Guest guest Posted July 15, 2006 Report Share Posted July 15, 2006 Re on line supplies. Vaccine shop -- got same for $25, outlet for Sanofi Pasteur. Can buy online, they'll invoice you and email notify when drop shipped. Discount for purchase on line -- only way to get Menactra for us at best price, sorry, have to buy 5 at a time :-( for about $410. Found local middlemen just could not match their prices. Matt Levin, MD Pittsburgh, PA Re: re PPd > Thank you to whomever mentioned that the PPD MDV needs to be discarded > after 30 days... somehow I never knew that! I've been vaccine shopping > and found something on esurg.com that may be of interest. It looks > like SDV! Yippee! See: > Tubersol Tuberculin PPD 5TU 10-Test 1mlx1ml EA Caution Aventis > Pasteur 04928-1752-21 EA $30.69 > Now that makes sense (if I've read it correctly)... no waste! > > >> >> I get aplisol from PSS. It is about $30. If I don't use the rest, > I just >> take it as a cost of doing business. >> > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 15, 2006 Report Share Posted July 15, 2006 Re on line supplies. Vaccine shop -- got same for $25, outlet for Sanofi Pasteur. Can buy online, they'll invoice you and email notify when drop shipped. Discount for purchase on line -- only way to get Menactra for us at best price, sorry, have to buy 5 at a time :-( for about $410. Found local middlemen just could not match their prices. Matt Levin, MD Pittsburgh, PA Re: re PPd > Thank you to whomever mentioned that the PPD MDV needs to be discarded > after 30 days... somehow I never knew that! I've been vaccine shopping > and found something on esurg.com that may be of interest. It looks > like SDV! Yippee! See: > Tubersol Tuberculin PPD 5TU 10-Test 1mlx1ml EA Caution Aventis > Pasteur 04928-1752-21 EA $30.69 > Now that makes sense (if I've read it correctly)... no waste! > > >> >> I get aplisol from PSS. It is about $30. If I don't use the rest, > I just >> take it as a cost of doing business. >> > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 15, 2006 Report Share Posted July 15, 2006 Re on line supplies. Vaccine shop -- got same for $25, outlet for Sanofi Pasteur. Can buy online, they'll invoice you and email notify when drop shipped. Discount for purchase on line -- only way to get Menactra for us at best price, sorry, have to buy 5 at a time :-( for about $410. Found local middlemen just could not match their prices. Matt Levin, MD Pittsburgh, PA Re: re PPd > Thank you to whomever mentioned that the PPD MDV needs to be discarded > after 30 days... somehow I never knew that! I've been vaccine shopping > and found something on esurg.com that may be of interest. It looks > like SDV! Yippee! See: > Tubersol Tuberculin PPD 5TU 10-Test 1mlx1ml EA Caution Aventis > Pasteur 04928-1752-21 EA $30.69 > Now that makes sense (if I've read it correctly)... no waste! > > >> >> I get aplisol from PSS. It is about $30. If I don't use the rest, > I just >> take it as a cost of doing business. >> > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 16, 2006 Report Share Posted July 16, 2006 Maybe no waste, but when I was doing PPDs (I stopped) I was only getting paid about $8-14 by most payers, so if I bought the 5 dose vial for about $40 and used it all, I would break even. Problem was not using it all. If you have to pay $30 for SDV, but collect less than half that, you are still in the hole.. Am I missing something here? Annie Re: re PPd Thank you to whomever mentioned that the PPD MDV needs to be discarded after 30 days... somehow I never knew that! I've been vaccine shopping and found something on esurg.com that may be of interest. It looks like SDV! Yippee! See: Tubersol Tuberculin PPD 5TU 10-Test 1mlx1ml EA Caution Aventis Pasteur 04928-1752-21 EA $30.69 Now that makes sense (if I've read it correctly)... no waste! > > I get aplisol from PSS. It is about $30. If I don't use the rest, I just > take it as a cost of doing business. