|
from Robert R Williams M.S., M.D., Sutter Gould Medical Foundation
from his presentation at the VHL Conference, June 2001, Palo Alto, California
The referral should specify what needs to be addressed and why, so that the reasoning is clear and the expense will be approved.
- List proper CPT codes (U.S., or use analogous codes for your health system)
- List proper ICD9 codes (U.S., or use analogous codes for your health system)
- Be specific to what is needed
- Give pertinent and specific information
- Refer to recommendations of the VHL Disease (VHLD) Task Force as shown in the VHL Handbook
Referral Example #1:
Referral: Urologist
Reasons for Referral: Lesion palpated in scrotum
New right scrotal mass epididymis area 1.2 cm first noticed march 2001.
Patient has VHLD which has high propensity for papillary cystadenoma.
CPT: 99243
ICD9: 759.6 VHLD
608.89 Scrotal mass
Referral Example #2:
Referral for MRI Brain and Spine
Cpt: MRI Brain 70553
MRI Spine cervical 72156
thoracic 72157
lumbar 72158
ICD9: 759.6 VHDL
Reason for test: VHL yearly surveillance.
Very high rate of tumors, hemangioblastoma’s of brain and spinal cord
Recommended by The VHLD task force
Last exam march 2000
List any previous Tumors or Neuro surgery
Keep copies of previous MRI’s for comparison
Referral Example #3:
Referral: Retinal Exam Indirect Ophthalmoscope
Cpt: Eye Exam 92003
Ophthalmoscopy 92226
ICD9: 759.6 retinocerebral angiomatosis VHLD
Reason for test: VHL yearly surveillance.
Very high rate of Retinal Hemangioblastoma
Recommended by The VHL task force
Last Exam march 2000
Try to use same ophthalmologist
Keep copy of previous exam for comparison
|
VHL Codes (U.S.) and estimated costs (U.S. dollars, June 2001) |
| Test |
|
CPT |
Cost |
| Genetic testing |
Southern blot initial |
83890-2,4,6,83912 |
$220 |
| |
Full |
83890-2,4,8,83912 |
$540 |
| Genetic counseling |
|
99244, v26.3 |
$275 |
| Comprehensive exam (FU) |
|
99214 |
$120 |
| Retinal exam (IO) |
Eye Exam complete |
92002 |
$160 |
| |
Ophthalmoscope |
92226 |
$ 80 |
| Lab |
Urinary catecholamines |
82384 |
$130 |
| |
Urinary metanephrines |
83835 |
|
| Nuclear study |
MIBG 131 |
78099 and 78990 |
|
| Abdominal MRI |
Pelvis |
72196 |
$700-$1700 |
| |
Abdomen |
74182 |
$700-$1200 |
| CT scan |
Abdomen |
74160 |
$200-$350 |
| Ultrasound |
Renal |
76770 |
$200-$350 |
| MRI brain |
(with contrast) |
70553 |
$1100-$2400 |
| MRI spinal |
Cervical |
72142 |
$800-$2000 |
| |
Thoracic |
72147 |
$800-$2000 |
| |
Lumbar |
72149 |
$800-$2000 |
|
