HomeMy WebLinkAboutAgenda - 03-07-2013 - 5dORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: March 7, 2013
Action Agenda
Item No. 5 -d
SUBJECT: Request to Add Colposcopy Fees to Health Department Fee Schedule
DEPARTMENT: Health PUBLIC HEARING: (Y /N) No
ATTACHMENT(S):
INFORMATION CONTACT:
Dr. Colleen Bridger, Health Director,
919- 245 -2400
1
PURPOSE: To consider a Health Department request that the Board of County Commissioners
adopt fees for Colposcopy services approved by the Board of Health at its January 16, 2013
meeting.
BACKGROUND: The Orange County Health Department (OCHD) clinics provide cervical
cancer screening services for clients in Family Planning, Maternal Health and Primary Care
Programs. In fiscal year 2011 -2012, 721 Pap tests were performed and 103 required
colposcopy follow -up.
Colposcopy is a diagnostic procedure to examine the cervix when the Pap screening test
reveals abnormal changes in the cells of the cervix. The health care provider uses a special
magnifying device called a colposcope to find problems that cannot be seen by the eye alone. If
needed, abnormal tissue may be collected for pathology during the colposcopy procedure.
Currently the department practice is to refer clients requiring colposcopy to UNC's Dysplasia
clinic in Chapel Hill. In many cases barriers such as transportation and difficulty in navigating
the UNC Healthcare System deter women from getting the needed follow -up. In FY 2011 -12
approximately 47% of total Health Department clients referred for colposcopy kept the
appointment. Thirty -six percent (36 %) of Hillsborough clinic patients kept the referral
appointment, and 55% of Chapel Hill clinic patients kept the referral appointment.
In order to reduce the rate of missed Colposcopy appointments for referred patients, the
department requested and received approval from the Board of Health to provide the
Colposcopy services in -house for clients. The fee to provide the service must be approved by
the Board of Commissioners.
FINANCIAL IMPACT: The service will be provided to Orange County residents with no
insurance coverage on an income based sliding fee scale with a minimum of $30. Medicaid and
other insurance providers will be billed for clients with coverage. Startup and supply costs are
minimal, and are based on Medicaid Reimbursement rates, the department's scheduling ability,
and the cost of providing services. The Health Department is requesting to add the following
fees:
CPT Code
Procedure
Proposed
Orange
County
Fee
(minimum
of $30.00)
57452
Colposoopy of the
$160.00
cervix (without
biopsy)
57454
Colposoopy of the
$208.00
cervix, with
biopsy and
endocervical
curettage
57455
Col posoopy of the
$193.00
cervix, with
biopsy
57456
Col posoopy of the
$183.00
cervix, with
endocervical
curettage
Staff anticipates having the capacity to perform sixty (60) colposcopies in one year, and if
needed, additional appointments could be set aside for the procedure.
RECOMMENDATION(S): The Manager recommends that the Board approve the addition of
Colposcopy fees for the Health Department as requested.