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Ablation Techniques for Benign Thyroid Nodules

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9 Table 4. Organizational Considerations When Implementing a New Thermal Ablation Program Operation step Considerations Initial patient consultation Within the multidisciplinary team, who are the best physicians to perform the ablative procedure? Will it be the main responsibility of one specialty? Does it make sense for specialties to partner together? If a partnership, who provides the consult? How will physicians wishing to perform ablation get appropriate training ? What are the credentialing requirements (if any) of the institution? Location: Where should the procedure be performed? What facility resources are available at your institution? (outpatient setting, ambulatory surgery center, interventional radiolog y (IR) suite, operating room) Need to consider the ease of preauthorization for each location (i.e., preauthorization for an outpatient setting is generally easier than for the operating room) e chosen location will also have implications for anesthetic options Billing Currently, there is no dedicated Current Procedural Terminolog y (CPT) code for RFA or microwave ablation (MWA) CPT code 0673T is a category III code specifically for laser ablation of thyroid nodules using the Elesta System (should not be used for RFA or MWA) Although recognition of the procedure and reimbursement by third-party payers is increasing, there is still no guarantee of reimbursement and there is high geographic and regional variability orough discussion and planning with your finance department is necessary to ensure smooth operations. Do you want cash pay only? If you choose to bill insurers, will you do an appeal? How many times will you appeal? If the appeal fails, will the patient be responsible for payment? If so, how much will they be responsible for?

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