iRhythm's ziopatach

Discussion in 'iRhythm' started by Anonymous, Feb 5, 2011 at 1:02 AM.

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  1. Anonymous

    Anonymous Guest

    Rhythm sells the MD the ZioPatch and is telling the MD to bill, hookup, technical fee and profee! How can the MD legally bill the technical fee when iRhythm is still doing the scanning and analysis?? Doesn't sound correct to me.
    thoughts??
     

  2. Anonymous

    Anonymous Guest

    FFS-fee for service. Everyone does it.
     
  3. Anonymous

    Anonymous Guest

    As long as the MD marks in box 20 of the HCFA form that they are using an outside lab and what fee they are paying the lab, it is legal.
     
  4. Anonymous

    Anonymous Guest

    Hey why not? There are LW reps out there telling offices to bill #93270 hook up reimbursement along with the #93228 interpretation for the ACT monitor. Get 'em while they are hot!!!!!!
     
  5. Anonymous

    Anonymous Guest

    How does the ZioPatch transmit the data? Is it wireless or land line transmission?
     
  6. Anonymous

    Anonymous Guest

    Patient mails back to company. Takes them about a week to complete report.
     
  7. Anonymous

    Anonymous Guest

    Yes I do agree that "Fee for Service" Is a standard of the industry especially with Holter. However if the Ziopatch users are billing 93268 the code states that 24 hour coverage is required and that the unit is trans-telephonic. The Zio patch is neither. It really is a product without a code.

    History will tell you these things ususally turn out bad.
     
  8. Anonymous

    Anonymous Guest

    More like 14 days. Great service, eh?
     
  9. Anonymous

    Anonymous Guest

    Actually it only takes about 1 to 2 days to process the report but it does take a couple days for the Patch to ship to the Clinical Center, depending where in the country you're mailing from. And the 93268 code doesn't require the device to be trans-telephonic. No Holters can transmit via phone and if they can then they'd be considered event monitors, which is an entirely different set of CPT codes.
     
  10. Anonymous

    Anonymous Guest

    Is it true iRhythm got approval for a 7 or 14 day CPT code for the ZioPatch?
     
  11. Anonymous

    Anonymous Guest

    Yes it is. Come January 1, eCardio, Cardionet, Lifewatch, etc. are going to see their quotas become increasingly more difficult to hit.
     
  12. Anonymous

    Anonymous Guest

    Careful what you wish for. Reimbursement for the patch would be less than a holter. Hookup would be cut drastically, scanning would stay the same, and read would stay.

    You would have to explain why you think it would go up. CMS will look at work load, which one of these is more work load and which is less.... by what amounts. Even if scan and read went up it would be offset by decreased hookup.
     
  13. Anonymous

    Anonymous Guest

    CMS will put that at $75.00. So what if the patient has to wear it for 14 days, how much work is it for MD and irhythm? They will not care if it is disposable, that is not their problem.
     
  14. Anonymous

    Anonymous Guest

    Why wouldn't it? It has the recording capacities of about a dozen Holters so how would scanning stay the same? And hook-up is the lowest reimbursable component while scanning is the most lucrative. Even if there's a drop in the hookup (which I can't see how you could argue there would be, even if hookup is marginally quicker, since we're talking mere minutes), it'd be more than offset by a significant rise in the Technical component.
     
  15. Anonymous

    Anonymous Guest

    You're right, they won't care. What they will care about is cost-effectiveness. Does it make fiscal sense to reimburse more for a device with several times the recording length and several times the diagnostic yield compared to a Holter? Yes, of course it does, because it will lead to a quicker diagnosis and cut down on additional health care costs. Pay a few dozen dollars more now to save hundreds, maybe even thousands, per patient over the long run? It would be irresponsible not to.
     
  16. Anonymous

    Anonymous Guest

    The ZioPatch will not have the corner on this market. Devices with the capability to record every beat for 14 days or longer (they are out there) will also be able to play if a new CPT code and subsequent payor support happens. Will be great for patients as it will improve diagnostic yield (48 hours of traditional holter just doesn't yield much).
     
  17. Anonymous

    Anonymous Guest

    Interesting argument. First off if you look at the reimbursed amounts, hook-up is second, about 25% more than profession read. Just look it up, you cant argue this fact.
    No drop in hookup, are you kidding? You really don't think anyone will believe attaching 7 electrodes, programming device, and then removing and cleaning, is the same as one patch that the patient mails back.
    Everyone knows the device is algorithm based, it is not beat by beat with quantification's like a holter. The effort to scan and edit a 24 hour holter is about the same as 7 day patch.
    I like the product just stating you are in fantasy land if you think any reimbursement goes up these days. Just my opinion, but this thing will get hammered and made non profitable for irhythm.
     
  18. Anonymous

    Anonymous Guest

    I totally agree with you, but this is not the way it works. The only time they look at yield is to get cpt approval etc.. Once that is approved, payment is based strictly on RVUs. Look it up, there is no place for arbitrary amounts. It is strictly workload. Period, nothing else. Please take a look at CMS calculations sometime and show us where they add in the arbitrary amounts to make you profitable etc. Sorry but they do not just grab things out of the sky to give to you. Great product but watch how fast CMS puts you out of business. IMO.
     
  19. Anonymous

    Anonymous Guest

    Whoops, you're right. Hook-up is second, although it's more like 10% more than Interp. But still, I think a lot of people are going to be pleasantly surprised in the coming months as CMS makes some announcements regarding the 2012 codes. And if not the device is still a viable option at existing reimbursement amounts.
     
  20. Anonymous

    Anonymous Guest

    I wasn't calculating arbitrary amounts in order to make iRhythm profitable but more to highlight the long-term cost savings for Medicare and commercial insurance providers associated with a marginal short-term reimbursement increase but, regardless, if you're right then I agree. Looks like the benefits of the Zio Patch (lower workloads) could actually be its shortcoming. Kinda scary. And sad.