Guest guest Posted January 9, 2009 Report Share Posted January 9, 2009 While true that Medicare will not cover its use (and I presume you're not really thinking of billing a patient for use of their own unit), you CAN bill for adjunct physical therapy (e.g. the aquatic therapy or land-based therapy). Most programs that use Anodyne use it for patients with diabetic peripheral neuropathy --- again, not charging for the Anodyne but billing for the accompanying aquatic or land based therapy. The theory is that exercise + calcium + L-Arganine = nitric oxide. In theory, Nitric oxide (NO)is carried by red blood cells into small blood vessels, is released, and helps to dialate said blood vessels. In patients with diabetes, the bond between RBC's and NO is strong, or " sticky " and the Anodyne helps to break the bond so that the NO can be used by the endothelial cells. Despite the fact that there are one or two continuing education providers extolling the virtues of using Anodyne for this purpose, and the theory may be strong . . . the evidence-base is sorely lacking with respect to Anodyne reversing the effects of DPN. Even the outcomes " research " conducted by these providers is highly suspect, as no control groups exist in the unpublished, non-peer reviewed, non-IRB approved trials touted in the courses --- meaning that we have no way of knowing if it was the anodyne, the exercise, or tissue heating that produced the effects of improved sensation. In theory, L-Arganine, calcium, and exercise would be required for healing to occur. Similarly, although I personally have seen positive effects with Anodyne used for wound healing, (again, despite a lack of well conducted peer-reviewed evidence in the literature) the clinician must consider if the building blocks of NO exist (e.g. L-Arganine, calcium, and exercise), because without the NO, in theory, Anodyne won't have an effect. In other words, if the patient is bed-ridden, NO conversion would theoretically be sub-optimal, resulting in substandard Anodyne effect as there is not much NO to be bealed away from RBC's for endothelial cell use. In such cases, I would wonder, if it might be possible to spray NO and then apply Anodyne. M. Ball, PT, DPT, MBA/PhD Doctor of Physical Therapy - Carolinas Medical Center - Northeast, Concord, NCAssociate Faculty Member - University of Phoenix MBA Program, School of Graduate Business and Management, Charlotte, NC To: ptmanager@...: noreen_e_v@...: Fri, 9 Jan 2009 19:15:17 -0500Subject: Anodyne Group, I have a resident in an SNF who has his own Anodyne Unit and wants therapy to apply it daily for " circulation " . He has 3 unstagable open areas on his heel and wants the anodyne applied directly to the wound ( over cellophane wrap). My staff and I are NOT familiar at all with Anodyne therapy or the indications, contraindications, protocol to use with this diagnosis or effectiveness of this treatment. Any help or guidance you can provide would be appreciated! Also I believe that Medicare WILL NOT cover this treatment.. especially for an ongoing " chronic " condition. Is that true? Noreen Vollmer,PTDirector of Rehab ServicesLutheran CareClinton, NY [Non-text portions of this message have been removed] _________________________________________________________________ Windows Live™: Keep your life in sync. http://windowslive.com/explore?ocid=TXT_TAGLM_WL_t1_allup_explore_012009 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2009 Report Share Posted January 9, 2009 Hey Noreen, About 3 years ago, our LTAC facility admitted a patient with an infected leg wound for IV abx. The patient reported the wound/burn was caused by Anodyne that was being used by home health PT for 'circulation'. The wound was rectangular and the exact size/shape of the Anodyne electrode surface. At the time, we were trialing the same unit and when we asked the rep about the risk of burns, she denied this was a risk/side-effect. A few weeks later, I recall the FDA sending the manufacturer a warning letter about several cases of burns caused by the unit. Not sure what happened after that but we stopped using it given the risk and no evidence that it worked,.. other than the unpublished case reports from the manufacturer. Hope this helps in your decision-making process. Darin Trees, DPT, CWS Rehab Manager Solara Hospital Conroe, TX ________________________________ To: ptmanager Sent: Friday, January 9, 2009 6:15:17 PM Subject: Anodyne Group, I have a resident in an SNF who has his own Anodyne Unit and wants therapy to apply it daily for " circulation " . He has 3 unstagable open areas on his heel and wants the anodyne applied directly to the wound ( over cellophane wrap). My staff and I are NOT familiar at all with Anodyne therapy or the indications, contraindications, protocol to use with this diagnosis or effectiveness of this treatment. Any help or guidance you can provide would be appreciated! Also I believe that Medicare WILL NOT cover this treatment.. especially for an ongoing " chronic " condition. Is that true? Noreen Vollmer,PTDirector of Rehab ServicesLutheran CareClinton, NY Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2009 Report Share Posted January 9, 2009 Hey Noreen, About 3 years ago, our LTAC facility admitted a patient with an infected leg wound for IV abx. The patient reported the wound/burn was caused by Anodyne that was being used by home health PT for 'circulation'. The wound was rectangular and the exact size/shape of the Anodyne electrode surface. At the time, we were trialing the same unit and when we asked the rep about the risk of burns, she denied this was a risk/side-effect. A few weeks later, I recall the FDA sending the manufacturer a warning letter about several cases of burns caused by the unit. Not sure what happened after that but we stopped using it given the risk and no evidence that it worked,.. other than the unpublished case reports from the manufacturer. Hope this helps in your decision-making process. Darin Trees, DPT, CWS Rehab Manager Solara Hospital Conroe, TX ________________________________ To: ptmanager Sent: Friday, January 9, 2009 6:15:17 PM Subject: Anodyne Group, I have a resident in an SNF who has his own Anodyne Unit and wants therapy to apply it daily for " circulation " . He has 3 unstagable open areas on his heel and wants the anodyne applied directly to the wound ( over cellophane wrap). My staff and I are NOT familiar at all with Anodyne therapy or the indications, contraindications, protocol to use with this diagnosis or effectiveness of this treatment. Any help or guidance you can provide would be appreciated! Also I believe that Medicare WILL NOT cover this treatment.. especially for an ongoing " chronic " condition. Is that true? Noreen Vollmer,PTDirector of Rehab ServicesLutheran CareClinton, NY Quote Link to comment Share on other sites More sharing options...
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