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22/09/2014 17:02:15
John Ryan
Captain-Cooker Appreciation Society
Taumata Whakatangi ..., Nouvelle Zélande
 
 
À
22/09/2014 12:43:57
Walter Meester
HoogkarspelPays-Bas
Information générale
Forum:
Science & Medicine
Catégorie:
Articles
Titre:
Divers
Thread ID:
01607799
Message ID:
01608005
Vues:
51
>>Well anything from laparascopic procedures, pickup, transfer, embryo reduction/removal... etc. See http://en.wikipedia.org/wiki/ICD-9-CM_Volume_3#.2872.E2.80.9375.29_Obstetrical_procedures. As you can see, the list is rather short and not detailed enough. Same applies to CPT BTW.

IVF pickup, transfer etc don't require a huge list of indications. You have a patient asking for the procedure with a defined purpose- that she wants viable embryos so she can get pregnant. Nobody who isn't having IVF is going to lie there meekly taking those drugs and undergoing unnecessary surgery. As for general laparoscopic procedures- I guess this is where it helps to be a physician. I'm reminded (again) of the manager who declared that physicians were excising too many benign lesions. The head surgeon responded that if the manager would be so good as to attend clinic and identify the benign lesions, they'd leave those ones alone.

In the case of laparoscopic investigative procedures for women- there are multiple legitimate indications, some quite vague, and you can be sued if you don't do it and something bad happens. These days there are quite good non-invasive tests as well, but people also say those are overused. This is one of the healthcare paradoxes- that increasingly technical care drives costs up rather than down.
"... They ne'er cared for us
yet: suffer us to famish, and their store-houses
crammed with grain; make edicts for usury, to
support usurers; repeal daily any wholesome act
established against the rich, and provide more
piercing statutes daily, to chain up and restrain
the poor. If the wars eat us not up, they will; and
there's all the love they bear us.
"
-- Shakespeare: Coriolanus, Act 1, scene 1
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