by
Lauren Dubinsky, Senior Reporter | February 04, 2015
DOTmed News: Let's follow that, what are some of the risks of liver biopsy?
AE: There are complications around putting a needle in anyone, especially liver disease patients. With any biopsy or interventional procedure, there is always risk. If a liver patient has an advanced stage of fibrosis or cirrhosis in the liver, these patients bleed very easily, so you really don't want to run the risk of inserting a needle.
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The other thing that happens is as the liver swells, the vessels become compressed and hard to see. Puncturing vessels can cause bleeding and hemostasis in the liver and more complications. The other issue is patient comfort, and needle biopsy is quite painful.
Liver disease patients might go in to get their values checked every 3 to 6 months and a needle biopsy is likely a part of that. Clearly an invasive procedure is much most costly, considers that complications can run into the tens of thousand of dollars.
DOTmed News: Are there other drawbacks of liver biopsy?
AE: Yes, very much so and this has to do with how representative the sample is. The problem is that a sample size of the liver biopsy also has limitations. A sample from one section of the liver can tell you that the whole liver is diseased or not diseased when that may not be the case at all. Let's say a patients ends up with a high liver enzyme test and you go in and get a biopsy and it comes back normal. That biopsy may not correct, may not be targeting the right spot.
DOTmed News: Are new technologies like ShearWave Elastography for liver disease staging reimbursable yet?
AE: Reimbursement is likely on the horizon for ShearWave Elastography. For now, there is a Category I CPT code available for billing in abdominal studies. Of course there is also the out-of-pocket option, which would only run a patient roughly $100 to $150.
It's a pretty minimal cost and most people would probably rather have a non-invasive technique than an invasive one. The bottom line is that this scanning technique saves the healthcare system a lot of money and is repeatable and therefore of great value to clinician.
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