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Modified Monday: A second set of eyes

More and more often, SLPs are doing MBS studies without the immediate presence of a Radiologist. And this can be okay-as long as they are available to take a quick look if needed and providing the final interpretation afterwards. The practice parameters set by both the American College of Radiology and ASHA for the completion of an MBS study agree. Furthermore, although it varies by state and pay source, chances are the MBS is not fully reimbursable if a Radiologist doesn't provide this.

Practice parameters and billing aside, there are good reasons why a Radiologist should be taking a good look at MBS studies. The anatomy and physiology of the head and neck is their jam, and as skilled as we may be at the swallow mechanism, there can be incidental findings that we may miss-which can lead to missed referrals and delay diagnoses and treatments of non-swallowing related conditions. This study has always been intended to be a collaboration between the SLP and the Rad.

This week's MM is great example of that second look. Our SLP with one of our Detroit teams noted penetration and aspiration at the posterior airway.. and something looked a little unusual about the bolus flow. She asked the Radiologist to take a look, and he confirmed a small mass protruding from the posterior tracheal wall, and recommended a neck CT to further assess, which we were able to pass along to the facility very quickly.

In this case, our SLP noted and was strongly suspicious of a tracheal mass, but the added clout of the Radiologist confirming was beneficial to the facility in deciding a plan of care... and there are definitely times when the Radiologist is the one that catches an important finding (as much as we SLPs hate to admit it) and certainly many times when the Radiologist identifies something that was just a big question mark for our team. (Once chased down our Radiologist at a Christmas party so he could identify a weird shadow on an MBS -turned out to be a calcified lymph node in case you were wondering.)

The Radiologist's interpretation of findings are necessary, both by most regulatory and reimbursement standards, helpful to the treating SLP and care team... and add valuable information to the complete diagnostic picture of the patient.

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