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If your doctor offers a billable (swelling, pain...) indication for the venous exam, it's not fraudulent (even if you think the indication is bogus after taking the patient's history).  If I get requisitions without a billable indication (ie: rule out DVT), I will bother the requesting doctor to choose a billable indication and resubmit the requistion(it helps avoid the issue next time).

 Matt

-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Phil White
Sent: Thursday, May 27, 2010 16:26
To: [log in to unmask]
Subject: Fraudulent Claims

Dear FLO-

Can anyone help me with specific rules regarding the responsibility of a
vascular technologist to make sure inappropriate exams are not billed to
Medicare or other insurers?  

Specifically, the ED department has stated and that they will order a Venous
study on everyone who comes to the ED with a leg or toe complaint, so they
do not miss a DVT.  This has been in effect for quite some time and the
increase in venous studies have doubled.  We have all experienced how
frustrating it is to be called in for silly stuff but now it kick up to a
new level.

I feel this is entering into the bizarre world and there is no end to it
except to explain to them this is fraudulent.

Thanks

Phil White BS RVT

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