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DVA/Veteran's Affaairs Doppler Assessments - how often?

Discussion in 'Australia' started by surfboy, Nov 22, 2011.

  1. surfboy

    surfboy Active Member


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    Dear Colleagues,

    With respect to DVA billing item numbers, specifically F104 Peripheral Vascular Assessment (Arterial and Venous).

    I see several DVA patients whom experience peripheral vascular disease and also diabetes mellitus.

    My question is, how often can we typically perform a 'screening' F104 assessment on a patient and reasonably claim payment from the DVA? Every 3 months? 6 months? What would be an acceptable time frame? - What is everyone else doing???

    I was completing 'screening' doppler assessments upon DVA patients annually, until I recently routinely performed a doppler on a patient with "mild" peripheral vascular disease and discovered severe insufficiency in his right tibialis posterior artery. This resulted in emergency angioplasty and actually salvaged his foot. Needless to say this had not been detected by the GP. -

    If others could please advise of their current practice with respect to the above, I would be very grateful.

    Many thanks colleagues.
     
  2. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    The issue you highlight is important, but I doubt you will find there are any clear guidelines from DVA about it.

    One suspects that in the evidence of any marked change in the clinical signs and symptoms of PAD, annual assessment would be reasonable.

    However, the bigger issue I see with this item number is that it is both an arterial AND venous assessment. How well can a podiatrist with a hand held Doppler assess venous competence? What findings do you report?

    I think the item number should be re-written to separate out arterial and venous assessments as per the MBS.

    LL
     
  3. cpoc103

    cpoc103 Active Member

    SB it depends on the stage of their disease. If they're well controlled diabetic with good sugar levels, or if mild pad with no past HX of foot ulceration, then Uk diabetic guidelines state annually.
    However, when I was in Uk and diabetic cntr a HX of foot ulcer be it what ever the cause it was either 3-6 monthly Doppler tests.
    However, like LL says reporting and knowing the differences between venous is quite difficult with handheld doppler.
    And prob best referred to vascular team if suspect venous insufficiency.

    Col
     
  4. surfboy

    surfboy Active Member

    Thanks guys, great posts.

    Good question regarding the venous assessment. I was wondering the exact same thing: How well can a Podiatrist assess venous competence with a handheld doppler, and how would the findings be reported??
     
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