I recently had the pleasure of participating in an administrative law judge (ALJ) hearing. Novitas, the Medicare administrative contractor had denied the E/M code 99291, critical care. The case was appealed to the qualified independent contractor, who also believed that the care, in this case, did not meet the CMS and CPT definitions of critical care. Subsequently, the case was appealed to the administrative law judge. The encounter occurred in an ...

Read more...

Our 20-bed ICU finally captured 10 intensivists — all board-certified in critical care medicine. We were fortunate enough to have one of these doctors in our ICU 24-7. Of course, they all practiced professionally with expertise. But I remembered this one the most: Dr. Jason McKenzie (name changed for privacy). He easily became our friend and "go-to" person. Clocking in at night and finding out that Dr. J was our doc, would give me ...

Read more...

Every week there is another health pronouncement saying what is now good for you and what is going to kill you. Unfortunately, the “what” is often interchangeable -- what was supposed to kill you last week is now suddenly good for you or vice versa. Foods, supplements, and activities, all studied extensively and determined to be either good or bad, then subject to a new study, with the opposite conclusion. How ...

Read more...

If an apple a day can keep the doctor away, how much more can a delicious burrito bowl with citrus lime vinaigrette do? About half of all American adults – 117 million -- have one or more preventable chronic diseases, many of which are related to poor quality eating patterns and physical inactivity. According to the U.S. Office of Disease Prevention and Health Promotion, more than two-thirds of adults and nearly ...

Read more...

Physicians often, by virtue of their degree, have easier access to medical care. Yet the care they actually receive may be substandard. Here's why. Years ago, I broke my wrist. Visiting a local hand surgeon, I was relieved to hear that surgery would not be required -- wearing a cast for a few months would probably do the trick. But then the doctor, knowing that I'm a swimmer, asked if I ...

Read more...

If you’re sexy, fit and nimble, if you can part your thighs and bend your knees, if you can see your private parts without a mirror, ignore this. Move on. This is not for you. This is for those with flailing sex-drive and failing abilities whose sex life is a challenge, but they’d like to make their partners happy and have some fun. Maybe your parents or grandparents. This must be an ...

Read more...

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 44-year-old man is evaluated in the office during a routine visit. Medical history is significant for HIV diagnosed at age 25 years, hypertension, and hyperlipidemia. He is a current smoker. Medications are chlorthalidone, tenofovir-emtricitabine, and raltegravir. On physical examination, the patient is afebrile, and blood pressure is 126/74 mm ...

Read more...

It was an ordinary afternoon in my outpatient internal medicine rotation. I prepared to enter a room for a congestive heart failure hospital follow-up patient. I mentally prepared myself. I was going to ask for his hospital records (particularly looking for the echocardiogram), make sure he was started on an ACE inhibitor and a beta-blocker, and ensure he had a follow up with a cardiologist in the coming weeks. “This ...

Read more...

Much media attention has been paid to the new guidelines from American College of Cardiology/American Heart Association (ACC/AHA) on the primary prevention of cardiovascular disease. Based on new clinical trial data, ACC/AHA no longer recommends that healthy adults without cardiovascular disease -- emphasis on without cardiovascular disease -- take daily aspirin for the primary prevention of cardiovascular disease. This change, while significant, is highly nuanced and dependent on ...

Read more...

I can vividly remember the day the phone call came. My cousin screaming over the phone, trying to make out words but unable to speak, disbelief, horror, the fear in her voice palpable even though she was thousands of miles away. It was barely 5:30 a.m., I was frantically rushing out to beat traffic, hoping to get a head start on pre rounding since I was on call. Confused, I ...

Read more...

133 Pages

Most Popular

Join 150,000+ subscribers

Get the best of KevinMD in your inbox

Sign me up! It's free. 
close-link
✓ Join 150,000+ subscribers 
✓ Get KevinMD's 5 most popular stories
Subscribe. It's free.