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Case No 8: misspelling, chlamydia Chlamydia in Italian or Latin? No case

Parts tariff: 90.89.3
CHLAMYDIA CULTURE FROM MICROSCOPIC IDENTIFICATION (Col. iodine, Giemsa). € 3.45
90.89.4 CHLAMYDIA BY CROP IDENTIFICATION (IF). € 3.65
90.89.5 CHLAMYDIA CULTURE REVIEW. € 25.70
90.90.1 CHLAMYDIA DIRECT RESEARCH (EIA). € 7.90
90.90.2 CHLAMYDIA DIRECT RESEARCH (IF). € 14.30
90.90.3 CHLAMYDIA DIRECT SEARCH (by hybridization). € 27.25

phylum chlamydiae Scientific name: Chlamydia trachomatis
, Chlamydophila pneumoniae, Chlamydophila psittaci
So either chlamydia or Chlamydiae not Chlamydia

some links:

• http://www.msd-italia.it/altre/manuale/sez13/1601332 . html
• http://www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm
• http://en.wikipedia.org/wiki/Chlamydiae
• MEDLINE

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7: reflex testing and prescription health

http://extra.ulss16.padova.it/NEWS/allegati/leggi/ @ 30575.258.pdf
http://pacs.unica.it/Guida_illustrata.pdf
http:// pacs.unica.it / Guida_rapida.pdf

For a variety of reasons (not to modify, exemptions, etc. ..) the additional benefits must be supported by additional commitments.
What happens if the prescriber assumes in advance the additional benefits, such as reflex testing? For example, asking for a bacterial culture as "any susceptibility?
patients, if necessary, agree to pay the additional fee for the examination, but do not understand the reasoning of the "share recipes".

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Case No 6: Free testosterone and SHBG

Current nomenclature:
TESTOSTERONE [P / U]. 13:25 € 90.41.3
free testosterone. € 16.10 90.41.4

performance niche AO Padova:
SHBG 17:50

94,774 Note: "... If testosterone levels are low-normal and the Symptoms and signs indicated hypogonadism, the testosterone study Should be repeated, and sex hormone-binding globulin (SHBG) or a free testosterone level by equilibrium Dialysis Should Be Determined ... "
( AAME 2002 guideline update )

Question: appropriate to include in the same request SHBG and free testosterone?

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case 5: EBV antibodies

Parts Now: 91.21.1
Epstein Barr virus [EBV] ANTIBODIES (EA or EBNA or VCA) (EIA). € 13.75
91.21.2 Epstein Barr virus [EBV] ANTIBODIES (EA or EBNA or VCA) (Titration by IF). . € 12.70
91.21.3 Epstein Barr virus [EBV] heterophilic antibodies (rapid test). € 7.80
91.21.4 Epstein Barr virus [EBV] heterophilic antibodies [R. Paul Bunnell Davidsohn]. € 8.85

Questions:

1. obsolete titration using IF? Paul Bunnell Davidsohn
2. obsolete?
3. typical panel (EBNA + EA + + VCAG VCAM) 91.21.1 x = 4?

link:
http://www.cdc.gov/ncidod/diseases/ebv.htm
http://www.labtestsonline.org/understanding/analytes/ebv/glance.html

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CUMUL: translation into Italian Swiss LOINC

"... To upgrade applications themselves, the Secretariat needs to CUMUL well inteso per ogni nuovo test, degli elementi chiave ma anche degli eventuali sinonimi e delle unità:
costituente proprietà durata sistema scala metodo sinonimi unità
Questi elementi possono essere inviati sotto forma di tabella (una linea per ogni test), dando preferenza al formato Excel, riferendosi rigorosamente alle convenzioni LOINC descritte nel manuale.
Si avete poco domande potete anche utilizzare nostra scheda online, però per una domanda nello stesso tempo...."

http://www.cumul.ch/2_pro_it.htm

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case 4: cytochemistry with discount of 70 € cent

• 90.63.4 ESAME MICROSCOPICO DEL SANGUE PERIFERICO. Caratterizzazione di cellule patologiche (con reaz. citochimiche e citoenzimatiche) € 3.75
• 90.70.4 leukocytes (white blood cell count and microscopic) [(Sg)]. € 4.45

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Lombardia: guidelines for the correct application of the tariff nomenclature. DIRECTORATE GENERAL HEALTH ORDER 'N. 32731 18/12/2000 (PDF)

"... Where are carried out directly by a specialist laboratory, certain benefits not expressly specified in the prescription (recipe), which is necessary for the conduct of the required or the successful completion of the diagnostic (as indicated below to see specific items, eg.: examination of molecular biology, electrophoresis, drugs of abuse, anti nuclear antibodies, variant DU research, culture tests, HIV serology, etc..) and was possibly exceeded the number of eight performances, should not be obtained from the patient a prescription for further tests to complete the number of services actually provided, must be generated in the detection of a new record in accounting for performance in excess of eight. ... "

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case No. 3: Exemptions in SLR?

