The Medical Landscape
As a doctor in today’s ever changing and fast paced medical landscape, it is difficult to keep up with new regulations and laws from Medicare, in fact it’s incredibly difficult, CMS Medicare and AMA guidelines for proper protocols relating to medical procedures change without notice and seemingly without rhyme or reason, more so Medicare does not take care to properly announce or alert practitioners to these changes, often times when a doctor finds out this CPT code is no longer reimbursed or this ICD-10 code is no longer allowed, is at the edge of an Audit or a claw back from these same agencies.
So what’s changed?
So having a compliance check or compliance officer is vital to keep ahead of the curve with these types of changes, one such change specifically oriented to the Autonomic Nervous system testing arena involves CMS Medicare changing their coverage policy for ANS systems that use plethysmography, or plate based systems to measure heart rate variability blood pressure monitoring. What is now allowed for these types of testing is EKG based systems or ANS devices that use leads which provide a more continuous flow of information to the physician allowing them to get a better understanding of any imbalance of dysfunction between the sympathetic and parasympathetic system of the patient.
Why is this important to note?
Because most Cardiologists, Internal Medicine, and even family practice or wellness practices that have acquires these type of diagnostic assessment tools have and ARE still using these system via plethysmography. What is even more disturbing is that the CPT Codes used for plethysmography is the same as used for EKG based testing! So Medicare technically would still pay out for them, except come the day when an audit would occur and they trace back all prior claims with use of plethysmography, in which case they will be issuing a clawback for a total sum of all claim values that were incorrectly paid out to that said practice. As you can imagine, not a fun day for anyone unaware of those changes.
Fortunately we have found out about a rebate and trade in program that can help doctors who have already made investments into these types of systems that are now no longer covered by Medicare and private insurances. The Intellewave Metrologix system, is an all in one diagnostic testing platform that is replacing the older no longer covered Plates based systems. It used EKG based testing to achieve a more comprehensive and holistic view of the patients cardiovascular system, including beat to beat continuous blood pressure monitoring, pulse oximetry, vascular testing, insulin resistance testing, cardio metabolic testing, endothelial testing and more. In addition to more testing parameters, better clinical efficacy and more comprehensive diagnostic data points provided to the physician, the system also reimburses better than past ANS based systems. It’s simply an all-around better choice for doctors looking for an alternate to plethysmography based units.
Trade in & Rebate Program
The manufacturer and participating distributors are working together to help the medical community save on their prior investments by providing a unique Trade in & Rebate Program, where they will provide the physician a credit of 50%! of the total cost they acquired the original system for, as long as they can provide a receipt or proof of purchase. These funds would be applied as a discount against the new EKG based system and the new system would also be applicable for Tax Code 179 for a full Tax write off.
We are grateful to have found this opportunity for our physicians nationwide as we know how inconvenient it can be to purchase and invest in certain technology only to have the coverage shift and change unpredictably. This program is a breath of fresh air and a sigh of relief as it will help our doctors get the right type of ANS testing equipment in their practice sooner, provide better clinical efficacy and data for their patients and fortify practice compliance to defend against potential future audits should they ever occur. We strongly recommend any doctors who have an interest in Autonomic nervous system testing to do their own independent research and due diligence about these recent changes to this kind of testing. It is the responsibility of each provider to be aware of these changes and to be cognizant of the potential consequences should they decide to take no action. Hopefully, we can continue to get the word out about these changes and bring this relief to more and more doctors nationwide.