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 16, 2006 Report Share Posted July 16, 2006 RE cost per item vs absorption. If you get $50+ for the physical, you need to decide how much to absorb to get the pt in the door. Everyone has their own setpoint for providing in office testing -- I do in office EKGs and Spirometry, yet others say "why bother?" I've picked up several cases of a fib in my office and have happy, loyal pts from such dx that I would have missed if sending to hosp for an EKG. Spirometry for bronchitics, acute asthma also doesn't pay much, but now I've paid for the machine so extra money is useful for me. I've decided NOT to do rapid streps (neither does our ER or any local lab, by the way) as the cost to do the standards and normals would eat up any possible profit, and would rarely make a difference in my treatment plan -- many ins plans wouldn't pay anyway. So I've sent off 1 strep culture in the last month or so, negative anyway. Everyone has their priorities and some accept loss for encouraging business. For me, I'll eat the cost of a PPD, and get about $95-100 for the annual physical. Just need to keep on top of this, and thanks for sharing. Dr Matt Levin RE: Re: re PPd Maybe no waste, but when I was doing PPDs (I stopped) I was only getting paid about $8-14 by most payers, so if I bought the 5 dose vial for about $40 and used it all, I would break even. Problem was not using it all. If you have to pay $30 for SDV, but collect less than half that, you are still in the hole.. Am I missing something here? Annie -----Original Message-----From: [mailto: ] On Behalf Of docboopsSent: Friday, July 14, 2006 7:54 PMTo: Subject: Re: re PPd Thank you to whomever mentioned that the PPD MDV needs to be discardedafter 30 days... somehow I never knew that! I've been vaccine shoppingand found something on esurg.com that may be of interest. It lookslike SDV! Yippee! See:Tubersol Tuberculin PPD 5TU 10-Test 1mlx1ml EA Caution AventisPasteur 04928-1752-21 EA $30.69Now that makes sense (if I've read it correctly)... no waste! >> I get aplisol from PSS. It is about $30. If I don't use the rest,I just> take it as a cost of doing business.> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 16, 2006 Report Share Posted July 16, 2006 I agree with you, sometimes you have to lose some in order to win later. I don't do strep either and I have a terrible EKG machine (a second hand of a second hand) but it saved my life twice in six months. For example, I discount school physicals A LOT and the parents become my patients so it saves me money for advertising. > RE cost per item vs absorption. >  > If you get $50+ for the physical, you need to decide how much to > absorb to get the pt in the door. >  > Everyone has their own setpoint for providing in office testing -- I > do in office EKGs and Spirometry, yet others say " why bother? " > I've picked up several cases of a fib in my office and have happy, > loyal pts from such dx that I would have missed if sending to hosp for > an EKG. > Spirometry for bronchitics, acute asthma also doesn't pay much, but > now I've paid for the machine so extra money is useful for me. >  > I've decided NOT to do rapid streps (neither does our ER or any local > lab, by the way) as the cost to do the standards and normals would eat > up any possible profit, and would rarely make a difference in my > treatment plan -- many ins plans wouldn't pay anyway. So I've sent > off 1 strep culture in the last month or so, negative anyway. >  > Everyone has their priorities and some accept loss for encouraging > business. For me, I'll eat the cost of a PPD, and get about $95-100 > for the annual physical. >  > Just need to keep on top of this, and thanks for sharing. >  > Dr Matt Levin >> Re: re PPd >> >>  >> >> Thank you to whomever mentioned that the PPD MDV needs to be discarded >> after 30 days... somehow I never knew that! I've been vaccine shopping >> and found something on esurg.com that may be of interest. It looks >> like SDV! Yippee! See: >> Tubersol Tuberculin PPD 5TU 10-Test 1mlx1ml EA Caution Aventis >> Pasteur 04928-1752-21 EA $30.69 >> Now that makes sense (if I've read it correctly)... no waste! >> >> >> > >> > I get aplisol from PSS. It is about $30. If I don't use the rest, >> I just >> > take it as a cost of doing business. >> > >> > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 17, 2006 Report Share Posted July 17, 2006 Sorry for the subject change ...but ...Is anyone currently using Epocrates? If so could you tell me pros and cons about it? