Skin Surgery: You Should Be Doing It in the Office
Good for the patient - good to increase your reimbursement.
Skin surgery is one of the easiest procedures to do in the office. All that it requires is inexpensive equipment, 2% Xylocaine to numb the lesion area, a 19 gauge needle to draw up the Xylocaine and a 30-gauge needle to inject the surgical area.
There is only one problem: You have to have a patienton which to do the surgery – and why don’t you have the patient to surgerize?
The answer is simple. Most patients know that we are very good at medical-surgical diagnosis and treatment, and, they know that we are the best and most complete for medical manipulation; however, no one knows which procedures you do in the officeunless you tell them, and most DO’s do not tell the patient the extent of what they do in their office.
We have solved this problem very successfully, and here’s how we do it. On the back of the appointment card, we list all the 50 procedures we do in the office including skin surgery. The other instrument that we us is a practice brochure.
In this practice brochure, we list our education, background, our specialty certifications, our hospital affiliations, and, on one page, we list all of the procedures done in our office. Everyone gets a practice brochure on their first visit, and, in each room, the practice brochures are in a rack so that they can be read while the patient is waiting.
Your skin surgery potential patient list is very vast. It includes little kids with verrucae on the fingers and feet, and the older patient who has a multitude of senile lesions, and, all of these patients will say: “I’m so glad that you’re removing these tumors. I’ve had them for years, and, I always wanted to get rid of them.”
The equipment is simple to use and inexpensive. We use an Ellman Electrosurgery Machine. It comes with a variety of electrical surgical destruction “needles” varying from graduated loops for pediculated lesions, and, incision cutting needles for opening and eradication of sebaceous cysts. There are needles for cauterizing, and then scraping lesions with a skin curette very efficiently.
My unit is foot controlled. I don’t like the surgical wand that activates the surgical current by a button on the hand pieces. I don’t want any outside pressure for activating the current, by pressing a button on the hand piece because it modifies your exactness in attacking a lesion. You might order some literature from the Ellman Company that will show you the multitude of different lesions you can address with this piece of equipment: inexpensive and efficient.
People will love you for getting rid of the lesions they have disliked for such a long time. The reimbursement is excellent. You not only file for electro surgical destructions of precancerous lesions, but, you may also file for an instrument tray. Have your office manager find and use codes to cover your work. If the patient is also there for OMT, do the heat massage and traction on the Anatomater Machine before you get there to render OMT and before you do surgery.
Add these charges all together and you have significantly increased your reimbursement. If you are not doing skin surgery in the office, you should be – make the patient happy.