Hey guys,
I work for an OB imaging center and for patients with commercial oxford insurance we are required to obtain prior auths through evicore. We use the United Healthcare Link website which allows us to obtain these auths hassle free online should the ultrasound be considered medically necessary.
This past week every case I’ve started requires us to submit medical records even if we answer the clinical questions correctly for patients who require these procedures. An example code is 76811 and using advanced maternal age as an indication for medical necessity. In the past we could get it approved on the spot, but now we need to submit medical records after receiving just a case number. This review process is indiscriminate and it applies for all our procedures/patients/indications.
Does anyone know what is going on? Or have any prior experience with this situation?
Hi all, I recently came across the concept of TI and MI. I'm not a radiologist so my knowledge is very limited. I came across guidelines that advocate for <1.0 with others stratifying by contact time.
When I look at the scans from my patients, I see that TIs 1.5 and MI 1.0 are fairly common. Some imaging facilities tend to use high TIs and MIs more than others. Is this due to error (e.g. forgetting to change settings), rad/sonographer preferences or are there patient characteristics that factor in like body habitus?
More curious than anything.
Hi everybody. I’ve posted here about having vaginismus - which I think have to some degree - but this point doesn’t address that very much. I’m posting here because I’d love to know if anybody who has vaginismus or had it in their past has any experience with Bartholin’s gland cysts. Also, I’d like to know how people get through doctor’s appointments while staying calm.
When I noticed a red, swollen, painful lump on the lower one-third of my left labia, I did some Googling and research. My symptoms are pretty consistent with a Bartholin’s (gland) cyst. I’m going to the doctor early tomorrow morning. I’m anxious but overall I’m glad that I’m going. Over the past two days, a small amount of metallic-smelling blood has come out of it. I think it may be draining a little on its own. I’ve taken two baths to soak and help it relax and hopefully start to drain itself.
Here are my questions:
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How will they treat this?
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Can this be treated without cutting or incisions or injections? I’m okay with them spreading my inner labia to look at my vaginal opening and even putting their finger on the cyst/on my vaginal opening to palpate it, or even swabbing my inner labia/outer entrance to my vaginal opening. I’m scared of them having to cut, drain, or incise the cyst.
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Does the bleeding mean it’s infected?
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If it’s infected, what will the treatment be? Will it involve any of the scary things mentioned above?
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How do I stay as calm as possible? I’m going to shower before I leave and wear a pantyliner so discharge/drainage won’t make me feel wet or dirty. I’m also not going to drink very much at those early hours of the morning before and during the appointment so I won’t have to pee a lot and feel wet/gross down there. I have a little hair and a few razor bumps/some irritation from shaving. What else can I do to keep calm besides breathing?
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What if they have to cut or drain it? I’m so scared. They have to do local anesthesia which involves putting a needle in my vulva/vaginal opening. UGH
Changes such as a wider pelvis and more energy intake seem obvious but what other changes would there need to be?
Could the placenta be made to be more efficient to so that carrying is less of a burden on the mother and more nourishing for the fetus?
What would the length be for such an optimized pregnancy be? More than 9 months? How long would a pregnancy last if the only concern were the strength and brain development for the baby? What new burdens would this place on the mother and how would those changes be solved?
What advantages would a baby grown in such a way receive at birth? How big could/should they theoretically get inside the womb before sharp diminishing returns simply make birth necessary?
Thanks for any thoughts.
Looking for a new OB, prefer female, down to earth, warm. Need to admit to Unity or Rochester General. Any one know of anyone personally recommended? Thank you
Maybe this is more for a Hebrew scholar than anthropology, but I was reading about the toll bipedalism takes on a woman's pelvis, and then somehow I was looking at the obstetrical dilemma, and then I was thinking back to Sunday school. So Adam and Eve eat from the tree of the knowledge of good and evil - which I guess would give you a bigger brain. All of the sudden, Adam and Eve are "aware." And then, In Genesis 3, God is talking about how he's gonna curse women and make childbirth really hard after Adam and Eve fucked up.
Could whatever Hebrew guy that wrote Genesis be talking about how babies bigger heads make childbirth a lot harder? Is this a dumb question? Have any other cultures made that connection?
