DiscoCare and Arthrocare

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Still in flux, still in litigation. It appears that part of the issue is coding as 63056 when the only appropriate code is 62287....
 
I went down to one of the Arthrocare courses. I have to say I left feeling like the whole thing was a bit shady. First off, they promise to take over the billing for you...just tell them the cases you want to do and they guarantee your reimbursement. When I told them I wasn't comfortable with that, they talked about all of the failures when providers didn't work through their billing service. Then at the talks, they practically encourage you to make a small skin incision prior to inserting the device, "then you can bill it like an open discectomy". Are you kidding? Maybe that satisfies the letter of the law, but I sure don't want to be defending myself for that practice...

I haven't done a nucleoplasty, excuse me a plasma disc decompression, since training and the more stuff like this that comes out makes me think that will continue.
 
I am on the coding committee of a large spine organization that shall remain nameless, and the straw poll is that 62287 is the only code acceptable for plasma disc decompression.
 
wow.....am i glad i left that practice years ago. I know some of the guys deposed and spoken about. Best thing that ever happened to me.

T
 
Stryker is behind all this negative propoganda.
 
The website reported above was brought to my attention by a reporter for a surgery journal. There was no apparent affiliation of this individual with any other industry company...
 
I doubt Stryker has anything to do with this.....these guys were milking it....i read the depo last night. Arthrocare/discocare was trying to hire attorneys and form a network with doctors where everyone received the procedure. I know some of the guys mentioned and they were slimeballs.....there is a reason i left in early 2004. It was my first job out of fellowship and i learned alot, i was green, but it was a factory. They were billing 3 level discograms too(some received it....some didnt). This is one of those "karma" deals. But i dont think Stryker is doing anything besides enjoying the bad press for Arthrocare.

T
 
if you guys ever met an arthrocare rep then this shouldn't come as a surprise...
 
But agreed on the slimeball thing. I had a rep come in just a week ago and tell me has was trying to form a network with lawyers in NY and if I wanted in on the action.
What they do in Connecticut is they have the pain doc do the discogram and bring in a neurosurgeon to do the nucleoplasty portion and bill as a discectomy. This one group was doing 3-4 car accident patients a week.
Pain doc gets discogram fee and first surgical assist.
 
i have an acquaintance who does just that:

he gets the cannulas placed (usually 3) - injects a drop of dye - bills for discogram

the surgeon walks in, makes a little incision, does his deal and bills for a 3 level micro-discectomy (!)...

this usually orchestrated w/ work.comp. or personal injury lawyer - he and surgeon make over 10-15k for this 45 min procedure

it is absolutely disgusting - you have 2 pain doctors, a lawyer and arthrocare all in on it...
 
Now I know this forum is truly biased, with the same MD's making comments on everything and anything, without any real substantive info. Let me set the record straight, kinda like Bill O'rielly does when MSNBC spins the Obama ticket.

When physicians, like myself, see PI patients they go through a series of treatment options, including; PT, chiro, antiinflammatories, Tramadol, meds, traction, CBT, epidurals, and so forth. If they continue to have pain for over 3-4 months duration and want some long-term treatment for their disc pathology (so they can settle a case in a reasonable time frame) the options are limited to disc decompression, formal surgery, or dealing with it.

Not everybody wants to be on 300mg of lyrica or 60mg of Oxycontin for the rest of their life. Obviously most spine issues improve with time, and most disc decompression procedures are occuring after at least 6-9months. I guess if everybody goes to Dr. Tenema's office, and receives one epidural, motrin, lidoderm patch, and a slap on the back, every one would be better. But in the real world, PI can work just fine. Patients have to be treated and if one remains ethical, PDD procedures are legit.

So stop making bogus statement, like MD's get 10K per case, etc. I have never seen this, the procedure is covered under commercial insurance/Medicare. And by state law one must submit a 62287 to commercial insurance first, before an attorney can make a pay-out.

If discocare is doing something unethical, then that is on them, but don't critique MD's, when you don't have a clue.

😛
 
Now I know this forum is truly biased, with the same MD's making comments on everything and anything

I'm not biased, I hate everybody and everything equally... 😀
 
stim4u --- sorry to correct you but workman's compensation in some states is sooo lax that you can negotiate your procedures and your bills and get paid quite well - unfortunately for the rest of us, that no longer is an option... maritime insurance doesn't even negotiate and legally has to pay whatever gets charged (unbelievable - but true)...

PDD ain't legit for discogenic pain - not yet at least.... it is legit for radicular pain...

i can critique MDs who tell me that they do these procedures because of the money and the continued referral stream from PI lawyers/Spine-surgeons, and still admit that the procedure doesnt' work...
 
I doubt Stryker has anything to do with this.....these guys were milking it....i read the depo last night. Arthrocare/discocare was trying to hire attorneys and form a network with doctors where everyone received the procedure. I know some of the guys mentioned and they were slimeballs.....there is a reason i left in early 2004. It was my first job out of fellowship and i learned alot, i was green, but it was a factory. They were billing 3 level discograms too(some received it....some didnt). This is one of those "karma" deals. But i dont think Stryker is doing anything besides enjoying the bad press for Arthrocare.

T


Since i was asked about this, i think i should clarify my post above. My personal comments about "slimeballs" was directed at individuals from my previous job M and GC who were mentioned in the deposition pdf file. Then i jumped back into what i read in the deposition.....about 3 level discos being done or not. I actually like the Arthrocare procedure, but as most disc procedures, i wish we had more research.

T
 
Does anyone know anything about the PPD Wand? I hear that doctors are charging $7,500; it that reasonable?
 
if you are a LAWCrawler then i would recommend a charge of $300,000 per level and make you guys pay it upfront - before the procedure
 
I havent done a nucleoplasty since 2006, but I'll tell you the only rep that was ever slimier was the Smith and Nephew rep in my area. They really turned me off to their company. I have stuck with stryker since then... But then again, i do like 5 of these a year.
 
i guess im out of the loop, but when did they change the name to "plasma disc decompression?" Is this what they did so they could bill 62287...
 
i guess im out of the loop, but when did they change the name to "plasma disc decompression?" Is this what they did so they could bill 62287...

My understanding was that the reps were not saying to bill it as 62287, but rather 63030 by using an 11 blade on the kin to allow the easier insertion on the canula.
 
My understanding was that the reps were not saying to bill it as 62287, but rather 63030 by using an 11 blade on the kin to allow the easier insertion on the canula.


unbelievable
 
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