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October 1992

A Few Bad Apples...

Author Affiliations

Silver Spring, Md

Arch Otolaryngol Head Neck Surg. 1992;118(10):1132. doi:10.1001/archotol.1992.01880100124024

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To the Editor.—As an otolaryngologist in my third year of medical practice, I am stunned by what I see going on around me. My sense of professionalism is offended by some of the billing and coding procedures that are occurring in my area. The actions of a few are affecting all of us.

I can understand that the setting of fees for medical and surgical services is not a simple task. On one hand, we all see the inadequacies that stem from the Resource Based Relative Value Scale that is being used in formulating Medicare fees. Clearly, the expertise, practice and malpractice costs, and cognitive effort used in performing an endoscopic anterior ethmoidectomy is worth more than the $382 that Medicare is allowing. On the other hand, a 2-hour "sinus operation," no matter how complex, cannot be worth the $12 000 that some are requesting. This discrepancy can only

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