SIR Applies for new codes.

[CCSVIofHouston]

First off, I would like to say hello. I represent a group of physicians (Neuro Interventional and Interventional Radiologists) based out of Indiana, in the Chicago suburbs. Our second center is set to open in 3-6 months in the Houston area.

I also wanted to let you know that the Society for Interventional Radiology has applied to get new coding in place for patients with CCSVI. What this means for patients, if approved, is that US patients will likely see insurers willing to pay for treatment.

While this is very preliminary, this coding, coupled with all the new data being published, will mean recognition of the disease entity and coverage for all US patients.

Thank you!


http://www.HoustonVIR.com (Coming Soon!)

[CureIous]

Best news I've heard in a long time.

[frodo]

First off, I would like to say hello. I represent a group of physicians (Neuro Interventional and Interventional Radiologists) based out of Indiana, in the Chicago suburbs. Our second center is set to open in 3-6 months in the Houston area.

I also wanted to let you know that the Society for Interventional Radiology has applied to get new coding in place for patients with CCSVI. What this means for patients, if approved, is that US patients will likely see insurers willing to pay for treatment.

Great news. This means nothing about the relationship between CCSVI and MS, but for sure patients with both diseases will benefit. And for sure this will spark further research.

[Cece]

This is hopeful, and seems almost too easy. The "if approved" could be the caveat. Recognition of CCSVI in its own right is something I would very much like to see.

Definitely appreciating SIR's involvement in CCSVI.

[Tracker]

CCSVI has been recognised by the Phlebologists


http://csvi-ms.net/en/content/consensus ... y-iup-2009

[CCSVIofHouston]

CCSVI has been recognised by the Phlebologists


http://csvi-ms.net/en/content/consensus ... y-iup-2009

The unfortunate thing about "phlebologists" is that it is a mixed group of clinicians. Of course I'm biased (but still a member of the ACP), but I feel their position was more of a monetary one. I think the disease needs to be given legitimacy through rigorous trials by those most adept at treating such disorders.

After all, Zamboni turned to Interventional Radiologists to start treating patients, and most of our data is coming from Drs Siskin and Sclafani, both Interventional Radiologists.

[drsclafani]

CCSVI has been recognised by the Phlebologists


http://csvi-ms.net/en/content/consensus ... y-iup-2009

The unfortunate thing about "phlebologists" is that it is a mixed group of clinicians. Of course I'm biased (but still a member of the ACP), but I feel their position was more of a monetary one. I think the disease needs to be given legitimacy through rigorous trials by those most adept at treating such disorders.

After all, Zamboni turned to Interventional Radiologists to start treating patients, and most of our data is coming from Drs Siskin and Sclafani, both Interventional Radiologists.

welcome ccsviofhouston. Nice to have another interventionalist in this discussion on this forum.

as a point of fact, dr zamboni went to his interventionalist because he could not do the procedures himself and has a very warm relationship with Roberto Galleati his interventionalist and Fabrizio Salvi, his neurologist. Dr Zamboni has been a great integrator of a great number of specialties. he makes it clear that teams of various specialties are the best way to move this work forward

i would disagree with you about grading the contributions thus far. This is a worldwide effort by many specialties, notably cardiology, neurology, phlebology, vascular surgery, fluid physiologists, in addition to interventional radiologists.

The International Society for Neurovascular disease (ISNVD) is the primary academic group focused on CCSVI. It includes many specialties. Specifically, the first president was a vascular surgeon, the second was neurologist imager and the current president is a phlebologist. No interventional radiologist has yet been in the leadership position .

The three years of research since the original Zamboni publications have been quite robust. The largest treatment series to date have been reported by drs simka (phlebologist) and Ludyga (surgeon) from Poland and Dr Ivo Petrov (invasive cardiologist) from Bulgaria. Very important work is being done by Bob Zivadinov , a neurologist and his treating colleague, Adnan Siddiqui, an interventional neurosurgeon. None of these are radiologists. All their work is great, robust and thoughtful. Other literature comes from the interventionalists in a variety of countries in addition to my work and that of dake and the albany group led by gary siskin. Some of the earliest work ccomes from an interventionalist from Jordan. Manny Mehta a surgeon in Albany published before Mandato published the Albany interventionalists results. And let us not ignore the contributions of world wide patient advocacy groups that have pushed this agenda forward.

We have much to do before we can claim to be the treatment leaders in CCSVI.

I invite you to join the ISNVD and share your experience with this talented multispecialty group. Treatment of CCSVI is very complicated and requires great understanding of the poorly understood disease called multiple sclerosis. It involves unfamiliar clinical territory ( It was forty years before I did another neurological examination. Lots of cobwebs to clear away. ), filled with political landmines in the academic, business and insurance worlds, all with competing goals. Neurologists are often not willing partners and rather shrewd and feisty opponents of CCSVI. There is a lot of money on the line and large multinational conglomerates might be quite concerned about impact on their bottom line.

Finally we IRs as a group have already been accused of inadequate followup of our patients. Patient disillusionment is just around the corner. These patients are demanding, very knowledgable and strong advocates. They are not tolerant of our turf battles.

We need to get our own house in order before we assert ourselves as the leaders of this venture.

All that have been said, this is an exciting and very rewarding therapy. But it aint no picnic.

Sal sclafani

[CCSVIofHouston]

Yes Sal,

You're right, but I admitted my bias up front. lol

The most unfortunate thing in all of this is the perception that anyone (Insurers especially) has any evidence to contradict any of this. We are at the birth of this science. The stenoses are real, and the treatment(s) are acceptable for these stenoses in other diseases. Unfortunately, logic is often prisoner to those in power (controlling the funding).

Both Mehta and Siskin are benefiting from Neurologists open to exploring this treatment option.

I hope IR's take the lead and make the landmark studies, but regardless, it's patients first!!!

Hopefully SIR's codes will be accepted and treatment will be open to far more people.

[Cece]

You're sure it won't go the other way? That the codes will be used by the insurers to specifically deny those codes?

btw, welcome to the forum, CCSVIofHouston! Have you personally treated patients for CCSVI? What are you finding? If the stenoses are real and the treatments are acceptable for these stenoses in other diseases, then it seems like it should be a simpler route to acceptance than what it has been. But we will get there.