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i just found out that my group is the last group that does bone marrow biopsies in my city. At the other hospitals the radiologists do it with CT guided imaging. Should we quit doIng it?
I stopped doing them about 20 years ago. In my experience the orthopedist have no idea what constitutes a "normal" needle core box and aspiration with a jams hide. Educate them or have a tech in the OR or you may get crap.i just found out that my group is the last group that does bone marrow biopsies in my city. At the other hospitals the radiologists do it with CT guided imaging. Should we quit doIng it?
We do them. Radiologist wanted more procedures so we gladly handed them over. They are picky about NPO (due to sedation) and late/weekend marrows, so I get requests now and then from Oncs and other docs for same day biopsies. Straightforward, but time consuming. They do CT guided biopsies which is the trend but needless if you know your anatomy.
i just found out that my group is the last group that does bone marrow biopsies in my city. At the other hospitals the radiologists do it with CT guided imaging. Should we quit doIng it?
They are radiologists. When your only tool is a hammer.....The ultimate in waste is a CT to identify the palpable posterior superior iliac crest.
I learned within weeks of my first job procedures were the bane of any high efficiency pathologist. Autopsies, bone marrow procedures and FNA (either attending them in interventional rads or doing them solo) are EPIC time sinks. I was able to jettison this dark triad after a year or so of concerted effort.
We don't perform them and the senior members in my current and former groups stopped doing so 20+ years ago. Once it's ordered, the patient would require a heme-onc consult anyway, so they just do it themselves. It is certainly a dying breed for pathologists. I don't know if the reimbursement for doing the procedure would justify continuing them in your practice. But if your hospital has always expected the pathologists to perform them, it may be difficult to pawn off to heme-onc or rads. Again, this is probably reimbursement dependent. I think this statement about doing them sums it up pretty well..
I think I'm stuck doing bone marrow biopsies: I've done them for 17 years and the heme-oncs and rads don't want to do them.
Stickyshaft,The procedure still pays OK, and it generates spinoff revenue for us (flow, ipox), but it's the time suck, really. I'm also the only pathologist at my hospital, so when I'm doing a bone marrow, I'm stuck for 30-45 minutes and unavailable for other things, e.g. frozen sections, FNA adequacies.
I can’t even convince my patients to get a BM Bx for free sometimes, who the hell is paying $16k cash for itResurrecting an old thread rather than starting a new one.
For those of you who still perform BMBx's, what do you get reimbursed?
I recently became aware of a hospital system in a formerly rural area (now overrun with California transplants), where the biopsies are done by radiology. In the hospital. With CT guidance. Under conscious sedation. At a cost of $16,000 if you're paying cash, or around $6300 if you go through insurance. Oh, and it's an all-day affair, thanks to the anesthesia.
This seems an outright scam to me, if not an opportunity. During my days as a real pathologist, we'd do these with local anesthesia and a lot of encouragement for the pt. Had them in and out in about an hour. What's stopping someone from setting up a bone marrow clinic and charging 2500-3000 in cash for the procedure? Is the collusion between insurers and hospitals that bad?
That $6300 is what is charged, not collected by physicians. And, I would think the vast majority of patients go through insurance vs paying $16K out-of-pocket. If the patient is still paying $6300 thru insurance, that's one heckuva cut by the insurance companies.At a cost of $16,000 if you're paying cash, or around $6300 if you go through insurance.