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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?