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 17, 2006 Report Share Posted July 17, 2006 Curious about your thoughts on rapid strep tests (RST). What do you mean that standards would eat up any profit? I go through one box of tests & then buy a new one. What controls are you referring to? Also, why would the RST results not change your treatment? It totally changes mine. If a sore throat “looks more viral” and the RST is negative -àno abx. If the RST is positive, no matter how the throat looks-àabx. I have never seen an insurance company deny the RST, even Medicaid pays pretty well for it here. On the contrary, a throat culture would serve very little usefulness in my eyes as it takes too long to get back. I order a TC maybe once per year. Re: Re: re PPd RE cost per item vs absorption. If you get $50+ for the physical, you need to decide how much to absorb to get the pt in the door. Everyone has their own setpoint for providing in office testing -- I do in office EKGs and Spirometry, yet others say " why bother? " I've picked up several cases of a fib in my office and have happy, loyal pts from such dx that I would have missed if sending to hosp for an EKG. Spirometry for bronchitics, acute asthma also doesn't pay much, but now I've paid for the machine so extra money is useful for me. I've decided NOT to do rapid streps (neither does our ER or any local lab, by the way) as the cost to do the standards and normals would eat up any possible profit, and would rarely make a difference in my treatment plan -- many ins plans wouldn't pay anyway. So I've sent off 1 strep culture in the last month or so, negative anyway. Everyone has their priorities and some accept loss for encouraging business. For me, I'll eat the cost of a PPD, and get about $95-100 for the annual physical. Just need to keep on top of this, and thanks for sharing. Dr Matt Levin Re: re PPd Thank you to whomever mentioned that the PPD MDV needs to be discarded after 30 days... somehow I never knew that! I've been vaccine shopping and found something on esurg.com that may be of interest. It looks like SDV! Yippee! See: Tubersol Tuberculin PPD 5TU 10-Test 1mlx1ml EA Caution Aventis Pasteur 04928-1752-21 EA $30.69 Now that makes sense (if I've read it correctly)... no waste! > > I get aplisol from PSS. It is about $30. If I don't use the rest, I just > take it as a cost of doing business. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 17, 2006 Report Share Posted July 17, 2006 Thanks for the feed back. Do you participate in their surveys? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 17, 2006 Report Share Posted July 17, 2006 I would suggest that if a throat is " suspicious enough " to check a rapid strep, you must send a throat culture if it is negative. It's the sensitivity/specifity of the test as well as the pre-test probability. Rapid strep test can be negative with a positive culture pretty often. Plus, antibiotics can be started within a week after a ST starts to protect from Strep sequelae which is the reason abx are given. So, most of time there's no hurry to give abx. For what it's worth, I rarely check rapid streps, butI believe they have a role in urgent care/ED settings due to potential difficulty in follow up care with patients. Tim > Curious about your thoughts on rapid strep tests (RST). What do you > mean that standards would eat up any profit? I go through one box of > tests & then buy a new one. What controls are you referring to? Also, > why would the RST results not change your treatment? It totally changes > mine. If a sore throat " looks more viral " and the RST is negative > --->no abx. If the RST is positive, no matter how the throat > looks--->abx. I have never seen an insurance company deny the RST, even > Medicaid pays pretty well for it here. On the contrary, a throat > culture would serve very little usefulness in my eyes as it takes too > long to get back. I order a TC maybe once per year. > > > > > > > > Re: Re: re PPd > > > > RE cost per item vs absorption. > > > > If you get $50+ for the physical, you need to decide how much to absorb > to get the pt in the door. > > > > Everyone has their own setpoint for providing in office testing -- I do > in office EKGs and Spirometry, yet others say " why bother? " > > I've picked up several cases of a fib in my office and have happy, loyal > pts from such dx that I would have missed if sending to hosp for an EKG. > > Spirometry for bronchitics, acute asthma also doesn't pay much, but now > I've paid for the machine so extra money is useful for me. > > > > I've decided NOT to do rapid streps (neither does our ER or any local > lab, by the way) as the cost to do the standards and normals would eat > up any possible profit, and would rarely make a difference in my > treatment plan -- many ins plans wouldn't pay anyway. So I've sent off > 1 strep culture in the last month or so, negative