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When Is Screening for Renal Artery Stenosis Medically Necessary?
Date:11/24/2008

on more than two blood pressure medications doesn't justify screening IF the patient doesn't meet one of the above four conditions. Doctors should avoid screening low risk patients because most times the positive results are "false positives" so additional testing only leads down blind alleys.

When one of the reasons to do renal artery stenosis screening is present, a renal artery doppler is the only initial medical screening needed. While it is less expensive than other tests, its drawbacks include its availability and the ultrasonographer's skill. Also screening larger patients is more difficult.

For an obese patient whose body-mass-index (BMI) exceeds 35, a doctor might consider imaging for other reasons. In this case, a CT angiogram or magnetic resonance angiography (MRA) of the renal arteries is needed only if the doppler test returned uncertain results or did not show the renal arteries clearly and is ordered by a cardiologist or nephrologist.

"Only when doctors find and document one of the four conditions in a patient is screening for renal artery stenosis medically necessary," Dr. Freedman said. "Following these guidelines will help decrease the unnecessary and inappropriate testing for renal artery stenosis, and improve the care of patients with the disease."

More information about the medical necessity review services offered by IROs can be found on AllMed's web site at http://www.allmedmd.com.


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SOURCE AllMed Healthcare Management
Copyright©2008 PR Newswire.
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