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Immediate Breast Reconstruction and CMS
A frustrating CMS billing dispute is recounted after performing immediate breast reconstruction following another surgeon's mastectomies, with Medicare refusing payment because the add-on code requires both procedures to be done by the same physician.
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Ivory Towers
A regional Level 1 trauma center refused a difficult transfer for specialized endovascular care, sparking reflection on how academic medical centers have drifted from their traditional mission of supporting community surgeons without question.
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Closing the Office
An announcement that the author is closing his elective surgical practice to join a local trauma group, a move driven by the rising costs of running a private office.
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No more white coats?!
A reaction to a UK government plan to ban the traditional white coat and restrict clothing to reduce hospital infections, arguing the policy lacks research support and that consistent hand-washing would produce far better results.
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TPA and the Trauma Patient
A cautionary case note on the dangers of using TPA in a trauma patient with a bullet wound crossing the liver, which led to three trips to the OR before Factor VII controlled the bleeding and the abdomen was finally closed about 36 hours later.
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Cuban flu Pt. 2
A follow-up citing a BBC report that Fidel Castro refused the colostomy procedure, confirming the prediction made in the original post about the root cause of his surgical complications.
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Cuban flu
A surgical analysis of Fidel Castro reported acute diverticulitis and multiple operations, arguing that skipping the standard Hartmann procedure in favor of immediate bowel reconnection was a critical error that caused all subsequent complications.
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Specialty Board Equivalency
A California Superior Court ordered the Medical Board to grant the American Board of Cosmetic Surgery specialty board equivalency after it met all 19 regulatory requirements, a win that lets cosmetic surgeons advertise board certification and raises questions about future turf disputes with plastic surgeons.
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Medical Reimbursement
A pointer to a blog series demystifying the maze of medical coding and reimbursement for a general audience that has little understanding of how physicians actually get paid.