Re: ErtlReconstruction.com Becomes Popular International Venue For Prosthetists,Surgeons,Amputees
Tony Barr
Description
Collection
Title:
Re: ErtlReconstruction.com Becomes Popular International Venue For Prosthetists,Surgeons,Amputees
Creator:
Tony Barr
Date:
9/6/2006
Text:
ErtlReconstruction.com surpasses 150,000 hits, available in nine languages,
as 'Ask The Ertls' link gains in popularity.
Inquiring healthcare professionals and amputees want to know Is there a
better way ?.
General Topic: Questions from a CPO regarding nerve pain
Submitted:
Aug 2006
I have a transfemoral patient - trauma post 3 years with remarkable nerve
pain and unstable tissue routing in the residuum. The local Ortho's want
him to undergo a series of injections to the nerve (in the spine) and
eventually an electrical stim unit surgically placed. I am very skeptical
that this will solve the true problem. I think an Ertl revision may be of
some assistance. Please advise, and thank you.
Note: J. Ertl performed an excellent revision on a transtibial patient of
mine, now he is a member of the US Para Olympic standing volleyball team.
Thank you in advance for all that you all do
It does sound as if at this time the patient has neurogenic pain, possibly
from a neuroma and also may have a component of centrally mediated pain. A
thorough clinical exam will be of help. An MRI can be done to assess the
limb to determine the presence of a large sciatic neuroma. Post-traumatic
amputees will have a higher incidence of chronic pain, therefore it is
important to determine the exact etiology of this pain. Centrally mediated
pain is a chronic condition requiring the expertise of chronic pain
specialists skilled in the clinical area. A revision may be of help, but
does require a complete exam, x-rays, possbibly and MRI.
William Ertl, M.D. ,Oklahoma City, OK
Q: From Betty, RN
General Topic: Questions from a nurse
Submitted:
Aug 2006
Would this procedure be beneficial for a double amputee. i.e. aka and bka
client ?
* Meaning, the procedure is for a bka, however, is a bilateral amputee
going to achieve the same success or would the greatest success be for a
single bka ?
* Is age a factor ?
* Do most insurance companies cover this procedure ?
* Are there any complications ? i.e. dvt ?
* Is the graft to build the bridge auto donated or cadaver material ?
I have treated several patients who were aka and bka bilateral amputees.
These were younger patients, meaning that they maintained their motivation
and persistence to participate in rehab and prosthetic care. The relative
success will depend on the goals desired, the capability of the surgeon, the
motivation of the patient and the overall clinical health of the patient. A
thorough exam of the patient will be required. I can not speak for the
insurance company but with proper surgical indications, the surgery can be
justified. Amputees can still develop dvts. To answer the question of graft
material would depend on the state of the limb. We have employed some
allograft material and have been successful in constructing a bridge in BKA
patients.
William Ertl, M.D. Oklahoma City, OK
Approximate cost of an Ertl Procedure
Q: From Kay
General Topic: Approximate cost of an Ertl Procedure
Submitted:
Aug 2006
What is the estimated cost of performing the Ertl procedure as
reconstruction of a transfemoral amputation?
A: From : Tony Barr
The 'suggested' reimbursement surgical codes for performing the Ertl
procedure are listed at < <URL Redacted>>
www.ErtlReconstruction.com These are only 'suggested' codes which the Barr
Foundation consolidated and which we are suggesting as possibilities for
review.
The responsibility for accurate coding lies with the patient care facility
and surgeon (office manager) to confirm the codes for their own use prior to
submitting appropriate billing paperwork. These recommendations are open to
revision and are provided as a starting point for research/determination of
codes to use. They are also subject to changes to the alpha-numeric system.
The above are suggested billing codes. Every case is unique and different.
There in not one exact pre-operative ICD-9 code for all amputees. All
appropriate pre-operative codes should be verified by the appropriate coding
department and link the diagnoses to the surgical codes.
The cost will vary from hospital to hospital, surgeon to suregon. Its been
reported to me, from several patients recieving the Ertl, that the cost can
range from $12,000 to $40,000 depending on the complexity of indivisual
cases, whether it is reconstruction or primary, transfemoral or transtibial,
complications re: neuromas, bone, nerve ending, reconstruction, etc.That is
also the approximate range for the cost of a new prosthesis !
Ask your surgeon to research the codes for your specific case.
Anthony T. Barr
President
Barr Foundation
< <URL Redacted>> www.oandp.com/barr
< <URL Redacted>> www.ErtlReconstruction.com
DISCLAIMER: Ask the Ertls is an ErtlReconstruction.com feature designed to
provide general information. It is not designed as a second opinion source
for the initial diagnoses of individual health care providers. It is
certainly not intended to take the place of your personal physician - should
you or one of your family members have a medical problem, always consult
your own physician for diagnosis and treatment.
