For CPT codes 36902 and 36905, quality measures listed for MIPS are:

measures   FLUORO recorded with dose: 145

                    Venous Thromboembolism Prophylaxis:  23

                    Antibiotic Prophylaxis:   21

                     Calculation of surg risk:  358

Measures 23 and 21 seem irrelevant for 36902 and 36905.  If you use these measures for these cases, you will check off "exempt" for each case you don't use prophylaxis.  You can get points for this, but in order to score a full number of points, you have to do at least 20 cases of prophylaxis for each measure.  Is anyone actually doing this?  Does anyone know why these measures are even linked to these CPT codes?  We have been in touch with CMS and they are silent on "why".  They simply state how they are used and how they score.

I routinely use 145 and 358.  But I need he other two measures to achieve compliance with the number of required measures.

Thoughts?

Thanks,

GMGaylord MD FSIR

Dear all,

Wanted to check in with members of the ASDIN community regarding the use of trialysis catheters in the hospital. Does anyone have specific policies/procedures regarding indications for placement and maintenance of these catheters? They are convenient in those patients in whom access sites are limited, but are there potential downsides to their use?

1. Are there any reports of increased infections, given that the third lumen is typically accessed for central venous access/infusions?

2. Any flow concerns? Though they are typically the same in diameter as temporary HD catheters (12-14 Fr), given that  there are now three ports instead of two, the individual diameters of each would be decreased, and may hypothetically result in flow limitations.

3. Any recommendations for routine care/maintenance including saline/heparin locks?

Thanks in advance for your input. 

I was just notified by my billing company that one of our major private carriers (UHC) is bundling the 36902 code with 36581 for all their patients. Thus they are denying the 36902. Has anyone else run into this problem and how did you resolve it. I have scheduled a physician to physician conference call with the medical director to express my disagreement with there ruling. I would love to hear anyone else’s similar experience.

Best Regards R Kris Ellis MD FASN, FASDIN

Does anyone know if you can use a PA as the interventionalist at an extension of practice?

Wondering if the MD has to be present at the facility when the procedure is being performed, like a dialysis visit in the hospital when the pt is on the machine.

I’ve seen other units use PA’s in this fashion with the PA being the person completing the entire procedure but there is always an MD on the premises.

Lastly, if the procedure can be billed under the PA do you only get 80% from CMS?

Thanks in advance.