News
NZSOHNS New Technologies Committee Report
25 October 2011 |Balloon Sinuplasty
Currently there are several affiliated provider agreements for balloon Sinuplasty in New Zealand. Centres that have negotiated their own affiliated provider agreement include SX Christchurch , Ormiston Auckland , Manuka St Nelson, Belvedale Wanganui, Kensington Northland and Hawke's Bay. Other individual contracts close to finalization are Gillies, Dunedin, New Plymouth.
Most centres have decided to use the three tier coding system for payment which includes
1 Balloon Sinuplasty single group of sinuses
2 Balloon Sinuplasty two groups of sinuses
3 Balloon Sinuplasty including ethmoidectomy/hybrid
We will look to streamline this coding process to fall in line with the US coding where each procedure is coded for including septoplasty, turbinoplasty etc
I would encourage any centre looking at this procedure to expedite the process for negotiation as there has been talk at southern cross insurance about whether they would continue to support balloon Sinuplasty going forwards. There may come a point in time we are no new contracts are allowed. Currently we are mining our current patient data which is already showing good efficacy but also to demonstrate cost savings in the reduction of expensive salvage surgery such as modified endoscopic Lothrop.
Balloon Sinuplasty in office
At the recent sinus forum at the Waldorf Astoria in New York there was a group of Kiwi surgeons who saw the demonstrations of balloon Sinuplasty used under local anaesthesia in the office. Here in Christchurch we have done a number of balloon Sinuplasty cases in our minor procedures rooms under local anaesthesia. These have all been revision cases. There was a recent primary case done in Christchurch under local but because of the affiliated provider contract done at southern cross hospital.
As our comfort and experience with this technique increases we now look to bring primary surgery into the rooms setting. I am currently in negotiation to set up an affiliated provider agreement model that we can utilise for in office procedures of this type. Anyone that is interested in performing these types of procedures primarily in the rooms setting should contact me so that I can have a good idea of what is required in other centres before finalising the contract. Various local Anesthesia options are available and we have not settled on the final protocol by any means.
Radiofrequency treatment for OSA
Currently we have made minimal headway into getting these procedures funded by southern cross. The Australian experiences have certainly shown the value of this type of procedure as an adjunct to palatal surgery. Coblation channelling of the tongue base in my practice has certainly been invaluable both under general anaesthesia and local anaesthesia in the rooms. Could I have an indication of other surgeons or centres that are using this technique or similar in order to move the case of this procedure more to the forefront.
Other Technologies?
Could anyone please let me know of any other new technologies that they have had experience with that they are interested in bringing forward to the committee for discussion and to help with funding approval.
Tom Kuruvilla
Update, 27.10.2011
An update with regard to affiliated provider contracts with Southern Cross for balloon sinuplasty:
I have been advised by Southern Cross that they are not currently approving any further applications for this at present. They are reviewing their data for the past year, and are not accepting new contracts in the meantime.
Regards
Jamie Ryan