Insurance Companies Deny Surgeries
According to statistics by the American Society of Plastic Surgeons (ASPS), increasing insurance company denials and restrictions on covered procedures contributed to a 10% decrease in reconstructive plastic surgeries in 2004, forcing people to live with their medical conditions and disfigurements.
“We are not positive, but we have some concern that the insurance market is suppressing the ability of patients to get needed reconstructive plastic surgery procedures. Going forward, we want to make sure that reconstructive surgery continues to be covered by insurance,” says Scott Spear, MD, ASPS president.
ASPS surgeons continue to see health care providers limit coverage on removing tumors and skin lesions. According to the statistics, the number of tumor-removal procedures performed decreased by 8% in 2004 and by 11% over the past 5 years. In addition, the number of hand-surgery procedures performed decreased by 10% in 2004 and by 14% over the past 5 years.
Other procedures that have been denied health care coverage are breast reductions and breast reconstructions. The number of these procedures performed dropped 7% and 8%, respectively, in 2004.
“We are working to have better relationships with third-party payors to help them have a greater understanding of the difference between reconstructive and cosmetic procedures,” says Michael Sadove, MD, president of the American Society of Maxillofacial Surgeons. “Part of this is an education of third-party payors, and the other part is educating the public.”
|ASPS Announces Upcoming Workshops|
The American Society of Plastic Surgeons (ASPS) is holding Plastic Surgery Coding Workshops June 23 and 24 in Chicago. The objectives of the workshop are to provide updated ethical coding information, to identify and explain new codes and code changes for 2005 that impact plastic surgeons, and to demonstrate effective communication with insurance carriers.
In addition, course participants will learn the correct coding for office visits and consultations, and the importance of ICD-9 coding and its relationship to demonstrating medical necessity. They will also learn how to make documentations audit-proof, how to use CPT modifiers, how to correctly apply the global surgical package concepts, and how to avoid upcoding and unbundling.
The ASPS will also offer Build a Winning Practice Workshop June 25 and 26 in Chicago. This workshop will offer 12.5 hours of continuing-education credits and will cover topics such as optimal management of financial operations, overall practice management, marketing efforts, human resource management, and risk management.
|Ethicon Introduces Body-Contouring Web Site|
Due to the 77% increase in bariatric surgery and body-contouring procedures performed over the last 5 years, Ethicon Inc (a Johnson & Johnson company) has introduced a resource center for plastic surgery professionals who perform body-contouring surgeries.
The Web site, www.shaping-futures.com, offers physicians access to an extensive repository of professional-enrichment materials, including news, clinical updates, case compendia, patient education, and live training events on specific procedures and surgical techniques. It also includes interactive forums to encourage interface between surgeons.
“My own experience reflects the exponential growth in body contouring overall,” says Susan Downey, MD, a Board-certified plastic surgeon at Los Angeles County–USC hospital. “Since I started performing these procedures several years ago, my massive-weight-loss patient load has nearly tripled and presently accounts for a substantial portion of my practice. Now, by providing incisive news, clinical information, and educational tools, shaping-futures.com can help both surgeons currently engaged in body contouring and those contemplating entry into this arena enhance their skill sets and capitalize on a significant opportunity to drive practice growth.”
|ASAPS Appoints New President|
During its 2005 annual meeting in New Orleans, the American Society for Aesthetic Plastic Surgery (ASAPS) selected Mark L. Jewell, MD, as its president.
“ASAPS has been the leader in aesthetic surgery education for plastic surgeons for more than 35 years,” says Jewell. “Today, our mission also includes educating the public. Cosmetic surgery can make a positive difference in people’s lives, but they need to be well-informed about their choices.”
An ASAPS member since 1992, Jewell is clinical assistant professor of plastic surgery at Oregon Health and Science University in Portland and an associate editor of the ASAPS peer-reviewed clinical publication, Aesthetic Surgery Journal. He has served as president-elect, vice president, secretary, parliamentarian, and member-at-large on the ASAPS board of directors, as well as chair of the ASAPS Communications Commission, which oversees public-education activities.
|Botulinum Toxin Type A Goes Mainstream|
Statistics released by the Aesthetic Surgery Education and Research Foundation (ASERF), the research arm of the American Society for Aesthetic Plastic Surgery (ASAPS), show that the typical user of botulinum toxin Type A is a working mother between the ages of 40 and 55. The survey also found that the respondents have annual incomes that range from less than $50,000 up to $100,000.
“The results of this survey may come as a surprise to some people,” says Leroy Young, MD, chair of the ASAPS nonsurgical procedures committee. “Many are under the assumption that botulinum toxin Type A is used mostly by models, movie stars, and the extremely wealthy. The reality is that the majority of users are working mothers, who are juggling their career and family and are just as likely to be administrative or clerical staff as managers.”
What is the top reason that people seek botulinum toxin Type A treatments? Survey respondents said it was to look more relaxed and less stressed. “The significance of these findings is that they support the new trend that it’s no longer a beauty contest out there,” Young says. “The working mothers that I treat don’t necessarily want to look younger or change the way they look. They just want to remove the two vertical lines between their brows that convey stress and fatigue.”
According to the statistics, the occupations of survey respondents ranged from professionals, proprietors, managers, administrative staff, marketing and sales, and technicians, to homemakers, retirees, and full-time students.
|Study: Laser Ablation Treats Varicose Veins|
Results of a study presented at the 30th Annual Scientific Meeting of the Society of Interventional Radiology reveals that laser ablation is a safe and effective treatment for a common but under-recognized cause of varicose veins.
“Until now, there haven’t been effective treatments for these types of veins,” says Robert J. Min, MD, MBA, an interventional radiologist at Cornell Vascular in New York City, and lead author of the study.
The study, which was conducted over a 56-month period, included 192 patients with varicose veins that were not caused by great saphenous vein reflux. Of the 204 limbs treated with laser ablation, 104 were treated for anterior accessory great saphenous vein reflux, 86 were treated for small saphenous vein, and 14 were treated for posterior thigh circumflex vein reflux.
The study’s authors noted that there were only seven treatment failures, all of which occurred early in the study. Six of the seven failures occurred before the 6-month follow-up period, indicating that the failure may have been due to inadequate treatment rather than recurrence. All cases were successfully retreated.
“This new study means that millions of patients will now have an effective nonsurgical treatment for their varicose veins,” says Min.