Ultrasound vs Fluoroscopy

[ampaphb]

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What percentage of interventional spine docs, would you guess, will continue doing ultrasound guided spine procedures once CMS reduces the value of 76942 (currentlly paying $175-200) to rates similar to fluoroscopicly guided procedures (77003, reimbursed at between $75 and 100)?

 

[Louisville04]

I'm sure you meant that as a rhetorical question. I think the vast majority of ultrasound guided injections are peripheral joints, soft tissues.

 

[RUOkie]

What percentage of interventional spine docs, would you guess, will continue doing ultrasound guided spine procedures once CMS reduces the value of 76942 (currentlly paying $175-200) to rates similar to fluoroscopicly guided procedures (77003, reimbursed at between $75 and 100)?

Bogduk claims it is easier for him to do cervical facets under US. Personally I can't see it, but he has a lot more experience.

I expect that the codes in 2015 will be bundled so that all peripheral and axial injections will be paid "with image guidance" and it will be up to the physician to choose the appropriate modality.

For example, hips were always done with Fluoro, but now the standard is US.

 

[Taus]

Bogduk claims it is easier for him to do cervical facets under US. Personally I can't see it, but he has a lot more experience.

I expect that the codes in 2015 will be bundled so that all peripheral and axial injections will be paid "with image guidance" and it will be up to the physician to choose the appropriate modality.

For example, hips were always done with Fluoro, but now the standard is US.

That's the first I've heard that US is "the standard" for hips. I really don't intend to sound rude, but what qualifies US as the standard vs fluoro?

 

[RUOkie]

That's the first I've heard that US is "the standard" for hips. I really don't intend to sound rude, but what qualifies US as the standard vs fluoro?

Sorry about that. I misspoke (no coffee). Not standard, but equivalent. And most people I know (both PM&R and ortho) who have ever used an US machine use it for hips. Since a hip injection with US is incredibly easy and never needs sedation.

 

[Taus]

Sorry about that. I misspoke (no coffee). Not standard, but equivalent. And most people I know (both PM&R and ortho) who have ever used an US machine use it for hips. Since a hip injection with US is incredibly easy and never needs sedation.

Thanks for clarifying- that makes sense. As for me, who has minimal US experience, ill have to stick to fluoro, which fortunately I can do very quickly and easily for hips. I hope to add some US skills in the near future when I can afford the courses.

 

[nvrsumr]

Sorry about that. I misspoke (no coffee). Not standard, but equivalent. And most people I know (both PM&R and ortho) who have ever used an US machine use it for hips. Since a hip injection with US is incredibly easy and never needs sedation.

I've had us guided hips denied this year by workers comp. Did with Fluoro instead.

 

[RUOkie]

I've had us guided hips denied this year by workers comp. Did with Fluoro instead.

interesting.

I've never had a U/S denial (for any joint or any insurer). I wonder who the reviewer was (ortho vs. PMR).

 

[nvrsumr]

PM&R. Weekend injection training and private practice "fellowship" now considered by himself as the "best" in town. haha

He's ******ed but I'm too busy to fight the system

 

[Gauss]

I've had us guided hips denied this year by workers comp. Did with Fluoro instead.

funny I've had the opposite happen, fluoro denied once they saw ASC costs.