|
|
BCBS and billing for iontophoresis
|
Logged in as: Guest
|
|
Users viewing this topic:
none
|
|
Login  | |
|
BCBS and billing for iontophoresis - August 30, 2006 11:39:00 AM
|
|
|
sabby731
Posts: 8
Joined: August 17, 2006
Status: offline
|
I have recently been told BCBS will no longer reimburse for ionto treatment. Has anyone else heard the same thing? I have found ionto to be very effective and helpful for some patients with localized inflammation and I hate to deny this treatment because of insurance. Has anyone found a solution? Someone suggested to charge "estim" instead when doing ionto because an electrical impulse is still being applied, but this seems deceptive to me and I don't want to get a bad reputation with BCBS. I have also thought of allowing the patient to pay cash to cover the cost of the pads and dexamethasone, but patients often hold off on anything they have to pay for. Any suggestions anyone?
|
|
|
|
|
Re: BCBS and billing for iontophoresis - August 30, 2006 1:28:00 PM
|
|
|
Karie
Posts: 107
Joined: August 14, 2006
From: Wisconsin
Status: offline
|
Hi sabby731,
Many insurances are not paying for it because the literature evidence does not support it's effectiveness. Your right about not wanting to charge the e-stim charge because it is deceptive. When an insurance company states a specific modality is not coverable and you creatively charge it a different way and they catch you doing it, in the very least it's grounds for you to loose your contract.
I don't use it alot, but when I have physicians that are adament about wanting it done, I have the patient get the dexamethasone from their pharmacy. I don't charge for it, because it's not the bulk of how I treat them, so I don't loose much, even though I know the pads are expensive.
Hope this helps!
Good Luck!
|
|
|
|
|
Re: BCBS and billing for iontophoresis - August 30, 2006 3:38:00 PM
|
|
|
drbuddy
Posts: 429
Joined: July 30, 2005
From: Pennsylvania
Status: offline
|
If you're using estim, then why not charge for the estim? It just happens that you are using the dex with it.
|
|
|
|
|
Re: BCBS and billing for iontophoresis - August 30, 2006 7:15:00 PM
|
|
|
Karie
Posts: 107
Joined: August 14, 2006
From: Wisconsin
Status: offline
|
Buddy T DC,
He can't charge e-stim Buddy because BCBS specifically states that it does not cover iontophoresis for him, no matter what code you bill it under. He can loose his contract with BCBS if they request medical record and it's noted that he used iontophoresis and he charged e-stim, it's grounds for at a minimum contract loss. Yes, they do request records from time to time.
|
|
|
|
|
Re: BCBS and billing for iontophoresis - August 30, 2006 7:18:00 PM
|
|
|
drbuddy
Posts: 429
Joined: July 30, 2005
From: Pennsylvania
Status: offline
|
It doesnt cover the ionto, but he still performed estim, right? Seems to be a gray area...
|
|
|
|
|
Re: BCBS and billing for iontophoresis - August 30, 2006 7:31:00 PM
|
|
|
Karie
Posts: 107
Joined: August 14, 2006
From: Wisconsin
Status: offline
|
He isn't doing just e-stim Buddy, he is adding the dexamethasone. The medical record would be indicating that. This is one that you can't be creative with, it is black and white.
|
|
|
|
|
Re: BCBS and billing for iontophoresis - August 31, 2006 1:16:00 AM
|
|
|
SJBird55
Posts: 2438
Joined: May 10, 2004
From: Michigan
Status: offline
|
Buddy, the reason it isn't a gray area is because there is a procedural code for iontophoresis. Since there is a procedural code for iontophoresis and that is what was performed then that is what has to be billed. Billing a procedural code that reimburses at a higher rate than what was performed is considered basically upcoding and is fraudulent.
Sabby, in Michigan, as a provider participating with BCBSM, I have the ability to sign up for an internet based service provided by BCBSM. BCBSM calls this product Web-DENIS. In Web-DENIS I can type in the iontophoresis procedural code and see the payable diagnosis codes that are reimburseable for that particular procedure. I have been paid for that procedure specifically with ICD-9 code 726.10.
|
|
|
|
|
Re: BCBS and billing for iontophoresis - August 31, 2006 2:38:00 PM
|
|
|
jlharris
Posts: 477
Joined: April 12, 2006
From: Nebraska
Status: offline
|
Does anyone have links to literature that points to the effectiveness (or lack there of) of Ionto. As a new grad, I too use Ionto for cases of localized inflammation. If it's just not shown to decrease inflammation I'd like to now so I don't waste my pt's money and time. Thanks.
_____________________________
Jason L. Harris, PT, DPT
My PT Blog
|
|
|
|
|
Re: BCBS and billing for iontophoresis - September 1, 2006 6:52:00 AM
|
|
|
sabby731
Posts: 8
Joined: August 17, 2006
Status: offline
|
You could try medline, or hooked on evidence through the APTA website. I will say that I have had experience with it working. It is probably overused, and should be discontinued if the patient can't tell a difference in pain level, but I have had patients for which it was a miracle drug and helped them tolerate and progress to exercise and normal ADL's.
|
|
|
|
 New Messages |
 No New Messages |
 Hot Topic w/ New Messages |
 Hot Topic w/o New Messages |
 Locked w/ New Messages |
 Locked w/o New Messages |
|
 Post New Thread
Reply to Message
Post New Poll
Submit Vote
Delete My Own Post
Delete My Own Thread
Rate Posts |
|
0.078
|
Printable Version
