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Sun Jan 11 13:22:36 GMT 2009

We routinely rescan patients for these reasons.

1. Often the referring facilities scanners are sub-par
2. Often the disks sent with the patient are either unreadable
(becoming less common now) or the images have been degraded
significantly. They certainly do not allow for
reformatting/reconstruction
3. Many times the studies are done non-contrasted.
4. The referring facility reports never come with the patient (like all
rads reports the formal report doesn't happen for 24hrs — don't get me
started on the fact that the radiologist can bill for picking up a
pneumothorax 24hrs after I've already treated it).

and in response to this
--> I'd think that this would be criminal, as it amounts to irradiating
a 
patient for money and no other benefit to the patient. If your system
is so 
"lovely" that your radiologists will refuse and you are even thinking
of 
this, then you should put the patient through a "dummy" scan without 
irradiation, bill it as a proper scan and THEN get the radiologist to
report 
the original images and bill as if he's reporting new ones...

I don't know what the malpractice situation is like in Oz but expecting
physicians to accept the liability without any reimbursement is not only
fundamentally unfair IMO but in fact will just not happen in most
facilities. There certainly should be a "transferred patient overread"
CPT code but in the government's infinite wisdom there is not. 

Performing a "dummy scan" and billing for it would be considered
knowingly fraudulent behavior in the US and would result in fines and
prison terms. Even in "Club Fed" type prisons that'd be no fun. 

Bill Bromberg

>>> "brenildo" <brenildo33 at uol.com.br> 1/11/2009 6:47 AM >>>
PERFECT
BENILDO TAVARES md
brenildo33 at uol.com.br 
RIO DE JANEIRO BRASIL
----- Original Message ----- 
From: "McSwain, Norman E Jr." <nmcswai at tulane.edu>
To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
Sent: Saturday, January 10, 2009 6:09 PM
Subject: RE: reimaging transfer patients

Sometimes they do and sometimes they do not, but a surgeon should never

operate on a patient without reviewing the radiographs him(her) self.
It is 
very helpful to do this review with a radiologist to be sure that
everything 
is discussed

Norman

Norman McSwain Jr, MD FACS
Trauma Director Charity Hospital
Professor of Surgery
Tulane University School of Medicine
504 988 5111

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] 
On Behalf Of Doc Holiday
Sent: Saturday, January 10, 2009 2:05 PM
To: .Trauma List
Subject: RE: reimaging transfer patients

From: joe.nemeth at mcgill.ca> What do people do regarding transferred
patients 
coming in with imaging on CD and radiology refusing to read (cannot
double 
dip, hence no pay, hence no read)...

--> Sorry. This might be a stupid question, so forgive a foreigner...
Don't the radiologists from the institution which created the images
report 
them? Why not get them to send the report on the same CD?

> Do you rescan the patient only to have it now read by the happy 
> radiologist?

--> I'd think that this would be criminal, as it amounts to irradiating
a 
patient for money and no other benefit to the patient. If your system
is so 
"lovely" that your radiologists will refuse and you are even thinking
of 
this, then you should put the patient through a "dummy" scan without 
irradiation, bill it as a proper scan and THEN get the radiologist to
report 
the original images and bill as if he's reporting new ones...

Then go take whatever you take to keep sane working in such a
system...

> Do you have a system in place where imaging from outside can be
accessed 
> by your own radiologist, i.e. function on a same database system

--> I am not aware of ANY system which is unable to store images on CD
for 
patient transfer. All modern ones are capable of image transfer via
network, 
but your institutions must be properly connected and interfaced to
receive 
these images, i.e. they need to be linked. But you could not buy a
system 
nowadays which cannot be linked.
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reimaging transfer patients