< http://www.statcounter.com/ >
<mailto:<Email Address Redacted>>
as 'Ask The Ertls' link gains in popularity.
Inquiring healthcare professionals and amputees want to know Is there a
better way ?.
General Topic: Questions from a CPO regarding nerve pain
Submitted:
Aug 2006
I have a transfemoral patient - trauma post 3 years with remarkable nerve
pain and unstable tissue routing in the residuum. The local Ortho's want
him to undergo a series of injections to the nerve (in the spine) and
eventually an electrical stim unit surgically placed. I am very skeptical
that this will solve the true problem. I think an Ertl revision may be of
some assistance. Please advise, and thank you.
Note: J. Ertl performed an excellent revision on a transtibial patient of
mine, now he is a member of the US Para Olympic standing volleyball team.
Thank you in advance for all that you all do
It does sound as if at this time the patient has neurogenic pain, possibly
from a neuroma and also may have a component of centrally mediated pain. A
thorough clinical exam will be of help. An MRI can be done to assess the
limb to determine the presence of a large sciatic neuroma. Post-traumatic
amputees will have a higher incidence of chronic pain, therefore it is
important to determine the exact etiology of this pain. Centrally mediated
pain is a chronic condition requiring the expertise of chronic pain
specialists skilled in the clinical area. A revision may be of help, but
does require a complete exam, x-rays, possbibly and MRI.
William Ertl, M.D. ,Oklahoma City, OK
Q: From Betty, RN
General Topic: Questions from a nurse
Submitted:
Aug 2006
Would this procedure be beneficial for a double amputee. i.e. aka and bka
client ?
* Meaning, the procedure is for a bka, however, is a bilateral amputee
going to achieve the same success or would the greatest success be for a
single bka ?
* Is age a factor ?
* Do most insurance companies cover this procedure ?
* Are there any complications ? i.e. dvt ?
* Is the graft to build the bridge auto donated or cadaver material ?
I have treated several patients who were aka and bka bilateral amputees.
These were younger patients, meaning that they maintained their motivation
and persistence to participate in rehab and prosthetic care. The relative
success will depend on the goals desired, the capability of the surgeon, the
motivation of the patient and the overall clinical health of the patient. A
thorough exam of the patient will be required. I can not speak for the
insurance company but with proper surgical indications, the surgery can be
justified. Amputees can still develop dvts. To answer the question of graft
material would depend on the state of the limb. We have employed some
allograft material and have been successful in constructing a bridge in BKA
patients.
William Ertl, M.D. Oklahoma City, OK
Approximate cost of an Ertl Procedure
Q: From Kay
General Topic: Approximate cost of an Ertl Procedure
Submitted:
Aug 2006
What is the estimated cost of performing the Ertl procedure as
reconstruction of a transfemoral amputation?
A: From : Tony Barr
The 'suggested' reimbursement surgical codes for performing the Ertl
procedure are listed at < <URL Redacted>>
www.ErtlReconstruction.com These are only 'suggested' codes which the Barr
Foundation consolidated and which we are suggesting as possibilities for
review.
The responsibility for accurate coding lies with the patient care facility
and surgeon (office manager) to confirm the codes for their own use prior to
submitting appropriate billing paperwork. These recommendations are open to
revision and are provided as a starting point for research/determination of
codes to use. They are also subject to changes to the alpha-numeric system.
The above are suggested billing codes. Every case is unique and different.
There in not one exact pre-operative ICD-9 code for all amputees. All
appropriate pre-operative codes should be verified by the appropriate coding
department and link the diagnoses to the surgical codes.
The cost will vary from hospital to hospital, surgeon to suregon. Its been
reported to me, from several patients recieving the Ertl, that the cost can
range from $12,000 to $40,000 depending on the complexity of indivisual
cases, whether it is reconstruction or primary, transfemoral or transtibial,
complications re: neuromas, bone, nerve ending, reconstruction, etc.That is
also the approximate range for the cost of a new prosthesis !
Ask your surgeon to research the codes for your specific case.
Anthony T. Barr
President
Barr Foundation
< <URL Redacted>> www.oandp.com/barr
< <URL Redacted>> www.ErtlReconstruction.com
DISCLAIMER: Ask the Ertls is an ErtlReconstruction.com feature designed to
provide general information. It is not designed as a second opinion source
for the initial diagnoses of individual health care providers. It is
certainly not intended to take the place of your personal physician - should
you or one of your family members have a medical problem, always consult
your own physician for diagnosis and treatment.
< http://www.statcounter.com/ >
<mailto:<Email Address Redacted>>
Citation
Tony Barr, “Re: ErtlReconstruction.com Becomes Popular International Venue For Prosthetists,Surgeons,Amputees,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 25, 2024, https://library.drfop.org/items/show/227233.
