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Sonorex no longer applicable to our practice

Posted by CBakkemo on 8/02/05 at 16:47 (179757)

Good afternoon all,

Our practice acquired the Sonorex modality 2.5 years ago. While this remains an excellent treatment and potential profit center, the makeup of our organization has changed from orthopedics/sports medicine to exclusively pain management. Thus the Sonorex has little application in our current business model without investing marketing effort and dollars. We are interested in a simple lease assumption with the equipment acquisition. The Sonorex (ESWT) treatments bill under CPT code 50590, are approved by Medicare, and bill out $750.00 per tx with a 50% reimbursement rate in most cases. Treatments are performed on an outpatient basis and are approx. 8-15 minutes in length. Again, this was an excellent profit center while we were seeing a volume of orthopedic patients and we had success in obtaining referrals from local DPM's re. plantar faciitis.
Interested parties may contact:

Chris Bakkemo
Practice Director, CEO
SpineOne
1411 South Potomac Street, Suite 200
Aurora, CO 80012
303-367-2225
(email removed)

Best regards,
C

Re: Sonorex no longer applicable to our practice

John H on 8/03/05 at 10:14 (179822)

Hope you sell it to some practice in Little Rock.

Re: Sonorex no longer applicable to our practice

Ed Davis, DPM on 8/04/05 at 17:58 (180004)

Chris:
The correct code for the modality is 0020T or 0019T. The code 50590 is for RENAL LITHOTRIPSY as per the Current Procedure Terminology Book of the AMA. One can use any code they wish but it must represent what you are doing and you are not using the Sonorex for renal lithotripsy if you are focusing on orhtopedic patients. You can code as you wish but I have to object to advising anyone else to do so. I own a Sonorex and it is a wonderful machine and we get great results with it.
Ed

Re: Sonorex no longer applicable to our practice

Dr. Zuckerman on 8/04/05 at 18:05 (180005)

Ed,
There area specific advisory warnings against using this code for ESWT on any part of the body. Do you know the diameter of the focal point for the sonocur.

Re: Sonorex no longer applicable to our practice

john on 8/05/05 at 08:24 (180032)

Dr Davis,

Using CPT code 50590 to bill Medicare for ESWT is Medicare fraud, plain and simple. CPT code 50590 is for renal lithotripsy! I wonder how many other Sonorex users are billing 50590?

Re: Sonorex no longer applicable to our practice

Dr. Zuckerman on 8/05/05 at 08:55 (180033)

John,
The APMA and the ACFAS in their position ESWT statement clearly point out that the use of 50590 shouldn't be used to bill for any type of ESWT procedures.

Re: Sonorex no longer applicable to our practice

Ed Davis, DPM on 8/06/05 at 12:54 (180128)

john:
You said it, I didn't. I agree with your opinon but medico-legally, it is the court system that has to make a binding legal interpretation of something like fraud.
Ed

Re: Sonorex no longer applicable to our practice

Ed Davis, DPM on 8/06/05 at 12:57 (180129)

ps. I am just amazed that a 'healthcare administrator' with any medicolegal background would make such an admission on a public forum.
Ed

Re: Sonorex no longer applicable to our practice

Ed Davis, DPM on 8/06/05 at 13:14 (180132)

pps.
I don't think that the legal system would accept a pleading of 'ignorance' of the rules. This 'administrator' must hope that no one from HCFA reads this site. Practically speaking, if the federal agencies are not alerted, then his 'action' can fly under their radar screen although this is a fairly popular site so who knows?
Ed

Re: Sonorex no longer applicable to our practice

CBakkemo on 8/09/05 at 18:25 (180272)

Thanks all for your responses, having recently assumed responsibility at this practice I should have performed a much more thorough review of the modality instead of simply cutting and pasting. As an FYI, claim review shows that upon acquisition the initial treatments were billed under 50590. Denials followed as 50590 didnt match with the dx codes of 726.32 and at the time 728.71 although I see this dx code is no longer active. A second round of billing using the corrected codes 0019T and 0020T were used with reasonable success. As the practice was not then and is not currently a Medicare provider this was not an issue, Medicare patients were not seen. The history seems a bit muddled from what I can gather but again this modality is simply not applicable in our current practice and thus our desire to divest. Finally I found no fraudulent activity only poor coding and, in my own post as well, lack of research. Irresponsible but recoverable. Best regards, C

Re: Sonorex no longer applicable to our practice

Dr. Z on 8/09/05 at 22:35 (180297)

Hi
Since we are on the topic. No insurance company should be paying for plantar fasciitis treatment with the Sonocur machine since it isn't FDA approved.

Re: Sonorex no longer applicable to our practice

Ralph on 8/10/05 at 07:24 (180303)

Dr. Z,
If there was 'total' insurance coverage would any 'off label' use of ESWT be covered including Sonocur? How could they pick and choose which off label use would be covered?

Re: Sonorex no longer applicable to our practice

John H on 8/10/05 at 09:03 (180308)

This is surprising Dr. Z. What is it approved for?

Re: Sonorex no longer applicable to our practice

Ralph on 8/10/05 at 15:56 (180337)

John,
I can see I got Sonocur confused with Sonorex mixed up but here is what Sonorex used for. http://www.kneesurgery.net/sonorex.htm

Re: Sonorex no longer applicable to our practice

Dr. Z on 8/10/05 at 22:46 (180356)

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