Hi Teresa,

We're Magic 5.5, but I think the issues are probably the same. We have
had our hospitalists doing 2-day Cardiolyte studies (as well as some
other Nuc Med studies such as Indium scans and thyroid uptake and scans
that sometimes span 2 to 3 days) for quite some time now. Our stress
test protocols call for a 2-day study if a male exceeds 250# and a
female exceeds 200#. Our schedulers book using a set with the same
account number, because the second day is a continuation of the same
study.  The hospitalist who performs the stress test dictates a report
for the treadmill (or Persantine stress test), and then after the Nuc
Med part of the study is completed and resulted, the consulting
cardiologist dictates an imaging report. We bill under one account
number for the Myocardial-SPECT-Multiple (78465), the perfusion with EF
(78480), the stress test (93015) and then the
isotopes/radiopharmaceuticals. We have never had an issue with using
only one visit number......I could go on, but if you have any specific
questions, I'd be happy to try and help.

 

Julie Carlson

Meditech Systems Analyst

Cascade Valley Hospital and Clinics

330 S Stillaguamish

Arlington, WA  98223

(360)435-2133 ext 5017

[EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]> 

 

________________________________

From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Zydonik, Teresa
Sent: Thursday, November 16, 2006 11:00 AM
To: [email protected]
Cc: Crawford, Kim; Shaffer, Stephen; Costan, William; Hawley, Lisa
Subject: [MEDITECH-L] Cardiolyte Stress Tests that follows a 2 day
protocoldue to obese patients

 

Meditech L Users, 

We are a C/S 5.4 Rel 3 version of Meditech. 

 

My Radiology and Cardio Staff are in need of some answers and would like
to know how other hospitals are handling the following:

 

How is everyone handling when an obese patient is to receive a
cardioloyte stress test/MUGA Scan? 

According to our Cardiologists these type of patients would need to
follow a 2 day protocol.  The first day the patient would have a resting
nuclear study with injection.  The second day the patient will return to
Cardio for a stress test and will follow up with another nuclear study
with injection.  In the past these studies were able to be completed in
one day and the codes were 78465 Multi Study with 78478 Infraction and
78480 Wall Motion along with the Stress Test Code and contrast media.

Scheduling/Admission  Module 
The schedulers would need to book to different accounts numbers since
this is over a two day span.  This could be handled in the SCH module by
asking the patient their weight and if they are obese then the schedule
must remember to book two appointments.  We currently have these
appointment types set up as a SET.  I am not aware of any system
functionality that the system would create 2 accounts based upon a set.
So this would have to be a manual trigger based upon the weight of the
patient.  

BAR Module 
The revenue codes associated to these procedures are unable to be billed
as a Recurring (RCR) account thus creating the need for a 2nd account
number for the 2nd day of the protocol. Therefore, we would need to bill
two separate procedure charges under 78464 for each day with the
coinciding 78478 and 78480 along with the injections.

How is anyone else handling this billing? 

ITS/Report Issue. 
The Cardiologist will then need to dictate a two day protocol report
associated to the first day Account.  You can only associate the req seq
numbers from the first Account.  You can not associate the second day
rec seq numbers because they are on a different account  and the doctor
does not want to dictate two reports.  The only option I see would be to
copy the report that is associated to the 1st account before it is
signed and add it to the second day account which would make the
Cardiologist sign this report twice.

Does anyone have a different solution to this type of protocol?  

Any help would be greatly appreciated. Thank-you in advance. 

 

Teresa Zydonik 
I.S. Director 
ACMH Hospital 
One Nolte Drive 
Kittanning,PA 16201 
(724)-543-8594 - Phone 
[EMAIL PROTECTED] - Email 

(724)-543-8535 - Fax 




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