Tables of exemptions from the ticket for the disease ( click ) are cross-sectional, not longitudinal.

That is, if an exempt supply (eg urine culture in diabetes, Code 013 exemption. 250; code CULTURE URINE TEST performance 90.94.2 [ urine culture ] Full Search microorganisms and yeast pathogens. Included: bacterial count. click ) reflex generates benefits not provided in the table [eg CULTURE OF BACTERIA SUSCEPTIBILITY 90.85.1 (Kirby Bauer, at least 10 antibiotics). € 6.50; 90.85.2 BACTERIA SUSCEPTIBILITY TO CULTURE (MIC, at least 10 antibiotics) 90.86.1 BACTERIA CULTURE OF BIOCHEMICAL IDENTIFICATION Nas. € 12.45, 90.86.2 BACTERIA CULTURE OF SEROLOGICAL IDENTIFICATION Nas. € 6.95 ; click ], logically they should "inherit" the exemption from the original performance, but that does not appear explicitly in any standard.

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case # 2: Angiotensin Converting Enzyme (ACE)

ER 19118/DIR The circular of 15 May 1998 reads:
"... Although the tests for the enzyme converting enzyme (ACE) falls between the services considered obsolete, some companies believe that is still outstanding. It is estimated that the test can be performed only in special situations for the diagnosis of pulmonary sarcoidosis and in the presence of specific medical request. Only in this case the determination can be equated with angiotensin II (code 90.08.2
)...." As we have seen, the AO performance of Padua has recovered from those "niche" (click ).
In some regions (Lazio), the code corresponds to 90.08.2 ACE, Angiotensin II does not.
Questions: ACE is a provision obsolete? E 'to be considered as an examination of niche? Rate 90.08.2 (€ 14.25) would be adequate to ACE, or rather it is the rate of Padua (€ 11.00)? The examination Angiotensin II is still in common use?
Links: LabTestsOnline click Analisidelsangue.net click

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case # 1: 90.65.1 FIBRINOGEN FUNCTIONAL. € 2.70

Question: Two methods are in use in laboratories for assay of fibrinogen to the Clauss and PT derived. The title link leads to the guidelines on SISET. The tariff nomenclature refers to both the performance, despite the difference in consumption of reagents, calibration work, quality control, etc. ..?

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Padova, list performance niche

Update April 2006 performance niche of the Hospital Padua.
As reported in reference DGR (2883/03), it is not in the exams tariff nomenclature corresponding to a set of requirements.
Click here or on the title to download the PDF file .

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enforceability of NICHE BENEFITS - DGRV 2883/2003

A careful reading of DGRV 2883 3.10.2003 (that is linked to a recent note from the AO of Padua) allows you to single out the requirements that should have the cd "PERFORMANCE OF NICHE" to actually be performed, invoiced and paid :

A - performed by AO or AO Padova Verona
B - on request only cookbook Regional
C - contains criteria effectiveness and appropriateness
D - explicit indication indispensability
And - do not fall explicitly stated other benefits of tariff nomenclature
F - authorization ULSS opinion with reference to their doctors
G - direct billing between ASL, flow out of the compensation

Problems:
1 - not allowed out-tariff structures other than PD and AO AO VR (eg, tacrolimus)
2 - should be defined in each ULSS a path to collect the characteristics of effectiveness, appropriateness, and do not fall indispensability (criteria C, D, E)

click to resolution 2883

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assimilation performance - Emilia Romagna proposal 06/17/2003

Original Document Nomenclatore_indicazioni_di_applicazione.doc
Dimensions: 186862 bytes

17/06/2003

Protocollo N °. ASS/DIR/03 / 23669

Date 06/17/2003

Oggetto: Risposta ai quesiti ed indicazioni relative all’applicazione del Nomenclatore Tariffario regionale delle prestazioni specialistiche ambulatoriali posti dalle Aziende Sanitarie al “Gruppo regionale di lavoro per il controllo della qualità della codifica delle prestazioni”.

Con la presente, si inviano le risposte ad alcuni quesiti sollevati dalle Aziende sulla "corretta codifica delle prestazioni specialistiche ambulatoriali". In merito ai suddetti quesiti si ritiene di fornire le seguenti indicazioni:

... omission ...

1. Search anti-worm . anti-alpha fodrina , anti-citrulline , anticorpi anti-neuronali , steroidal anti- , anti-myelin , tests of intestinal permeability , permeability tests gastric , dosing of Helicobacter pylori CagA antigen , fecal elastase assay , dosage and dosing pepsinogeno1 pepsinogeno2 .

is asked to assimilate the services provided to other already existing nomenclature.

