Charged to Medicare: How much is too much?

Royce G. Haiman

It was just a tiny spot on my leg, but the dermatologist said it should come out soon-and he was booked for the month. So he called a plastic surgeon who was able to work me in right away-and whose specialty, we both knew, would result in a smaller scar. That, of course, appealed to the vanity in me. I had had some shoulder tissue removed years ago by a plastic surgeon, and I recalled it as a relatively simple office procedure.

But this plastic surgeon said his preference was to remove the tissue in the hospital where a pathologist was standing by to determine, immediately upon removal, if sufficient margins had been taken, obviating the need for a return visit if more tissue needed to come out.

I protested that I didn't want to go through conventional prehospital testing and was assured that such preliminaries were unnecessary.