Experience with Intracept.

RoloTomassi

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lobelsteve

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b/l L2-4 facet joints

Axial pain is predominant but some upper buttock and thigh pain, thought it was worth a try

Didn't want to neglect inferior endplate of L1

She doesn't want meds. Thanks
Tough case with a no win situation. I think you did it perfectly.
 
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dipriMAN

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If they were to extend that fusion- it would be 3 additional vertebral levels fused. If successful, she maybe would have 1-2 good years before adjacent level degeneration kicks and this will be a miserable back once again.
Several surgeons in my area do L2-S1 fusion and lami for many patients they see ….. “there’s severe canal stenosis at L4-5, but then there’s a protrusion and mild stenosis up at L2-3 and 3-4, might as well fuse those”.
 

bedrock

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Due to reimbursement issues I now do most cases in outside ASC, make very little on the pro fee side. Make more per hour doing bread and butter.
How low is the reimbursement? Is it clinic low? or just lower than doing ESI/MBB?

I'm interested in helping patients with whatever is appropriate, however if it doesn't reimburse me appropriately I don't plan to offer it myself.

I may refer out some of these patients in the future to a HOPD based physician who does them, though I'm curious just how low is the ASC pro fee?

Do the RVUs make sense for an HOPD employed physician?
 
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RoloTomassi

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How low is the reimbursement? Is it clinic low? or just lower than doing ESI/MBB?

I'm interested in helping patients with whatever is appropriate, however if it doesn't reimburse me appropriately I don't plan to offer it myself.

I may refer out some of these patients in the future to a HOPD based physician who does them, though I'm curious just how low is the ASC pro fee?

Do the RVUs make sense for an HOPD employed physician?
Medicare, pro fee closer to E&M, ASC fee is profitable if efficient, HOPD is nice margin. Commercial is all over the place, can be a loss, can be bank. For Medicare, I do them when I would otherwise be in bed so it's not nothing, and it's a fun procedure.
 

ziggyziggy

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Did my first case today.

It reminds me of when I did my first nucleoplasty. I was so excited. What a great name - was it Dekompressor?

I'm much less enthusiastic this time, however.

Did this case today. Severe axial LBP. Failed RFA. Failed TFESI and ILESI. Stenosis severe but not as bad on axials. If Intracept not an option, and fails SCS, you wouldn't even consider fusion extension? Anecdotal but I'll let you know how she does 2 weeks after L1/2/3 BVNA

updates?
 
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clubdeac

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Now at the end of every MRI report that has modic changes our radiologists make special note of the changes and state they could be amenable to Intracept. They also add their scheduling number to get the patient in for an urgent consult
 
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Agast

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Now at the end of every MRI report that has modic changes our radiologists make special note of the changes and state they could be amenable to Intracept. They also add their scheduling number to get the patient in for an urgent consult
Man, talk about a solution looking for a problem to fix
 
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Over the rainbow
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Now at the end of every MRI report that has modic changes our radiologists make special note of the changes and state they could be amenable to Intracept. They also add their scheduling number to get the patient in for an urgent consult

We're seeing epidemic levels of Modic-related back pain.
 
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