Reducing blood lead levels the "alternative" way; An answer to ABPM headaches; Time to blow the whistle
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Maybe alternative medicine isn't simply "alternative." Perhaps it's just ahead of its time ["Alternative medicine ain't disco," Mar. 7]. New information, which is coming faster than ever, may force medical boards and malpractice insurers to rethink their negative attitude toward certain therapiesfor example, chelation to treat heavy metal toxicity.
A journal no less prestigious than Circulation recently has shown the association between arsenic intake and carotid artery disease. And a study published in JAMA [Mar. 26] called for "continued efforts to reduce lead levels in the general population, especially women" in light of findings that connect blood lead levels to elevated blood pressure.
After a few more articles in mainstream journalsthere are already a few thousandoral ETDA chelation therapy may eventually become the standard of care. Then, the true heroes are going to be the real alternative medical doctors (the ones from the American College for the Advancement of Medicine) who have been doing chelationand getting beaten up by everyonefor years.
It's important for physicians to keep an open mind. There are a lot more studies out there than you could possibly imagine. Alternative medicine isn't disco; it is medicine, which is why it isn't going to go away.
I used to grumble about how inadequate the Medicare reimbursement guidelines were for ambulatory BP monitoring to diagnose white-coat hypertensionfor all the reasons outlined in your Apr. 11 Coding Consult column, "Ambulatory BP monitoring."
Now, however, ambulatory BP monitoring is almost obsolete because patients can check their own blood pressure at home so easily. I'm glad the procedure is available for the occasional exception, but it has become very rare.
What should you do "When third party players try to play games" by offering to speed an incomplete claim through the system if you accept a 10 percent reimbursement reduction [Practice Management Q&As, Mar. 21]? Your experts advise to find out what information is missing and resubmit the claimwith a warning that you'll contact the state insurance commissioner if the plan doesn't pay promptly.
I'd send a complaint regardless. It seems the insurer had enough information to pay 90 percent of the claim.
Stanley L. Pollock
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Jun. 20, 2003;80:9.