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Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
Taking Another Step Toward a Secure Future
In 2008, the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released a literature review on chiropractic care for low back disorders.
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
The MRI: What to Do With the Results
As I wrote in my previous article on this topic, it is my goal for you, the doctor, to be an expert in interpreting MRI images yourself; and to be able to independently make decisions based upon a combination of clinical presentations and findings, followed by the MRI images.
Lab Rats (Roaming the Streets)
The title of this article is an accurate description of American consumers (regardless of age) in the modern era.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
Treating Pain: The Hypermobile Coccyx
When I write about the coccyx, I recognize that I am talking about a relatively small subset of patients. When I write for Dynamic Chiropractic, I am trying to reach 60,000 chiropractors.
Chiropractic Around the World: WFC Country Reports December 2015
The following country updates are reprinted with permission from the December 2015 World Federation of Chiropractic (WFC) Quarterly World Report. Information is excepted for space and edited to DC-specific style guidelines.
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
Diet, Nutrition and the Context of Risk (Part 1)
Food and supplement safety is a topic that often comes up when I speak to chiropractors for CE relicensing, even when it is not the advertised subject.
Is There a Neurological Basis and Correction for Macular Degeneration?
Macular degeneration, aka AMD (age-related macular degeneration), is a common eye disease and a leading cause of blindness in people age 50 years and older, according to the National Institutes of Health National Eye Institute.
Enhancing Performance in Cross-Fit Athletes
Cross-fitness centers are expanding in number and increasing in popularity. To remain relevant to this growing portion of society, practitioners need to learn about the exercises and injuries common to this group.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
RAND Study Recruiting DCs
Dr. Ian Coulter, RAND / Samueli chair for integrative medicine and senior health policy researcher for the RAND Corporation, has issued a call for participation, recruiting doctors of chiropractic for a practice-based research study that will examine "the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low back pain and neck pain."
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
The Clinical Versatility of Milk Thistle (Part 2)
Evidence is growing that the silymarin complex of flavonolignans from milk thistle can impact serum ferritin and iron overload in various clinical circumstances.
Do Doctors Lie to Patients? (Do You Lie to Yours?)
In a previous column ["When Patients Lie (Bribe or Flatter)," Oct. 1, 2015], I discussed the issue of patients lying to doctors, and the many reasons why this can occur.
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
January, 2004, Vol. 04, Issue 01
By Whitney Lowe, LMT
The highly refined palpation skills of massage practitioners are such that we often identify tissue abnormalities before the client is aware of them. An indication that we should refer a patient for further evaluation is when we identify something we aren't sure of but know shouldn't normally be there.One such example may occur with a synovial ganglion cyst, which occurs most commonly around the wrist, though they may occur elsewhere.
Exactly how and why these ganglions form is poorly understood. This makes it difficult to formulate a consistently reliable treatment. Despite the similarity in name, a ganglion cyst is different than the ganglion that is a collection of nerve cells. The ganglion cyst is a fibrous swelling that occurs near joints and is often associated with joint capsules or tendon sheaths. It contains a clear mucinous fluid that is different than the synovial fluid contained within joint capsules.
It is estimated that about 60 percent to 70 percent of all ganglions are dorsal wrist ganglions. Those on the volar surface of the wrist make up about 20 percent, and the remaining percentage occur in other regions of the body. The cysts are more common in women than men, and there does not appear to be any association with hand dominance. They are most commonly evaluated through clinical examination, although much greater detail about the makeup of the ganglion can be derived from a detailed diagnostic study, such as MRI. They usually become evident from a visible bump under the skin and may or may not be painful; however, as they get larger, they will likely become painful, especially if pressed. In some cases, the cysts may not be visible at all. These are called occult ganglions. You may discover them with palpation and treatment of the wrist region before the client is aware of them.
How and why ganglions occur is still something of a mystery. Various theories have suggested that they involve growths on the retinacula of tendons, knots of dysfunctional tissue, herniation of the synovial sheath of joints, or various other lesions. Some people report noticing them after an acute injury, but there is no significant evidence that suggests they are caused by another mechanical trauma to the region. Because the swelling can become pronounced, there is often concern about the nature of the problem. While for some it is a cosmetic issue, others may fear it is related to a more serious problem like a cancerous growth.
It is important to evaluate these other possibilities; however, the most likely pathology - especially with wrist ganglions - is not serious. In many cases, the ganglion itself will not be painful, but may cause pain because of where it is has developed. For example, ganglion cysts are one possible cause of pain from nerve entrapment in certain regions. Compression of the ulnar nerve in Guyon's canal or the median nerve in the carpal tunnel can occur from ganglions. Since nerve entrapments in these regions can be relatively common, it is easy to overlook the presence of the ganglion as a cause in favor of one of the more common explanations for nerve entrapment pain.
There are a number of options for treatment of ganglion cysts. Ironically, pressure directly on the ganglion is still advocated by some as a means of treating it; however, you should not treat the ganglion by pressing on it. It is better to leave treatment decisions to other professionals. The more common procedure for ganglions is aspiration with a needle to remove the excess fluid and then let the ganglion dissipate on its own.
Luckily, few people today advocate the former treatment, which was to whack the ganglions with the Bible! There are a number of reports in the medical literature about distal radius fractures that occurred from this "treatment." Knowing a little more about ganglions will help you address the problem when you come upon it.
Click here for more information about Whitney Lowe, LMT.
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