Answers to Questions You Might Have About MBS Frequently Asked Questions What is an MBSS or Modified Barium Swallow Study? An MBSS is a Modified Barium Swallow Study. It is actually a video recorded x-ray of an individual’s swallow. The clinic speech pathologist feeds the patient various consistencies of liquids and foods to monitor and evaluate the swallowing mechanics. Based on these findings, the speech pathologist can recommend a safe diet and swallowing strategies to improve the quality of life of the patient. The recommended diet should prevent the patient from aspirating food or liquids into their lungs which can lead to the development of pneumonia and other health complications. Is a Mobile Modified Barium Swallow Study or mobile MBSS appropriate for my patient? If your patient is exhibiting signs of pharyngeal dysphagia (e.g. wet/gurgly voice, coughing, choking, unexplained weight loss) and does not have oral apraxia with a significant oral hold, then s/he is appropriate for a MBSS to determine severity of the swallow disorder and appropriate diet recommendations, postures, and strategies for safety of oral intake. How do I schedule a mobile Modified Barium Swallow Study with Diamond Diagnostics? Please see the Scheduling section of this site for detailed information. You can also download the required forms from the links below. Simply follow the simple instructions, complete the necessary information and return to us by either FAX at (866) 728-9321 or email at [email protected] Download the Skilled Nursing Facility Intake Form Download the Home Healthcare Intake Form Download the Facility Agreement Form Why do I need to write my physician's order "dysphagia consultation including a modified barium swallow study" ? We cannot bill for the physician dysphagia consultation components of the study if you do not use this precise wording when you write your order. Why is an MBSS relevant to a nursing home and its staff 80% of patients between the ages of 18-80 (that’s our entire patient population) that enter the hospital with a diagnosed aspiration pneumonia eventually die from aspiration pneumonia. Aspiration pneumonia is caused when a patients’ swallowing mechanism is not functioning properly causing the patient to swallow food and liquid into the lungs. In order to meet state and federal regulations, nursing homes need to make sure that the diet of each patient is in line with their swallowing abilities. Nurses may sometimes notice their patients choking or coughing when eating or drinking, this is an indication that an MBSS should be ordered by their doctor. What makes Diamond Diagnostics services unique from hospital MBSS services? WE ARE MOBILE! Diamond Diagnostics comes to the doorstep of your facility or home, which helps to avoid the inconvenience of transportation to and from the hospital. Our reports are printed out immediately following the MBSS. The results and dietary recommendations are ready within minutes, as opposed to waiting, often times for several days, for the hospital to get the results back to the Speech Pathologist and staff at the nursing home. We also include a video recorded DVD copy of the entire study, which family members and other staff members who may not have been present during the study can observe themselves. Digital copies of the SLP and/or physician reports are available upon request. What is the cost benefit of using a mobile x-ray service over sending a patient to the hospital? The advantage of using the mobile service is that you do not have to transport the patient to the hospital or other X-ray center, thus improving patient comfort, safety and reducing the cost to your facility for the transportation charge. It also allows us to assess the patient in a comfortable available environment without a concern for fatigue in the patient which can affect the quality of the study and appropriate advice for rehabilitation. It is our goal to provide the Dysphagia Consultation including a modified barium swallow study to your patients within 24-48 hours of receiving your request. What services are included with the Dysphagia Consultation? Diamond Diagnostics performs the MBSS, physician assessment, vocal fold assessment under fluoroscopy, and esophagram on each patient seen in our clinic. Do you need to do a bedside evaluation prior to an MBSS? It is highly recommended but not required by Medicare. Can I do an MBSS on a patient that is on Hospice? Yes, the billing is slightly different than regular Medicare patients; hospice is responsible for the technical component of the MBSS which would be consistent without charge for any other Part A patient. Hospice must agree to cover the cost of this service. If they will not approve payment, still contact Diamond Diagnostics, as we will still help you. The patient has told me that they will refuse an NPO recommendation. Should I still do the MBSS? Yes. It is important for documentation, informed consent, and liability issues. What should I do when a doctor refuses to give an order for the MBSS? First, ask the physician his/her reasoning for refusal. Try to explain how important this test is for determining the safest diet for the patient and to devise a treatment plan that is not fraudulent. If this does not help, document that an order has been requested for an MBSS to determine the extent of the dysphagia and the safest PO diet, but that the physician denied the request. DOCUMENT THAT A DIET RECOMMENDATION CANNOT BE MADE UNTIL THIS EVALUATION IS COMPLETED. DO NOT RISK YOUR LICENSE FOR ANYONE. What do I do if the nursing staff is not following through with the diet recommendations for a patient? First, be sure that you have posted diet recommendations by the bedside and document them in the chart. Then, try to educate the nursing staff through an in-service on dysphagia and diet protocol. If they are still non-compliant, document that upon entering the room the liquids the patient had at bedside were unthickened, that they were switched to the appropriate consistency by your request and direct supervision, and that you will continue to educate nursing staff and other support staff. Then document whether the patient has had any respiratory changes, temperature spikes, etc. since this occurrence. The patient/family refuses to follow the modified diet recommendations. Have them sign an informed consent. The patient's diet has been recommended NPO. Can they still have ice chips? NO. Ice melts into a thin liquid, and is still a risk. What is the standard for repeating an MBSS or Modified Barium Swallow Study? Approximately 4 weeks, however, it CAN be repeated sooner if there is a significant change in status. Document the nature of the change when ordering the follow-up test if a need arises in less than 4 weeks. Can an NPO recommendation still be made from an MBSS even though the patient did not aspirate during the exam? Yes. There are times when esophageal pathology is found in which an NPO recommendation must be made for the safety of the patient. How do I sign up my facility for a contract with Diamond Diagnostics, LLC? Download and print the form below. Simply follow the simple instructions, complete the necessary information and return to us by either FAX at (866) 728-9321 or email at [email protected] Download the Facility Agreement Form Is our contract/agreement with Diamond Diagnostics exclusive? No. If your facility wishes to enter into an agreement with Diamond Diagnostics, you are still able to utilize the hospital for your MBSS needs if you wish. Our agreement is not exclusive. Is Diamond Diagnostics really the original provider of the Mobile MBSS and Dysphagia Consultations in Arizona? Absolutely YES! See our About Us section of this site for details. While others have tried to imitate our model, they have come and gone. Diamond Diagnostics remains the foremost experts in the field of Mobile MBS and Dysphagia Consultation. How do I contact Diamond Diagnostics? Please feel free to call our main office at (480) 926-4363, or by FAX (866) 728-9321. You can email us at [email protected]You may also use the handy electronic form located in the Contact Us section of this site. At Diamond Diagnostics, we're dedicated to improving the quality of life for the people and communities we serve and support. We are committed to providing the very best care, following proven practices, and using the best technologies available.