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Ultrasound in rheum- worth it?

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Dr. Gogu

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There's been a lot of talk about ultrasound for rheumatologists. Since most of the rheumatologists I've met do not use it, do you think it's worth the money and effort to get certified? We have a machine in clinic and it just takes a significant amount of time to set it up and in the end you get a hazy picture that you have to be ridiculously good at reading to tell what it means. So I have a hard time picturing how useful it would be in daily practice in a busy clinic (I am a fellow currently).

Another question: does it provide extra re-imbursement? If so, how much? e.g. a traditional knee injection vs US-guided.

Thanks.
 

bronx43

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There's been a lot of talk about ultrasound for rheumatologists. Since most of the rheumatologists I've met do not use it, do you think it's worth the money and effort to get certified? We have a machine in clinic and it just takes a significant amount of time to set it up and in the end you get a hazy picture that you have to be ridiculously good at reading to tell what it means. So I have a hard time picturing how useful it would be in daily practice in a busy clinic (I am a fellow currently).

Another question: does it provide extra re-imbursement? If so, how much? e.g. a traditional knee injection vs US-guided.

Thanks.
You're about 5 years late on this. Ultrasound reimbursement got gutted several years ago, and now they pay barely anything at all. You used to get paid $200+ for a complete scan, but now you're lucky to get half that. If you use an US to guide an injection, you get like $35 more than a blind injection. With that said, a machine may still be useful if you have high volume procedures, since that $35 does add up. You can also scan to evaluate arthralgia/arthritis, which will be more revenue.
 

bronx43

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How about reading Dexa scans to increase income?
It's not bad, but it's not the road to riches. You get some wRVU for dexa but the majority of your compensation will be patient volume in the form of E&M coding (which can be fairly lucrative if you know how to do it well).
 

Successor12

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Can you elaborate more on the how to do it well part?
And as a first year fellow what skills do I need to pick up to achieve this?
 

bronx43

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Can you elaborate more on the how to do it well part?
And as a first year fellow what skills do I need to pick up to achieve this?
I mean it's just knowing how much you need to bill level 4s. A lot of people underbill and leave a substantial amount of money on the table. It's too complex to type out the rules but I'm sure all your attendings have a billing guide.
 
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