tag:blogger.com,1999:blog-7675087351939177300.post5273308730989872849..comments2023-08-15T09:39:41.235-05:00Comments on Sutured for a Living: Gynecomastia: Is Pathologic Examination Justified?rlbateshttp://www.blogger.com/profile/15236331355857884458noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-7675087351939177300.post-76519393964302760092010-12-09T06:36:31.397-06:002010-12-09T06:36:31.397-06:00I wasn't trying to goad you but was hoping for...I wasn't trying to goad you but was hoping for your opinion. The reimbursement did sound high but needed you to tell me for sure. Thanks for commentingrlbateshttps://www.blogger.com/profile/15236331355857884458noreply@blogger.comtag:blogger.com,1999:blog-7675087351939177300.post-49412560565701690912010-12-08T23:07:22.197-06:002010-12-08T23:07:22.197-06:00How interesting! Are you goading me:)
A few mont...How interesting! Are you goading me:)<br /><br />A few months back, I found ADH (atypical ductal hyperplasia) in a case of gynecomastia. I showed it to a partner - since it was a first for me. He pointed out a reference in Rosen, which I quoted in the comment, saying that ADH does not carry the same risks in men as it does in women. <br /><br />I wonder who in the heck is getting $1268 for bilateral path exam of gynecomastia. We charge 88305 - this CPT code gets about $80-$100 in global fees for Medicare - 60% technical and 40% professional. Doesn't add up. I get about two to three gynecomastia cases a year, so we are certainly not padding our pockets with benign male breasts.<br /><br />You also have me thinking if this argument could be stretched to other areas - gallbladders, skin margins, herniated discs, etc. I like to think that by examining tissue, we are a sort of a check for the surgeon. Yes, there is pathology here. There was a reason for the excision. And once in a blue moon, that fracture was pathological (neoplastic). There is CLL in that node adjacent to the benign gallbladder. If we weren't confirming disease, couldn't you surgeons just run rampant (not you of course) and take out whatever you want, citing any excuse? Ugly, yes, but it could happen.<br /><br />A lot of dermatologists read their own path, and this scares me for the same reason that I worried when a cardiothoracic pediatric surgeon was doing his own autopsies. "Yes, I know I cleared those margins." "Cause of death was as I predicted." A little too biased, I think.<br /><br />Thanks for making me think! Looking forward to getting together on Saturday.Gizabeth Shyderhttps://www.blogger.com/profile/06730800855783255834noreply@blogger.comtag:blogger.com,1999:blog-7675087351939177300.post-26578789304078119112010-12-08T19:57:58.659-06:002010-12-08T19:57:58.659-06:00I found you from Dona Nobis Pacem. I love your si...I found you from Dona Nobis Pacem. I love your site. I’m going to poke around a little bit, but don’t worry I’ll put everything back where I found it!!Katehttp://www.recommendeddailydose.comnoreply@blogger.com