We only bill for the graft flow unless the contralateral limb has new
symptoms or other indication, then we will also perform an indirect test
with waveforms etc and will bill for the additional test. It is my
understanding that you must have appropriate indications for each test and
the documentation showing the written orders and indications from the ref.
MD must be on the chart when HCFA comes to audit you.

I was at a meeting last weekend where a Technologist told me that the
radiologists that she works for insists that she perform a complete
bilateral arterial duplex and full segmental Pressures and waveforms and
bill for both complete tests on ALL arterial exam patients regardless of
their history or orders. (food for thought if you have a radiology lab
telling your hospital admin that they make more money than the lab in
vascular and therefore should be the ones running it!) When I asked her what
the reimbursement was for those tests at her facility - she had no clue. I
am positive that this is NOT what HCFA had in mind for Medicare
reimbursement.  Medicare pays all upfront, BUT they come after you later
with the audit (you pay back at that time plus HUGE penalties).  Here in
California the PPO's are the least likely to pay without harrassment. HMO's
and PPO's do not have to pay you, and usually don't, without badgering and
sending 3 or 4 requests and documentation. A very very costly process that
causes additional loss of revenue.  Some labs I have talked with actually
just write it off because it is too expensive to go through the process of
collecting and the HMO's and PPO's are aware of this and appear to be taking
advantage of it.  bj

Bonnie L. Johnson RDMS, RVT, FSVT
Stanford Medical Center
Director, Vascular Laboratory Services
Division of Vascular Surgery
Stanford, CA


-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]]On Behalf Of Michel
Comeaux
Sent: Wednesday, April 12, 2000 11:08 AM
To: [log in to unmask]
Subject: Re: Graft follow-up


Bill,

We don't charge for the ABI only the duplex.

Michel Comeaux
New Iberia, La.

-----Original Message-----
From:   Bill Schroedter [SMTP:[log in to unmask]]
Sent:   Wednesday, April 12, 2000 9:50 AM
To:     [log in to unmask]
Subject:        Graft follow-up

Hi, Was talking with a colleaque and a question arose about the routine
post-op
follow up of lower extremity bypass. It would seem that imaging has become
pretty much the standard along with an ABI. (I am talking about obtaining
waveforms at the ankle here in addition to obtaining the pressure.) Our
question
was, how many of you charge for the physiologic component in addition to the
duplex charge? Those that charge for both, any problems with payment??
Thanks.

Bill Schroedter
Venice,Fl.