anyway. > > > > Everyone has their priorities and some accept loss for encouraging > business. For me, I'll eat the cost of a PPD, and get about $95-100 for > the annual physical. > > > > Just need to keep on top of this, and thanks for sharing. > > > > Dr Matt Levin > > Re: re PPd > > > > Thank you to whomever mentioned that the PPD MDV needs to be discarded > after 30 days... somehow I never knew that! I've been vaccine shopping > and found something on esurg.com that may be of interest. It looks like > SDV! Yippee! See: > Tubersol Tuberculin PPD 5TU 10-Test 1mlx1ml EA Caution Aventis > Pasteur 04928-1752-21 EA $30.69 > Now that makes sense (if I've read it correctly)... no waste! > > >> >> I get aplisol from PSS. It is about $30. If I don't use the rest, > I just >> take it as a cost of doing business. >> > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 17, 2006 Report Share Posted July 17, 2006 Epocrates is golden! I could not really get by without it. I almost never use my old paper drug books (monthly prescribing reference, etc). I have the Pro (paid) version of Epocrates, along with the Lab, Infectious Disease, Symptoms, Diagnoses modules. There are no “cons” other than it requires a PDA & you have to sync it at least weekly to stay up to date, & the Pro version costs money every year. Epocrates is a must have, above all other PDA programs. Re: Re: re PPd Sorry for the subject change ...but ...Is anyone currently using Epocrates? If so could you tell me pros and cons about it? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 17, 2006 Report Share Posted July 17, 2006 I have the online version and access it on my tablet, usually right i front of the patient. It has decent info on drugs to print out to give to patients. I have usually been able to get my friend Pharma rep to pay for it. rocky --- Brock DO wrote: > Epocrates is golden! I could not really get by without it. I almost > never > use my old paper drug books (monthly prescribing reference, etc). I > have > the Pro (paid) version of Epocrates, along with the Lab, Infectious > Disease, > Symptoms, Diagnoses modules. There are no " cons " other than it > requires a > PDA & you have to sync it at least weekly to stay up to date, & the > Pro > version costs money every year. Epocrates is a must have, above all > other > PDA programs. > > > > > > > > Re: Re: re PPd > > > > Sorry for the subject change ...but ...Is anyone currently using > Epocrates? > If so could you tell me pros and cons about it? > > > > Rakesh Patel MD Arizona Sun Family Medicine, P.C. 633 East Ray Road, #101 Gilbert, Arizona 85296 www.azsunfm.com PLEASE NOTE: Email is not a secure form of communication. It should not be used for urgent or sensitive messages. Email may be done securely through our web portal. If you have a medical emergency go to an Emergency Room or call 911. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 17, 2006 Report Share Posted July 17, 2006 Inexpensive access to very good prescribing information on a handheld. Use it daily. High value, low cost, high convenience. Weakness: need to go to online resource like Micromedex to get into complicated issues like " Which bugs does this ABX cover? " Does not have tables (like in Drug Facts and Comparisons) for equating narcotic analgesics, comparing oral contraceptive formulation. Overall assessment: slam dunk. Get it. Gorodn At 03:25 PM 7/17/2006, you wrote: Sorry for the subject change ...but ...Is anyone currently using Epocrates? If so could you tell me pros and cons about it? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 17, 2006 Report Share Posted July 17, 2006 I have used the epocrates pro after a promotional offer in the past--it worked well/had an ID section sorta like Sanford's but not as detailed as well as a few tables that had ACLS/PALS algorithms on it. After the offer I elected not to subscribe (only to save $) and went to the web site and downloaded the basic version. It lacked the two above mentioned features, but continued with drug formulary assistance with some plans, a drug interaction checklist that is helpful but not as in depth as Micromedix (but portable), and lists drugs dosages adults/peds, contraindications, and costs for the drugs. Well worth the free price. I use it daily. Up to date has a more detailed drug site, but lacks the portability--I use it daily also. It has things like monitoring parameters that I find helpful--ie ACEI check basic every # of months, etc. Mike Jewett Re: Re: re PPd Sorry for the subject change ...but ...Is anyone currently using Epocrates? If so could you tell me pros and cons about it? