[Dysphagia] More on Head and Neck Cancer

[cclikes at yahoo.com (Christa Likes)]

I agree with Eric. I have not had any denials so far. Almost all of my patients have at least one deficit I can target on the plan of care, i.e. xerostomia, dysphagia, dysphonia, etc. prior to beginning XRT, chemo, etc. (especially if they've already had surgery).   I do a full evaluation and education session with them before they begin XRT, chemo (or at least in their first week or so of treatment) and typically follow them one a week or once every other week throughout their treatment. Their deficits almost always magnify about the 4th week of XRT if not before.
  Hope this is useful- Christa Likes, MSR,CCC-SLP

"Dolinger, Eric" <EDolinger@Christianacare.org> wrote:
  The pre-emptive approach is really becoming the standard of care.
Interestingly, havent really gotten many (any?) denials.

Many of these patients do have speech/voice/swallowing problems prior to
their treatment regimens...use that as your entrance point

eric

Eric Dolinger, MA CCC-SLP
Senior Speech Pathologist
Christiana Care Health System 
Phone 302-733-1015
Fax 302-733-1061
edolinger@christianacare.org


-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On Behalf
Of Carol Ringo
Sent: Sunday, April 23, 2006 9:19 PM
To: dysphagia@b9.com
Subject: [Dysphagia] More on Head and Neck Cancer


Hi,



For those of you who work with head and neck cancer patients undergoing
radiation or concurrent radiation and chemo, what is your model of service
delivery? We opened an oncology center at my hospital within the last
couple of years, and there is an increasing awareness by the physicians,
nurses and dieticians in our center that these patients are at risk for
trismus, as well as dysphagia. I have been asked what services I can
provide to the head and neck cancer population. My thought was that I would
be able to see these folks before the start of their treatments, for
education and counseling, and to offer preventive exercises, but my director
informs me that this kind of service is not covered by most (all?) private
insurance companies. Under this scenario, she feels we must wait until
problems develop and then have patients referred when we can bill insurance
companies for evaluation and treatment-or have them referred with the
understanding that they will be responsible for the bill. Do you provide
nonbillable education, counseling and preventive services to these patients?
If you have found a way to bill for these services, how do you do so? I am
all for providing the services as part of the "package" that they sign on
for when they begin their treatments, but I am not an employee of the cancer
center, and my director needs to keep her eye on her budget and the bottom
line. Any ideas out there?



Thank you,



Carol Ringo, Ph.D., CCC-SLP

Concord Hospital

Concord, NH



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Christa P. Likes, MSR, CCC-SLP
Certified Speech-Language Pathologist
Center Coordinator of Clinical Education (CCCE)
Regional and Oncology Rehabilitation Services
Spartanburg Regional Healthcare System
101 East Wood Street
Spartanburg, SC 29303
Phone: (864) 560-2132
Fax: (864) 560-2199
Pager: (864) 560-6070 #5421
Email: cclikes@yahoo.com
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