Home sleep testing (HST) provides an easy, accurate, and less costly way to diagnose Obstructive Sleep Apnea (OSA), but not all patients with suspected OSA are appropriate for home testing. This post will highlight co-morbid conditions that would represent a contraindication to HST and how by communicating the condition to prior authorization companies, will result in an approved PSG every time.
The introduction of a safe, accurate, and less costly home sleep diagnostic test gave the medical community an alternative to a facility study in the diagnosis of obstructive sleep apnea. When a choice between two different diagnostic tests becomes available, insurance companies often implement prior authorization programs to help determine when a home study is indicated and when it is not.
During the intake process, PA nurses will want to know the reason for the request. Giving explicit answers, “rule outs”, and “suspected diseases” is the key to obtaining approval every time.
Ultrasound is the diagnostic imaging study of choice for most cases of abdominal aortic aneurysm
Providers are often unaware that ultrasound of the abdomen, pelvis, or retroperitoneal area have two separate scopes: a complete or a limited study. Each one has a distinct definition, a separate CPT code and a different indication.
Where does the Abdomen end and the Pelvis Begin?
There are so many choices for imaging studies to evaluate abdominal pain: Ultrasound? CT? MRI? MRCP?. Imaging without contrast, with IV contrast or both? Gadolinium or Eovist? CT enterogram or CT enteroclysis? Abdomen imaging or Pelvis imaging or both? It’s hard to be certain which one is best.
Lesser-known tips for imaging the spine and diagnosing common causes of back pain
When to request it and when to wait. What exactly do they mean by “6 weeks of conservative treatment?”
When to request it and how to get it approved
A few simple steps can prepare you by knowing the ‘8-10 clinical questions’ in advance.
The provider’s office can be a source of denials and P2Ps, but these too can be remedied.
Technological advances in CT scanning and how they change the way we order imaging