I have a question regarding billing procedures.  How do you bill for
Transcranial Imaging studies when performed on a daily basis . Sometimes
we'll do over 30 studies for vasospasm monitoring and I'm sure our
compensation is not sufficient.
                                                      Thanks,
                                                                Tom
Rosendahl, RN BS RVT
                                                                  Cedars-
Sinai Medical Center
                                                                      Los
Angeles
> ----------
> From:         kathryn sorrell4[SMTP:[log in to unmask]]
> Reply To:     UVM Flownet
> Sent:         Tuesday, November 19, 2002 6:28 PM
> To:   [log in to unmask]
> Subject:      Re: Transcranial Doppler
>
> we started TCD in 1987 or 88 with the "blind" pulsed TCD systems and
> converted
> to color duplex TCD in the early 1990's - have never looked back nor
> regretted
> the switch to the imaging modality.  TCD performed by a duplex system is
> equally sensitive (once you get over the training hurdles) and much more
> reassuring to the performing technologists.  There are bony and soft
> tissue
> landmarks which make identification of the intracranial arteries more
> certain
> and reproducible.  It's much easier to teach new techs the technique
> because
> they can see landmarks where they can direct their search.  That
> said....it
> does take a command of color doppler to perform these studies effectively;
> specifically, the technologist should have excellent knowledge of the
> secondary
> and tertiary color doppler controls so they can optimize visualization of
> blood
> vessels where acoustic windows are limited.  Side benefits of the imaging
> technique include visuzlation of some aneurysms, AVM's, 3-D images of
> vascular
> structures (newer software) and other general brain pathology.  I believe
> most
> major ultrasound vendors sell a low frequency 2 - 2.5 mhz phased probe
> with
> software on board to perform TCD.  I certainly woulnd't invest in a
> dedicated
> non imaging system unless you need it for extended TCD monitoring or don't
> have
> sufficient duplex systems to cover your TCD demand.  Make sure you have
> the
> proper software on the duplex system to perform the time averaged "peak"
> mean
> value.  This is different from the time-averaged velocity which many
> systems
> calculate as part of volume flow calcs.
> Kathryn
>
> "John K. Jain" wrote:
>
> > Hello Friends, Colleagues and Fellow Countrymen,
> >
> > I have a technical question for you all. Is there anyone who is doing
> > transcranial with only a duplex scanner? If so what frequency transducer
> > are make/model of equipment are you using.
> > Our old transcranial machine went to the boneyard years ago and without
> > ever having a significant volume of patients to justify replacing it we
> let
> > the program go. Now of course there are new nuerosurgeons who are
> banging
> > the TCD drum and I am trying to evaluate our options.
> >
> > Thank you  ahead of time for your help,
> >
> > John K Jain
> >
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