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 18, 2006 Report Share Posted July 18, 2006 RE standards for strep testing 1) State of PA health dept MANDATE standards every quarter to be done by EVERY PERSON WHO RUNS testing. For me, that would be 6 unreimbursed tests. 2) Many of my insurers will NOT PAY ANYTHING for strep testing, and when they do, only 3-5 dollars over the cost of the test. They want me to provide it as part of the visit. 3) So, I'd loose money on each test -- go back to the older way of treat presumptively, and do a strep culture to send to hospital by courier if I'm not sure. Case of tech not being used. Wish it weren't so.... but is Dr Matt Levin RE: Re: re PPd Maybe no waste, but when I was doing PPDs (I stopped) I was only getting paid about $8-14 by most payers, so if I bought the 5 dose vial for about $40 and used it all, I would break even. Problem was not using it all. If you have to pay $30 for SDV, but collect less than half that, you are still in the hole.. Am I missing something here? Annie -----Original Message-----From: [mailto: ] On Behalf Of docboopsSent: Friday, July 14, 2006 7:54 PMTo: Subject: Re: re PPd Thank you to whomever mentioned that the PPD MDV needs to be discardedafter 30 days... somehow I never knew that! I've been vaccine shoppingand found something on esurg.com that may be of interest. It lookslike SDV! Yippee! See:Tubersol Tuberculin PPD 5TU 10-Test 1mlx1ml EA Caution AventisPasteur 04928-1752-21 EA $30.69Now that makes sense (if I've read it correctly)... no waste! >> I get aplisol from PSS. It is about $30. If I don't use the rest,I just> take it as a cost of doing business.> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 18, 2006 Report Share Posted July 18, 2006 I’m not really sure what purpose QC testing would serve when there is no “device” that gets re-used with a rapid strep test. I guess I kind of have to assume that the tests are not intrinsically defective when I use them. I suppose there is some small amount of a chance for performance error on my part, but even then QC testing does not prevent it. QC would only say that the test strips work. I can see QC checks on cholesterol device, PT/INR, A1C, but why a disposable box of RST strips? Also, are you using a -25 modifier when you do a rapid strep? I do & I am reimbursed $16 even from Medicaid. My cost is about $1.82 per test (almost $15 profit per test, even with Medicaid). That is a pretty darn good margin if you ask me, & I often base my decisions on the test results. Maybe reimbursement varies in PA on these waived tests. A throat culture can take 2 – 3 days to come back. What would I do for the mother/school that wants to know if their child has strep throat before sending them back to school? Re: Re: re PPd RE standards for strep testing 1) State of PA health dept MANDATE standards every quarter to be done by EVERY PERSON WHO RUNS testing. For me, that would be 6 unreimbursed tests. 2) Many of my insurers will NOT PAY ANYTHING for strep testing, and when they do, only 3-5 dollars over the cost of the test. They want me to provide it as part of the visit. 3) So, I'd loose money on each test -- go back to the older way of treat presumptively, and do a strep culture to send to hospital by courier if I'm not sure. Case of tech not being used. Wish it weren't so.... but is Dr Matt Levin Re: re PPd Thank you to whomever mentioned that the PPD MDV needs to be discarded after 30 days... somehow I never knew that! I've been vaccine shopping and found something on esurg.com that may be of interest. It looks like SDV! Yippee! See: Tubersol Tuberculin PPD 5TU 10-Test 1mlx1ml EA Caution Aventis Pasteur 04928-1752-21 EA $30.69 Now that makes sense (if I've read it correctly)... no waste! > > I get aplisol from PSS. It is about $30. If I don't use the rest, I just > take it as a cost of doing business. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 18, 2006 Report Share Posted July 18, 2006 I’m not really sure what purpose QC testing would serve when there is no “device” that gets re-used with a rapid strep test. I guess I kind of have to assume that the tests are not intrinsically defective when I use them. I suppose there is some small amount of a chance for performance error on my part, but even then QC testing does not prevent it. QC would only say that the test strips work. I can see QC checks on cholesterol device, PT/INR, A1C, but why a disposable box of RST strips? Also, are you using a -25 modifier when you do a rapid strep? I do & I am reimbursed $16 even from Medicaid. My cost is about $1.82 per test (almost $15 profit per test, even with Medicaid). That is a pretty darn good margin if you ask me, & I often base my decisions on the test results. Maybe reimbursement varies in PA on these waived tests. A throat culture can take 2 – 3 days to come back. What would I do for the mother/school that wants to know if their child has strep throat before sending them back to school? Re: Re: re PPd RE standards for strep testing 1) State of PA health dept MANDATE standards every quarter to be done by EVERY PERSON WHO RUNS testing. For me, that would be 6 unreimbursed tests. 2) Many of my insurers will NOT PAY ANYTHING for strep testing, and when they do, only 3-5 dollars over the cost of the test. They want me to provide it as part of the visit. 3) So, I'd loose money on each test -- go back to the older way of treat presumptively, and do a strep culture to send to hospital by courier if I'm not sure. Case of tech not being used. Wish it weren't so.... but is Dr Matt Levin Re: re PPd Thank you to whomever mentioned that the PPD MDV needs to be discarded after 30 days... somehow I never knew that! I've been vaccine shopping and found something on esurg.com that may be of interest. It looks like SDV! Yippee! See: Tubersol Tuberculin PPD 5TU 10-Test 1mlx1ml EA Caution Aventis Pasteur 04928-1752-21 EA $30.69 Now that makes sense (if I've read it correctly)... no waste! > > I get aplisol from PSS. It is about $30. If I don't use the rest, I just > take it as a cost of doing business. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 19, 2006 Report Share Posted July 19, 2006 How are you using -25 for Rapid Streps? I thought it had to be a situation where you are dealing with some problem unrelated to the procedure in question (Like patient in for skin lesion biopsy, but wants to get refill on allergy medicines at the same visit. Without the -25 they pay only the biopsy fee and no office visit, so I put the -25 on the 99213 and get paid for both) But if the only diagnosis is acute pharyngitis it is hard to argue that the RSS is unrelated…Please clarify. Annie Re: Re: re PPd RE standards for strep testing 1) State of PA health dept MANDATE standards every quarter to be done by EVERY PERSON WHO RUNS testing. For me, that would be 6 unreimbursed tests. 2) Many of my insurers will NOT PAY ANYTHING for strep testing, and when they do, only 3-5 dollars over the cost of the test. They want me to provide it as part of the visit. 3) So, I'd loose money on each test -- go back to the older way of treat presumptively, and do a strep culture to send to hospital by courier if I'm not sure. Case of tech not being used. Wish it weren't so.... but is Dr Matt Levin Re: re PPd Thank you to whomever mentioned that the PPD MDV needs to be discarded after 30 days... somehow I never knew that! I've been vaccine shopping and found something on esurg.com that may be of interest. It looks like SDV! Yippee! See: Tubersol Tuberculin PPD 5TU 10-Test 1mlx1ml EA Caution Aventis Pasteur 04928-1752-21 EA $30.69 Now that makes sense (if I've read it correctly)... no waste! > > I get aplisol from PSS. It is about $30. If I don't use the rest, I just > take it as a cost of doing business. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 19, 2006 Report Share Posted July 19, 2006 How are you using -25 for Rapid Streps? I thought it had to be a situation where you are dealing with some problem unrelated to the procedure in question (Like patient in for skin lesion biopsy, but wants to get refill on allergy medicines at the same visit. Without the -25 they pay only the biopsy fee and no office visit, so I put the -25 on the 99213 and get paid for both) But if the only diagnosis is acute pharyngitis it is hard to argue that the RSS is unrelated…Please clarify. Annie Re: Re: re PPd RE standards for strep testing 1) State of PA health dept MANDATE standards every quarter to be done by EVERY PERSON WHO RUNS testing. For me, that would be 6 unreimbursed tests. 2) Many of my insurers will NOT PAY ANYTHING for strep testing, and when they do, only 3-5 dollars over the cost of the test. They want me to provide it as part of the visit. 