Per le prestazioni di cui sopra, si propongono le seguenti assimilazioni:

- " anticorpi anticitrullina " assimilata a " anticorpi anti antigeni nucleari estraibili ( ENA) "cod. 90.47.3 tariffa pari a euro 13,35;

- " anticorpi antineuronali " assimilata a " anticorpi antiorgano " cod. 90.52.5 tariffa pari a euro 14,50;

- " anticorpi anti-steroidali " assimilata a " anticorpi anti organo " cod. 90.52.5 tarifa pari a euro 14,50;

- "anti-myelin" corresponding to "anti MAG" cod. 90.51.3 fee of € 11.40;

- "dosage dosage pepsinogen pepsinogen 1 and 2" treated as "gastric parietal cell antibodies (PCA)" code. 90.48.1 fee of € 8.35;

- "fecal elastase" corresponding to "chymotrypsin (I)" code. 90.13.1 fee of € 5.40;

- "anti - GAD" assimilated to "antibodies antitransglutaminasi" code. 90.49.5 fee of € 11.40.

As for performance, anti-worm, anti-alpha fodrina, Helicobacter pylori CagA antigen assay, tests of intestinal permeability and gastric permeability test, given the low prevalence of the same and therefore the necessary information for a proper evaluation, it is not possible to propose any assimilation.

Franco Rossi

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Sample chapter for discussion: examination for urinary tract infection in the region of Veneto

• 90.93.6 ESAME COLTURALE DELL'URINA [URINOCULTURA] RICERCA COMPLETA MICROORGANISMIE RICERCA COMPLETA MICROORGANISMI E LIEVITI PATOGENI - SOSTITUISCE PREST. 90.94.2.Incluso: conta batterica e saggio di inibizione della crescita 11.35
• 90.87.1 BATTERI POTERE ANTIBATTERICO RESIDUO IN MATERIALI BIOLOGICIDIVERSI.Saggio di inibizione della crescita 4.65
• 91.11.7 URINOCULTURA SU TRE CAMPIONI - TEST DI STAMEY.Comprensiva di: ricercaTrichomonas. Clamidia, Micoplasma Escluso: massaggio prostatico 55.35
• 90.44.2 URINE CONTA DI ADDIS. 3.85
• 90.44.3 URINE ESAME CHIMICO FISICO E MICROSCOPICO. 2.3 URINE TEST PART
• 90.44.4 (Acetone quantity and glucose). 0.7

Questions propose:

1. because the Veneto is unique among the regions to associate Necessary outpatient urine culture and PAR test? (90.93.6)
2. the nomenclature is also used for the enhancement of benefits for patients admitted inside. It may be useful to have next to 90.93.6, 90.94.2 performance, simple urine culture, at least in these cases?
3. counts of Addis is a test obsolete?
4. latest technologies lend themselves to counting protocols like "urinary reflex", where the crop may follow the positive result a count of bacterial cells. The performance is appropriate in these cases, 90.93.6, 90.94.2, 90.44.2 or 90.44.3?
5. Stamey test is obsolete?
6. which method would be appropriate for the detection of chlamydia in the Stamey test? The rate is proportionate?

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Statement on outpatient care

original document on Parts tariff for the provision of outpatient specialist care: Updated 11/03/2005 rates.

• DGR 486 of 03/05/2004 (pdf 75KB)
• Annex No DGR 1 486 of 03/05/2004 (pdf 276KB)
• DGR 4304 of 29.12.2004 (pdf 78KB)
• DGR n. 61 del 21/01/2005 (pdf 65kb)
• Allegato alla DGR n. 61 (pdf 400KB)
• Allegato alla DGR n. 61 (csv 153KB)
• DGR n. 750 del 11/03/2005 (pdf 121KB)

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Working Tariff Performance Parts

Secondo il Collegio dei Primari di Laboratorio del veneto, il gruppo di lavoro su "Nomenclatore Tariffario delle Prestazioni" non si limiterà alla definizione delle tariffe, ma si occuperà della definizione univoca degli esami, compresi i problemi di standard ai fini di comunicazione, della eliminazione di esami inutili, ecc.
Tramite il CISMEL ( www.CISMEL.it ), di cui ha chiesto il patrocinio, the group will try to reconnect the international standards on terminology, nomenclature of laboratory measurements. Among these, prEN 1614-2004 (replaces ENV 1614:1995, entitled Healthinformatics - Structure for nomenclature, classification, and coding of properties in clinical laboratory sciences ) was precisely to overcome approaches aimed at "... restricted Purposes Such as ...". Reimbursement prEN 1614-2004 is mainly based on the IUPAC / IFCC. Quantities and Units in Clinical Laboratory Sciences. Approved Recommendation (1994).