HST repeat

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HST repeat

Postby o0rangeo » Wed Jul 10, 2013 2:28 am

If a patient comes in and the insurance wants an HST and not a full PSG, but the patient keeps taking off the cannula during the night at home. Can we then order an in lab test if the patient isn't giving us a complete test, or do we repeat the HST until he gives us a full night w/o ripping the cannula off while he sleeps?
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Re: HST repeat

Postby labman2 » Thu Jul 11, 2013 7:53 pm

o0rangeo wrote:If a patient comes in and the insurance wants an HST and not a full PSG, but the patient keeps taking off the cannula during the night at home. Can we then order an in lab test if the patient isn't giving us a complete test, or do we repeat the HST until he gives us a full night w/o ripping the cannula off while he sleeps?


Up to the mighty insurance bean counters.... may need to appeal via MD that pt can not handle at home testing but they may want multiple attempts before in lab
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Postby linuxgeek » Thu Jul 11, 2013 9:58 pm

How does ins. know how many times you have tried? Since the study never gets submitted for diagnosis or payment. And my understanding is that they don't want them submitted. So what constitutes an attempted HST?
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Postby labman2 » Fri Jul 12, 2013 8:25 pm

linuxgeek wrote:How does ins. know how many times you have tried? Since the study never gets submitted for diagnosis or payment. And my understanding is that they don't want them submitted. So what constitutes an attempted HST?


Most likely this info of a failed HST would have to come from the MD in an appeal for an in lab titration...

As for us, we just send em out again for another crack at a usable HST and have not billed a failed HST.... cause we are nice guys trying to do right by the patients -unlike mAIM Care Coordinators! :lol:
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Postby cloverdizzle » Sun Aug 18, 2013 3:58 am

I had an Aetna patient the other night that had a HST (said it was a finger probe and wrist band) and then was given an A-pap. A 2nd hst was done and they had an average apap pressure of 14 and the patient desating into the 70s, so they sent the patient home with 2L o2. The pulmonologist sent the patient to the lab and we retitrated the patient to 9cm with the last two Rem cycles supine and sats never dropped below 96% w/o supplemental o2. HST must die.
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Postby stars » Sun Aug 18, 2013 7:58 am

cloverdizzle wrote:I had an Aetna patient the other night that had a HST (said it was a finger probe and wrist band) and then was given an A-pap. A 2nd hst was done and they had an average apap pressure of 14 and the patient desating into the 70s, so they sent the patient home with 2L o2. The pulmonologist sent the patient to the lab and we retitrated the patient to 9cm with the last two Rem cycles supine and sats never dropped below 96% w/o supplemental o2. HST must die.

HST ok when lab make right selection patient
Aetna must die
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Postby strawberri » Sun Aug 18, 2013 9:06 am

I agree with clover...the problem is how many patients have to die before the almighty insurance companies or docs see the light?

People being placed on oxygen therapy as labman described without needing it, patients ending up in ICU (if they are lucky) because of heart attacks and strokes caused by OSA, which the HST missed...patients trying APAP and failing miserably...but thinking they can't win against the insurance companies -stay silent and stop being compliant....etc..etc!

Sleep medicine in the past was Preventive ....now it's damage control...that's my mantra.

HST and AIM must GO!
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Postby labman2 » Mon Aug 19, 2013 7:43 pm

strawberri wrote:I agree with clover...the problem is how many patients have to die before the almighty insurance companies or docs see the light?

People being placed on oxygen therapy as labman described without needing it, patients ending up in ICU (if they are lucky) because of heart attacks and strokes caused by OSA, which the HST missed...patients trying APAP and failing miserably...but thinking they can't win against the insurance companies -stay silent and stop being compliant....etc..etc!

Sleep medicine in the past was Preventive ....now it's damage control...that's my mantra.

HST and AIM must GO!

HST - place the S in front of the H, add in I for I hate em, and add the T
what's that smell? Oops! What that spell? :wink:
and
AIM rhymes with MAIM! Coincidence? :wink:
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Postby bruins » Fri Aug 30, 2013 7:42 pm

the major insurance carriers in our area (indiana) typically have a 2 fail HST clause before they can get an in-lab pre-auth. we keep the failed data for proof, but to be honest, i've never had one fail twice on the same patient, so have not had the opportunity to test the clause.
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