3) So, I'd loose money on each test -- go back to the older way of treat presumptively, and do a strep culture to send to hospital by courier if I'm not sure. Case of tech not being used. Wish it weren't so.... but is Dr Matt Levin Re: re PPd Thank you to whomever mentioned that the PPD MDV needs to be discarded after 30 days... somehow I never knew that! I've been vaccine shopping and found something on esurg.com that may be of interest. It looks like SDV! Yippee! See: Tubersol Tuberculin PPD 5TU 10-Test 1mlx1ml EA Caution Aventis Pasteur 04928-1752-21 EA $30.69 Now that makes sense (if I've read it correctly)... no waste! > > I get aplisol from PSS. It is about $30. If I don't use the rest, I just > take it as a cost of doing business. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 19, 2006 Report Share Posted July 19, 2006 restrep testing and reimbursement State mandates the quality testing (pa) Many insurers will just not pay for test Lab for all i know may not get paid enough to even do strep test Look I can't even get paid for ua from one ins co in my office; local bcbs pays me a big 3.72 for a ua I don't write the rules just have to live under them RE: Re: re PPd Maybe no waste, but when I was doing PPDs (I stopped) I was only getting paid about $8-14 by most payers, so if I bought the 5 dose vial for about $40 and used it all, I would break even. Problem was not using it all. If you have to pay $30 for SDV, but collect less than half that, you are still in the hole.. Am I missing something here? Annie -----Original Message-----From: [mailto: ] On Behalf Of docboopsSent: Friday, July 14, 2006 7:54 PMTo: Subject: Re: re PPd Thank you to whomever mentioned that the PPD MDV needs to be discardedafter 30 days... somehow I never knew that! I've been vaccine shoppingand found something on esurg.com that may be of interest. It lookslike SDV! Yippee! See:Tubersol Tuberculin PPD 5TU 10-Test 1mlx1ml EA Caution AventisPasteur 04928-1752-21 EA $30.69Now that makes sense (if I've read it correctly)... no waste! >> I get aplisol from PSS. It is about $30. If I don't use the rest,I just> take it as a cost of doing business.> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 19, 2006 Report Share Posted July 19, 2006 restrep testing and reimbursement State mandates the quality testing (pa) Many insurers will just not pay for test Lab for all i know may not get paid enough to even do strep test Look I can't even get paid for ua from one ins co in my office; local bcbs pays me a big 3.72 for a ua I don't write the rules just have to live under them RE: Re: re PPd Maybe no waste, but when I was doing PPDs (I stopped) I was only getting paid about $8-14 by most payers, so if I bought the 5 dose vial for about $40 and used it all, I would break even. Problem was not using it all. If you have to pay $30 for SDV, but collect less than half that, you are still in the hole.. Am I missing something here? Annie -----Original Message-----From: [mailto: ] On Behalf Of docboopsSent: Friday, July 14, 2006 7:54 PMTo: Subject: Re: re PPd Thank you to whomever mentioned that the PPD MDV needs to be discardedafter 30 days... somehow I never knew that! I've been vaccine shoppingand found something on esurg.com that may be of interest. It lookslike SDV! Yippee! See:Tubersol Tuberculin PPD 5TU 10-Test 1mlx1ml EA Caution AventisPasteur 04928-1752-21 EA $30.69Now that makes sense (if I've read it correctly)... no waste! >> I get aplisol from PSS. It is about $30. If I don't use the rest,I just> take it as a cost of doing business.> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 19, 2006 Report Share Posted July 19, 2006 Yeah, routine UA’s I can actually see being bundled, mine often are. I still do not get doing QC checks on something like a rapid strep test (or a UA for that matter). Oh well, I guess reimbursement differs everywhere. Re: Re: re PPd restrep testing and reimbursement State mandates the quality testing (pa) Many insurers will just not pay for test Lab for all i know may not get paid enough to even do strep test Look I can't even get paid for ua from one ins co in my office; local bcbs pays me a big 3.72 for a ua I don't write the rules just have to live under them Re: re PPd Thank you to whomever mentioned that the PPD MDV needs to be discarded after 30 days... somehow I never knew that! I've been vaccine shopping and found something on esurg.com that may be of interest. It looks like SDV! Yippee! See: Tubersol Tuberculin PPD 5TU 10-Test 1mlx1ml EA Caution Aventis Pasteur 04928-1752-21 EA $30.69 Now that makes sense (if I've read it correctly)... no waste! > > I get aplisol from PSS. It is about $30. If I don't use the rest, I just > take it as a cost of doing business. