Saturday, November 14, 2009

New blog series called: "Did you know?"

For the next few blogs I will address some of the most common issues related to advanced imaging and the preauthorization of such studies in a non-urgent setting.
Did you know that an MRI brain without contrast is the preferred study for the sole complaint of worsening headaches in a patient without any underlying medical history? For a patient with cancer or a known brain tumor, the preferred study would be an MRI brain with or with/without contrast. Of course, if an MRI is contraindicated, CT would be the preferred study.
Many medical providers choose CT because they think it is cheaper and will be easily approved by the insurance company/advanced imaging management company. MRI can actually be cheaper in the long run. Specifically, when a CT is done and it comes back negative. If the patient continues to have symptoms an MRI is ordered anyway. Most importantly, MRI is the preferred study for neural imaging. Dr. Robert B. Daroff said at the annual meeting of the American Headache Society, "sensitivity of an MRI scan far exceeds that of CT scans for all neurologic conditions, not just headache".
Medical providers should think twice about ordering a CT vs an MRI for nonurgent conditions. Not only can an MRI save money in the long run, it prevents radiation exposure and gives better results.

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