Unresolved Problems in Heart Failure

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Edema, hyponatremia, and renal insufficiency
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Edema, hyponatremia, and renal insufficiency
Edema, hyponatremia, and renal insufficiency
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Panel discussion

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Domenic A. Sica, MD
Section of Clinical Pharmacology and Hypertension, Division of Nephrology, Virginia Commonwealth University Health System, Richmond, VA

Gary Francis, MD
Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH

W.H. Wilson Tang, MD
Section of Heart Failure and Cardiac Transplantation Medicine, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH

Steven R. Goldsmith, MD
Division of Cardiology, Hennepin County Medical Center, Minneapolis, MN

Mihai Gheorghiade, MD
Divison of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL

Dr. Sica reported that he has no financial relationships that pose a potential conflict of interest with this article.

Dr. Francis reported that he is a consultant to and has done teaching and speaking for the Amgen, Merck, Novartis, and Otsuka corporations.

Dr. Tang reported that he has served as a consultant to the FlowMedica, Medtronic, Neurocrine Biosciences, and Otsuka corporations.

Dr. Goldsmith reported that he is a consultant to the Astellas corporation and is on the speakers’ bureaus of the Astellas and GlaxoSmithKline corporations.

Dr. Gheorghiade reported that he is a consultant to the GlaxoSmithKline, Medtronic, Otsuka, PDL BioPharma, Pfizer, and Sigma Tau corporations.

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Gary Francis, MD
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W.H. Wilson Tang, MD
Section of Heart Failure and Cardiac Transplantation Medicine, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH

Steven R. Goldsmith, MD
Division of Cardiology, Hennepin County Medical Center, Minneapolis, MN

Mihai Gheorghiade, MD
Divison of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL

Dr. Sica reported that he has no financial relationships that pose a potential conflict of interest with this article.

Dr. Francis reported that he is a consultant to and has done teaching and speaking for the Amgen, Merck, Novartis, and Otsuka corporations.

Dr. Tang reported that he has served as a consultant to the FlowMedica, Medtronic, Neurocrine Biosciences, and Otsuka corporations.

Dr. Goldsmith reported that he is a consultant to the Astellas corporation and is on the speakers’ bureaus of the Astellas and GlaxoSmithKline corporations.

Dr. Gheorghiade reported that he is a consultant to the GlaxoSmithKline, Medtronic, Otsuka, PDL BioPharma, Pfizer, and Sigma Tau corporations.

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Section of Heart Failure and Cardiac Transplantation Medicine, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH

Steven R. Goldsmith, MD
Division of Cardiology, Hennepin County Medical Center, Minneapolis, MN

Mihai Gheorghiade, MD
Divison of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL

Dr. Sica reported that he has no financial relationships that pose a potential conflict of interest with this article.

Dr. Francis reported that he is a consultant to and has done teaching and speaking for the Amgen, Merck, Novartis, and Otsuka corporations.

Dr. Tang reported that he has served as a consultant to the FlowMedica, Medtronic, Neurocrine Biosciences, and Otsuka corporations.

Dr. Goldsmith reported that he is a consultant to the Astellas corporation and is on the speakers’ bureaus of the Astellas and GlaxoSmithKline corporations.

Dr. Gheorghiade reported that he is a consultant to the GlaxoSmithKline, Medtronic, Otsuka, PDL BioPharma, Pfizer, and Sigma Tau corporations.

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Diagnostic imaging: Radiation dose and patients' concerns

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An elderly man with syncope caused by right ventricular infarction and anomalous coronary vasculature

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'I'm not that sick!' Overcoming the barriers to hospice discussions

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Can a Children's Vaccine Help Adults with HIV?

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Amelanotic Conjunctival Melanoma

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What's Eating You? Chiggers

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A New World Record [editorial]

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Code for perineoplasty depends on setting

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Q Can a perineoplasty be performed in the office as a minor procedure or does this require an operating room? Is there some way to bill for a simple repair in the office?

A CPT code 56810 (perineoplasty, repair of perineum, nonobstetric [separate procedure]) was valued under the Resource-Based Relative Value Scale as an inpatient procedure, and there are no practice expense relative value units added if the procedure is done in the office. That does not mean that a private payer will not pay for it in an office setting, but you would not be paid for the added expense of performing it in the office setting. Also keep in mind that the perineoplasty code, which has a 10-day global period, was valued based on hospital admission and subsequent hospital care as well, so if the payer denies it in the office setting it will be because you are not providing these services.

If a repair only is documented, your other possibility is to use codes 12001–12004 (simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities [including hands and feet]; 2.5 cm or less up to 12.5 cm). These codes do have a practice expense differential when the procedure is carried out in the office. Like the perineoplasty code, this code series has a 10-day global period.

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Q Can a perineoplasty be performed in the office as a minor procedure or does this require an operating room? Is there some way to bill for a simple repair in the office?

A CPT code 56810 (perineoplasty, repair of perineum, nonobstetric [separate procedure]) was valued under the Resource-Based Relative Value Scale as an inpatient procedure, and there are no practice expense relative value units added if the procedure is done in the office. That does not mean that a private payer will not pay for it in an office setting, but you would not be paid for the added expense of performing it in the office setting. Also keep in mind that the perineoplasty code, which has a 10-day global period, was valued based on hospital admission and subsequent hospital care as well, so if the payer denies it in the office setting it will be because you are not providing these services.

If a repair only is documented, your other possibility is to use codes 12001–12004 (simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities [including hands and feet]; 2.5 cm or less up to 12.5 cm). These codes do have a practice expense differential when the procedure is carried out in the office. Like the perineoplasty code, this code series has a 10-day global period.

Q Can a perineoplasty be performed in the office as a minor procedure or does this require an operating room? Is there some way to bill for a simple repair in the office?

A CPT code 56810 (perineoplasty, repair of perineum, nonobstetric [separate procedure]) was valued under the Resource-Based Relative Value Scale as an inpatient procedure, and there are no practice expense relative value units added if the procedure is done in the office. That does not mean that a private payer will not pay for it in an office setting, but you would not be paid for the added expense of performing it in the office setting. Also keep in mind that the perineoplasty code, which has a 10-day global period, was valued based on hospital admission and subsequent hospital care as well, so if the payer denies it in the office setting it will be because you are not providing these services.

If a repair only is documented, your other possibility is to use codes 12001–12004 (simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities [including hands and feet]; 2.5 cm or less up to 12.5 cm). These codes do have a practice expense differential when the procedure is carried out in the office. Like the perineoplasty code, this code series has a 10-day global period.

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