RE: Ancillaries: PFTs and PAD screen

[Guest guest]

1.

I have a hand-held spirometer, I think it is called a “Simplicity,”

and it is fairly easy to use, though you should get instruction on how to do

accurate spirometry from someone who knows how to do it.. It uses

disposable but unique mouthpieces and they have a system so you cannot do it

without a new mouthpiece for each patient. I think the mouthpieces cost a

buck or so. I generally do yearly spirometery on patients with COPD and

with Asthma, and on all smokers. Patients accept it well. One issue

is the need to calibrate the machines. The machines cost from $900 -$2000

new, and the calibration syringes may cost several hundred dollars, too.

You might check with Respiratory Therapy at a local hospital to see if they can

teach you how to do spirometry correctly and can offer calibration services, to

save the cost of the syringe.

2.

I do ABIs when I want to see what they are, with a hand-held,

but I don’t charge for it because Medicare requires that you use a

machine that will give a graphic printout, and those machines cost

$1200.00. I paid $25.00 for a used Vascular Doppler device at a

medical surplus store, but it doesn’t give a printout.

3.

I generally do an EKG yearly on hypertensive patients, and

annually on other high risk patients.

dts

From:

[mailto: ] On Behalf Of Jacques

Guillot

Sent: Saturday, January 19, 2008 1:56 PM

To: practiceimprovement1

Subject: Ancillaries: PFTs and PAD screen

I want to add some ancillary services for more income (and better care and

patient convenience).

1. PFTs. What spirometers are you using? Please give general

recommendations and experiences with cost and reimbursement. It seems

annual spirometry is recommended for COPD patients and more screening for those

at risk and with appropriate symptoms. Do patients usually accept it

well?

2. PAD screening. Does anyone use a handheld u/s for ABI and charge

and collect for that service with success?

3. EKG. I probably should do more of them. I'm

ultraconservative. What are some policies or practices you use, eg, does

anyone do annual EKGs on hypertension patients?

Thanks,

Jacques Guillot, MD

Med-Peds

Mandeville, LA