI joint itself.
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how far medial from the SI joint?
 
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