Results 1 to 3 of 3

Philosophical Fluoro Question and Rant

  1. #1
    St. Joseph County, Indiana
    Default Philosophical Fluoro Question and Rant
    Medical Coding Books
    Philosophical question: Are they going to eventually bundle fluoro with all pain procedures eventually?

    Rant: I completely disagree with the AMA's bundling of fluoro primarily due to the personal risk associated with fluoro. Pain fluoro is the only radiological service where the physician stands next to the x-ray device. While the physician is shielded with aprons, collars, glasses and even lead-lined latex gloves, the phsyician is still exposed radiation several thousand times a year. Also the physician is personally manipulating and directing the equipment...Not sitting in a dark room hundreds of miles away reviewing films.

    Thank you and good night

    Brock Berta

  2. #2
    Thank you for sharing.

  3. #3
    Denver Colorado
    We need to consider another reason that the AMA included the requirement of image guidance with both the facet joint injection and transforaminal epidural injection codes...

    The utilization / frequency of both of these codes sets have ESCALATED in recent years. Both of these procedures have been on the OIG Work Plans in the last few years with corresponding reports that showed abysmal error findings. There have been many claims reviewed that these procedures were being performed WITHOUT any image guidance, mostly by providers who were trained in a weekend course and don't have / can't get access to either fluoroscopy or CT for image guidance and localization. Often this technique is referred to as "blind" or anatomically guided. Typically the providers performing these procedures without image guidance are not pain management specialty providers but they get paid just the same as those providers that do verify their needle placements. In many cases, during the rewiews, these procedures were determined to more likely be either trigger point injections or other peripheral nerve injections at best, but again the providers that were not using image guidance got paid just the same as our pain mangement providers.

    One mechanism to require the use of image guidance for these procedures was to change / revise the code descriptors, in that if the injection procedure was performed without image guidance, it would not be compliant to report these codes. Payer review could consider it to be fraudulent billing if a provider billed these new / revised codes when they were performing these procedures via a "blind" / anatomic guidance technique.

    The change in RVU for these codes was in part based on the information obtained from practice surveys regarding physician work and practice expense currently associated with these procedures.

    I agree with your sentiments regarding the changes but we also need to hold those practices accountable that are driven purely by revenue and report procedures non-compliantly.

Similar Threads

  1. Fluoro Help PLEASE!
    By meganbruce in forum Employment General Discussion
    Replies: 3
    Last Post: 05-04-2015, 09:56 AM
  2. Fluoro question
    By in forum Interventional Radiology
    Replies: 1
    Last Post: 12-12-2014, 03:25 PM
  3. question on fluoro guidance
    By Anna Weaver in forum Anesthesia
    Replies: 5
    Last Post: 05-15-2009, 07:59 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.