Wiki Endosee Handheld Hysteroscope

kknudsen

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Has anyone had any luck in negotiating increased reimbursement for using the Endosee handheld hysteroscope? To date most of the health plans have not modified their fee schedule to reflect the increased in the MFS for the same procedure. While using the new scope is more efficient, the cost of the disposable portion cuts away 1/3 of the net reimbursement. Just wondering how others are using the device and billing for it.

Kandi Knudsen
 
From my experience, I have never been able to negotiate an increased reimbursement due to any specific equipment being used in the office. If you work for a large healthcare system or IPA, they may be able (through provider contracting or a similar department) to negotiate the reimbursement for the specific CPT codes you would be using. Most carriers pay based on RVUs and for most of the hysteroscopy codes you would use in the office, there is an increased value. It does not really account for the very expensive disposable portion. Of course, you do also have decreased expense and work in cleaning/disinfecting other types of hysteroscopy equipment.
I work in an office that was private practice until about 2 1/2 years ago, and was then acquired by a large health system. As private practice, we had a AAAASF surgical suite on premise. We did it for the convenience of the physicians, and it was not a heavy money making situation. We had autoclavable hysteroscopes (maybe Olympus, but I'm not sure about that). Once we became part of the health system, their internal requirements prevented us from continuing to use that equipment, and required using the Endosee. Our expenses went way up, but our reimbursement was also a little better since the large healthcare system has better contracted rates than we could get as a private office with no negotiating power. I will note the physicians commented on the better quality of images on the Endosee. If we were doing a LOT of hysteroscopy, it is possible to not be making any profit (especially depending on the carrier).
To me, it's just one of those things you need to make a business decision about whether the additional expense is worth the potential benefit in your specific situation.
 
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