PPD (is there a limit how many one can have done in the pregnancy, how often etc)

[Lily Dalke]

Here is information re: PPD testing as per CDC recommendations/website:

How Often Can TSTs Be Repeated?

In general, there is no risk associated with repeated tuberculin skin test placements. If a person does not return within 48-72 hours for a tuberculin skin test reading, a second test can be placed as soon as possible. There is no contraindication to repeating the TST, unless a previous TST was associated with a severe reaction.

[Mimi Niles]

Also, for a woman who may be suspect and is not reliable in coming in for a reading, we could order quantiferon - that's the serum test.

The cost is likely to be $30-60. It is not yet approved for reimbursement by NY State Medicaid but is approved

by Medicare. QFT-G can yield cost savings in terms of medical staff time by elimination of a second patient visit

for test interpretation, and the elimination of common false-positive results, the latter involving both unnecessary

follow-up testing and treatment for LTBI.

[Lily Dalke]

Thanks Mimi. What are the implications if we order this - given that Medicaid doesn't currently reimburse? Will Woodhull cover regardless? Also, what do you type in to Quadramen to order the test? When I type in "Quantifer-" no results appear.

[Mimi Niles]

hey...
so im finally back in clinic and could NOT order the quantiferon - TB... that's too bad.
i thought we would be able to because I had a conversation with one of the Bellevue residents about how they order the Quant-TB Gold, when they have problematic situations...yet again Bellevue trumps us ... just kidding...sort of.
 
BTW, there are many tests that we order that Medicaid doesn't cover.. por ejemplo..the dreaded 'yearly' pap is normally not covered by CMS. It is only covered every 2 years for all women.
Hoping this will change with new guidelines, but it might take years.
 
and yearly if you are High Risk... or if you had an abnormal pap over a 36month period...
(I only know this for a class I took).
So the hospital doesn't make much money, or takes a hit on most well woman exams - but it doesnt' stop us from doing them. Another example is pyelonephritis, it is not reimbursed unless the woman has failed outpatient mgmt, but we just admit them and HHC goes in the red for it..
 
Mimi