Peds growth charts

[Guest guest]

Would anyone like some peds growth charts???

If you pay for shipping I will send them to you.

Dannielle Harwood

To: practiceimprovement1 Sent: Thu, March 4, 2010 3:28:41 AMSubject: RE: Vitamin D Levels

Great thought, thanks Ellen.Though now that they are up though do you think I can just get away with a regular calcium for screening and that would do?iPTH is expensive and I am cheap.is a low D an indication to get bmd without other risk factors?clinically, most of these are very obese women some as young as 18, though one is a 75 year old non obese male undergoing treatment for bladder cancer in situ. What I think is the fat cells are sucking up the vitamin D and not letting go.BMD on the older white male is a good idea, I will do that. Graham, I think she is saying that the low D would be masking the hyperparathyroidism but not causing the low D? Lynn

To: Practiceimprovement 1yahoogroups (DOT) com; practiceimpvement1@ yahoogroups. comFrom: nellegreen@earthlin k.netDate: Wed, 3 Mar 2010 14:03:12 -0800Subject: RE: [Practiceimprovemen t1] Vitamin D Levels

Lynn----If someone has a really low Vit D and it's hard to get up, you should check an intact PTH to make sure there isn't another cause for the low D. Many have borderline iPTH and don't need rx but you wouldn't want to miss a case of true hyperparathyroidism .In someone so low, would be good to get a BMD too. Ellen

Re: [Practiceimprovemen t1] Vitamin D Levels

My lab sent a form with the approved diagnoses for vit D level. Can't find it however. I think ostreoporosis is one of them, however. Check with the lab. The right diagnosis code is likely all she needed. Otherwise, just use the code for vitamin d deficiency since you are presuming it (right?) and already giving her vitamin d, and now you need to measure to be sure her supplementation is adequate.Tim Malia, MD (phone / fax)www.MaliaFamilyMedi cine.comwww.SkinSenseLaser. comMalia Family Medicine & Skin Sense Laser6720 Pittsford-Palmyra Rd.Perinton Square MallFairport, NY 14450-- Confidentiality Notice --This email message, including all the attachments, is for the sole use of the intended recipient(s) and contains confidential information. Unauthorized use or disclosure is prohibited. If you are not the

intended recipient, you may not use, disclose, copy or disseminate this information. If you are not the intended recipient, please contact the sender immediately by reply email and destroy all copies of the original message, including attachments. [Practiceimprovemen t1] Vitamin D LevelsYikes, everyday seems to be

bringing on new issues. I have an elderly lady with osteoporosis, kyphosis, height shrinkage, etc who was asking about checking Vitamin D levels to see if she needs extra supplement. I complied, thinking no big deal, it is all over Oprah/Dr. Oz/etc and everyone is talking about it. Now the patient called stating that Medicare will not pay for the test unless I write a letter of medical necessity. My first thought was to write, Test was a medical necessity. Period. Amen.Any thoughts?? Are you guys ordering them?? It is the patient who gets stuck paying Quest though because they signed the advanced blah, blah, blah notice. I really don't want to have anything to do with medicare right now with this 21% paycut and our checks being held while they try to figure out if they will really go though with the paycut or not. Margaret Coughlan------------ --------- --------- ------