Medicare will start paying

[Hernandez]

Just got the word, Medicare will start paying for low dose CT lung cancer screening.

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[jdh71]

aw man

 

[Baller MD]

nvm

 

[Leo Spaceman]

We're still not sure if it's worth it right...esp in areas with high prevalance of histo/blasto/cocci/immigrants? More business for IP I guess..

 

[Hernandez]

Read the studies yes it improves mortality with minimal increase in inappropriate diagnostic testing, it has been shown to have a potential monetary benefit. But like many in pretty damn sick of diagnosing N2 disease cancer.

No it should not mean more procedures. Read the original study they were very picky in who got tests. And despite superDs claims I am not sold on the 80% yield of 1 cm lesions abutting the pleura.

 

[jdh71]

I wasn't really that impressed with the data.

It's just more nodules to deal with that I'd prefer not to. If we had a decent system where I am working for following them I might be happier about this.

 

[Hernandez]

If we had a decent system where I am working for following them I might be happier about this.

Personally, this is what I'm working on.

 

[jdh71]

Personally, this is what I'm working on.

They had an ideal nodule tracking system at the VA in Minneapolis. They assigned an RN to the database. She entered every nodule patient into the data base, scheduled all the follow up studies per fleischner, made all the phone calls to patients, and updated the docs per a set of criteria (new nodules of initial size >4mm, ground glass nodules, any change in size of nodule per rads dictation, and any new LAD noted in the radiology dictation - all needed a doc to look at the film).

Worked pretty slick. They published their data this last year I think. I'll have to try and track it down.

 

[tartesos]

Personally, this is what I'm working on.

Have you guys used that blood test for lung nodules on any of these patients?
That should be an interesting little project.

 

[Hernandez]

Have you guys used that blood test for lung nodules on any of these patients?
That should be an interesting little project.

It's not FDA approved yet is it?

 

[tartesos]

It's not FDA approved yet is it?

It hadn't last time I checked, but it can be obtained.
Would be nice to see first hand it's usefulness.
Would be nice if positive, but if neg I would keep fishing.