Managing refractory overactive bladder patients (OAB) can be challenging. It’s not just about finding effective treatments, it also about finding the resources and space to incorporate the OAB therapies into clinical practice.
Percutaneous tibial nerve stimulation (PTNS) delivered via the Urgent PC Neuromodulation System gradually and gently retrains the nerves responsible for bladder control. It’s remarkably effective and has no severe side effects. However, it takes time -- weekly 30-minute treatments for twelve weeks, plus occasional treatments after that to maintain results.
You might think you don’t have enough time to treat patients with Urgent PC, regardless of potential patient benefit. But using Shared Medical Treatments, finding the necessary time may be easier than you think.
What Are Shared Medical Treatments?
Many leading Urgent PC practices are performing Urgent PC in what is called a “Shared Medical Treatment” setting, where two or more patients are treated in the same room at the same time.
So, when is it possible to do this, what are the concerns, and how can you handle them? By using some creativity and the example of other clinics using shared treatments, you can maximize your space and time with your patients.
Efficient Use of Time and Space
Initiating patients for group treatment settings can be achieved in two ways.
- Bring all the patients back at the same time and initiate treatment one after the other.
- Stagger patients starting time every 10–15 minutes.
Both systems work well and depend on what better fits your particular clinic.
Often clinics will start new patients in an individual treatment setting. This allows them to answer all the startup questions a patient may have, as well as gauge the patient’s temperament for participating in a shared treatment environment.
Also, clinicians don’t need to be with their patients the entire time. Once the needle is placed, it’s possible to visit other patients or complete other activities.
One of the key concerns in treating patients together is privacy. In a shared medical treatment setting, patients need to give their consent to be treated together, and many clinics have added that to their consent forms. Cogentix Medical offers a consent form for clinic use.
The following suggestions will ensure compliance with HIPAA regulations when performing group Urgent PC treatments:
- Prior to treatment, inform the patient about the group treatment setting. The patient should always be given the opportunity to request private therapy.
- Take measures to ensure that patients’ private information isn’t disclosed in the group setting. You may choose to do a review of the patient’s progress and answer questions in a separate room prior to seating them in the group treatment room.
- Patients do not need to sign a specific consent form for group treatment. However, the Urgent PC consent form now includes a checkbox with the statement, “If recommended, I agree to be treated in a group setting with other PTNS patients.”
Some clinics find it helpful to have initial conversations with patients in a private setting so that patients may freely ask questions and express concerns.
Shared medical treatments should not affect the usual billing and coding for Urgent PC, nor should it affect reimbursement.
While Medicare has not published an official payment or coding rule, they have issued the following answer to a question about billing for services whether in a private exam room or in front of other patients, “There is no prohibition on group members observing while a physician provides a service to another beneficiary.”
Similarly, private insurers have been very supportive of Urgent PC shared medical treatments. For more information, talk to your insurers or your Cogentix Medical territory manager.
Efficient Use of Time and Space
Urgent PC is a low-risk option that allows you to effectively treat OAB. Shared medical treatments benefit patients and clinics, allowing more treatment slots throughout the week, support groups for patients, and efficient use of clinician’s time and clinic space.
Shared treatment also offers additional time to educate patients during their sessions. Treatment time can be used to discuss dietary and fluid management, pelvic floor exercises and other coping strategies and therapy expectations.
And because clinics are able to treat more than one patient at a time in the same clinical space, the revenues for clinics can multiply during shared treatment times.
Urgent PC is indicated for the treatment of Overactive Bladder and associated symptoms of urinary urgency, urinary frequency and urge incontinence. Treatment with Urgent PC is contraindicated for patients with pacemakers or implantable defibrillators, patients prone to excessive bleeding, patients with nerve damage that could impact either percutaneous tibial nerve or pelvic floor function or patients who are pregnant or planning to become pregnant during the duration of the treatment. Most patients don't experience side-effects. If side-effects occur, they are typically temporary and include mild pain and skin inflammation at or near the stimulation site. Caution: Federal law (USA) restricts this device to sale by or on the order of a physician. For complete instructions for use, storage, warnings, indications, contraindications, precautions, adverse reactions and disclaimer of warranties, please refer to the insert accompanying each product or online at www.cogentixmedical.com. Urgent PC is a registered trademark of Cogentix Medical © 2015 Cogentix Medical. All rights reserved.