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 19, 2006 Report Share Posted July 19, 2006 My interpretation is that a procedural (CPT) code is almost always distinct from the E/M code. It is really the E/M code you are “modifying” & not the procedure code. I would never just walk in & do a throat swab without first evaluating & then subsequently managing (hence, the E/M). The CPT book says: “separately identifiable E/M SERVICE above and beyond . . . the procedure that was performed. The E/M service may be prompted by the symptom or condition for which the procedure and/or service was provided. As such DIFFERENT DIAGNOSES ARE NOT REQUIRED for reporting of the E/M services on the same date.” By not putting the -25 modifier what you are really saying to the payor is “please bundle the E/M into my charge for the procedure (strep test) because they are one and the same.” Technically they should be paying only for the strep test and not the E/M if you do not use the modifier. Re: Re: re PPd RE standards for strep testing 1) State of PA health dept MANDATE standards every quarter to be done by EVERY PERSON WHO RUNS testing. For me, that would be 6 unreimbursed tests. 2) Many of my insurers will NOT PAY ANYTHING for strep testing, and when they do, only 3-5 dollars over the cost of the test. They want me to provide it as part of the visit. 3) So, I'd loose money on each test -- go back to the older way of treat presumptively, and do a strep culture to send to hospital by courier if I'm not sure. Case of tech not being used. Wish it weren't so.... but is Dr Matt Levin Re: re PPd Thank you to whomever mentioned that the PPD MDV needs to be discarded after 30 days... somehow I never knew that! I've been vaccine shopping and found something on esurg.com that may be of interest. It looks like SDV! Yippee! See: Tubersol Tuberculin PPD 5TU 10-Test 1mlx1ml EA Caution Aventis Pasteur 04928-1752-21 EA $30.69 Now that makes sense (if I've read it correctly)... no waste! > > I get aplisol from PSS. It is about $30. If I don't use the rest, I just > take it as a cost of doing business. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 19, 2006 Report Share Posted July 19, 2006 My interpretation is that a procedural (CPT) code is almost always distinct from the E/M code. It is really the E/M code you are “modifying” & not the procedure code. I would never just walk in & do a throat swab without first evaluating & then subsequently managing (hence, the E/M). The CPT book says: “separately identifiable E/M SERVICE above and beyond . . . the procedure that was performed. The E/M service may be prompted by the symptom or condition for which the procedure and/or service was provided. As such DIFFERENT DIAGNOSES ARE NOT REQUIRED for reporting of the E/M services on the same date.” By not putting the -25 modifier what you are really saying to the payor is “please bundle the E/M into my charge for the procedure (strep test) because they are one and the same.” Technically they should be paying only for the strep test and not the E/M if you do not use the modifier. Re: Re: re PPd RE standards for strep testing 1) State of PA health dept MANDATE standards every quarter to be done by EVERY PERSON WHO RUNS testing. For me, that would be 6 unreimbursed tests. 2) Many of my insurers will NOT PAY ANYTHING for strep testing, and when they do, only 3-5 dollars over the cost of the test. They want me to provide it as part of the visit. 3) So, I'd loose money on each test -- go back to the older way of treat presumptively, and do a strep culture to send to hospital by courier if I'm not sure. Case of tech not being used. Wish it weren't so.... but is Dr Matt Levin Re: re PPd Thank you to whomever mentioned that the PPD MDV needs to be discarded after 30 days... somehow I never knew that! I've been vaccine shopping and found something on esurg.com that may be of interest. It looks like SDV! Yippee! See: Tubersol Tuberculin PPD 5TU 10-Test 1mlx1ml EA Caution Aventis Pasteur 04928-1752-21 EA $30.69 Now that makes sense (if I've read it correctly)... no waste! > > I get aplisol from PSS. It is about $30. If I don't use the rest, I just > take it as a cost of doing business. > Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.