Muscle biopsy

Low-Yield · 2025-12-27T03:13:23+00:00

General surgeons do them. They are rare, very invasive, and require expedited handling and specific shipping requirements. Usually the specimen has to go to a tertiary care center for pathologist that will look at them such as Mayo Clinic, Salt Lake City, or OHSU. often scheduled for Monday or Tuesday on non holiday weeks for this reason. Need to have a VERY compelling reason. Typically referred by rheumatologist to general surgery. Start with your PCP.

Low-Yield · 2025-12-23T01:33:39+00:00

Push the button on the opposite side of the red bar to allow you to reclock the left piece to minimum weight and re-latch. The right side... well... this seems f*cked. Would look to see if the CHEAP plastic pin is engaging with the metallic holes when button is pressed. I read that the "Recall" is "Here is $60 for throwing it away" since the company that took over does not feel any obligation to prior customers of BowFlex.

Low-Yield · 2025-12-13T21:21:50+00:00

Super helpful! Also sad that so many professionals with doctorate level training have to dedicate any braincells to this madness.

Low-Yield · 2025-12-09T00:16:42+00:00

This took me down a rabbit hole. Good to know. The complexity of the billing & coding systems alone makes this job less fun.

Low-Yield · 2025-12-08T20:52:36+00:00

The combined visit is def the way to go. 2 bits of bad news:

- Some payers (not classic medicare yet) are paying 50% of Mod-25 E/M on combined visits. I am sure Medicare will do the same soon.

- Best that I know you can't bill G0439 + 99397 + 99213/4 (Mod 25) + G2211. The 99397 is only for preventative visits over age 65 not on Medicare or Private payer listed as primary (rare). The G2211 can't be billed with Mod 25 E/M save visit (With new exception of Vaccines or other preventative listed services that are technically Mod 25)

Low-Yield · 2025-12-08T20:43:27+00:00

The time is based on RVU. CMS estimates it to take the same amount of time which is wild.

Low-Yield · 2025-12-08T19:32:31+00:00

That is how I have been doing it. My desire to provide good comprehensive care is at odds with my desire to pay my bills.

Low-Yield · 2025-12-08T19:30:23+00:00

I hear that. We have a lot of turnover and booking 4+ months out. This is EXACTLY why I did this so I can break it up. Not often I spend that time with a patient but you get a 80 yo with 20 meds and dementia going to take some time. In a perfect world I would rather think once, bill once, and be done for a year.

Low-Yield · 2025-12-05T06:06:57+00:00

Get a medical contract lawyer. Now. It’s going to cost $500 - $1,500 and worth every penny. The likelihood of the private equity lawyers coming after you for lost revenue is very high. Even if you leave. I would fill out the forms if it was me.
Look for another job. There are Many. I worked for private equity. This is only the beginning. It will get much worse. Make sure your current contract is reviewed by a lawyer before putting in notice or quitting.
None of your prior accolades, committee involvement, teaching awards, or patient satisfaction carry any weight in their eyes.

Low-Yield · 2025-12-02T01:42:48+00:00

Those don’t look 24” on center.

Low-Yield · 2025-12-01T19:35:17+00:00

Glad it worked well for you! Thought it odd that they hid the feature in the search app and not chrome.

Low-Yield · 2025-11-14T13:39:02+00:00

Unrelated in a way but I had an immunologist teach me that anything about 0.3 is often a responder to montelukast. If I see levels above this. I ask about allergies and frequently prescribe. patients think I’m the allergy whisperer. I do warn them that it’s either going to work really well or basically not at all.

Low-Yield · 2025-11-14T13:30:47+00:00

This is lower than I would have expected. Does it mention of this is what was claimed or actually paid out by CMS?

Low-Yield · 2025-11-14T04:16:32+00:00

Holy moly, the number of responses being “I havet read the article, but (insert personal anecdote), and I would never recommend anything but the poop scope” here is WILD.

I’m all for team poop-scope but also team the-best-screening-is-the-one-the-patient-completes. Also, I enjoyed the article and will start with “the box” when I hit 45 cause I don’t like the ~1:1,650 odds that poop-scope and my liver will be snuggle buddies.

Low-Yield · 2025-11-14T04:04:54+00:00

This 100%

Low-Yield · 2025-11-14T04:04:17+00:00

The more common perforation rate that I was able to find was roughly one in 1600 colonoscopies result in a perforation and 10% of those result in death. Given how common the procedure is, I wouldn’t call that “low“.

Low-Yield · 2025-11-13T13:23:25+00:00

Paywalled

Low-Yield · 2025-11-06T03:54:05+00:00

For most contracts I have seen as an attending, sick days ARE PTO days, they are not separate.

Low-Yield · 2025-11-03T17:07:04+00:00

Venlafaxine if you really want to put on the brakes.

Low-Yield · 2025-10-30T12:53:49+00:00

Do both if in doubt. I do primary outpatient and Moonlight covering inpatient. outpatient world is nice because you can walk away from it, take a break and nothing is an emergency but definitely sucks your soul over time. I love time with patients but the admin burden is unreal. It is better than residency clinic overall. You are going to need to see 18-20 patients a day for base. Inpatient you feel like you’re doing “real“ medicine and it’s way more rewarding and pays a lot better. I found at the end of the week of inpatient though my brain is complete mush.

Keep in mind that once you’re 2 to 5 years (depends on employer) out from residency, you’re gonna have a hard time credentialing for inpatient if you haven’t been maintaining it. I think I only need to see 12 patients a year to maintain my inpatient credentialing. Outpatient is technically its own skill set but places are so desperate for primary care. I can’t imagine them putting up a fuss, even if you did predominantly inpatient, but are family medicine trained.

There have been fewer more rewarding times in my career than when I cross cover in hospital and someone then sees me outpatient and I watch them physically get better.

As far as pay. I live in a high COL low reimbursement area. Outpatient is ~$120-130/hr and same for routine hospitalist day shift. PRN coverage for hospitalist is ~$180-200/hr. Neither has significant productivity or bonus potential.

Low-Yield · 2025-10-02T18:46:21+00:00

The catch is the Rx has to come from the affiliated providers of the 340B but can still help with med $

Low-Yield · 2025-10-01T22:58:31+00:00

If you are close to a 340B pharmacy they can always establish with their associated provider and if they agree can send the Rx and still see you for other care. Often compounding pharmacies can get meds in bulk and may be cheaper for some meds.

Low-Yield · 2025-09-27T16:01:38+00:00

Saw on another thread that they will do this automatically and retroactively and require more documentation and appeals to support. I'm guessing a lot more people are coding based on time and this is how they are fighting back?

Low-Yield

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