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Hi People,
Just wanting to get a general response from the brains trust of practitioners out there if we as podiatrists have any entitlements to refer our patients for pathology services under Medicare, ie. without the patient being charged.

I had an interesting moment today when I sent a swab from an ulcer on the 4th met head, with the patient to be dropped off to his GP. I rang and advised a letter would follow today explaining my request, detailing history of previous amputation/infection, poor IDDM control and other risk factors.
Apparently the nursing staff/GP took offense that I took a swab and didn't write the request myself and that they now need to see the patient to validate this swabs need (even though dressing occurs by nursing staff every 2 days).

So basically where do our request rights stand for podiatry, if any?

Many thanks,

Al

 

Al,

Podiatrists have no access to Medicare funded pathology, currently this is only available to
Medical Practitioners, Dentists and Nurse Practitioners.
The A.Pod.C. has made submission on this, but so far, no luck.

The work around, would have been to get phone approval from the GP to send to Pathology in his name, take the swab and sent to pathology yourself, with a path slip indicating GP details, but unsigned, the path lab will then usually confirm with GP. That way you can also arrange a copy of the path report to be sent to yourself.

You can always sent a path slip directly to a lab, but the patient will pay the private fee, which should be in the vicinity of $35 or $50 for fungi, which is the 100% Medicare rate

 

"You can always sent a path slip directly to a lab, but the patient will pay the private fee, which should be in the vicinity of $35 or $50 for fungi, which is the 100% Medicare rate"

I wonder if we can bill DVA for this if the patient is DVA entitled?

I have a DVA Pt who is high risk diabetic, multi co-morbidities, previous amputations, who often presents with a pus filled lesion on a toe. So, I swab the pus, clean up and dress the ulcer and send her with the swab + a letter to her GP straight after the appt, which she does dutifully and GUESS WHAT---- the GP throws out the swab, gets the nurse to undo the dressing to swab it again and GUESS WHAT---it comes back with no growth of bacteria......funny that, when all she is swabbing is Iodosorb!! AAARRGGHH!!

 

I think the answer will still be no - just as you can't refer to any other medical specialist through DVA channels.

Steve's comments above are correct, and I too periodically will send through private referrals/requests for m/c/s for tissue specimens and wound swabs. Saves a lot of mucking around, and the patient (usually a busy working person) is generally grateful for the option of doing so.

Most podiatric surgeons I know in Australia also do the same thing with histology on specimens obtained during surgery (eg neuroma).

There is little doubt that MBS rebates for pathology services should be the 'next big thing' for APodC to be lobbying for. Especially since the growing number of podiatric prescribers are using terbinafine, IMHO - but also to better use targeted culture-driven ABs for the obvious benefits this brings.

LL