I would like to compliment you on your article about Vietnam combat veterans who suffer from post-traumatic stress disorder ["Is the war ever over?" Jan. 25].
As a Navy combat physician who served in Vietnam with the Marines in 1967, I witnessed the incredibly barbaric acts of the military machine that dropped bombs and napalm on the enemy and civilians alike. I can relate to my Vietnam combat vet patients who observed and committed acts of war that became burned into their minds forever.
John P. Miller, MD
The article "Coding Consult: When you remove a skin lesion" [Dec. 3] suggests that lesions needn't be measured exactly. I disagree.
CPT 2002 includes diagrams on the measuring and coding of a lesion. Lack of measurement in the medical record could lead to downcoding upon audit, since the auditor will look at the pathology report, and the lesion will have shrunk in the medium.
Also, the article states that physicians should use modifier 76 if they need to re-excise a lesion within a week. However, this would be within the 10-day global period, and the appropriate modifier would be 58.
Use of other modifiers mentioned in the article, such as 51 and 59, differs among carriers. The only way to be sure you're using the modifiers correctly is to carefully read your carriers' guidelines.
Vernell St. John
American Academy of Dermatology Association
Cloning! With the exception of flag burning, school prayer, and abortion, few words stir as much passion in this country. As the Senate prepares for a vote on this issue, I want to emphasize how important therapeutic cloning is to the health of millions of Americans.
Therapeutic cloning creates embryonic stem cells to repair unhealthy tissue. For example, let's say a patient has Parkinson's disease. The genetic material from one of his cells would be inserted in a human egg that had had its genetic material removed. After a period of time, stem cells are derived. These are coaxed into becoming brain cells which are then transplanted into the patient to cure Parkinson's. Because the cells are an exact match of the patient, no rejection would occur.
A combination of therapeutic cloning and stem cell therapies offer one of the brightest hopes for treating and curing many disorders including cancer, heart disease, Alzheimer's, diabetes, and spinal cord injury.
The House of Representatives has passed legislation banning all types of cloning. I strongly agree that human reproductive cloning should be outlawed. But if the Senate joins the House in prohibiting therapeutic cloning, the course of medical science would be altered, therapies that could save lives would be lost, and many scientists would leave the United States for countries that permit such research.
Please write or call, urging your US senator not to ban therapeutic cloning.
Sen. Arlen Specter (R-PA)
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Liz O'Brien. Letters to the Editors. Medical Economics 2002;7:13.