CMS Reimbursement Changes Discussion

Charles and Christopher discussed upcoming CMS reimbursement changes affecting various medical specialties, with orthopedics projected to decrease by 7%, plastics by 3%, and hand surgery by 5%. They explained that the new fee schedule includes a proposal affecting modifier 25 codes, which would reduce reimbursement for procedures like injections when performed on the same day as other services. While many surgical specialties are facing decreases, non-surgical specialties are seeing increases, and mentioned the American Medical Association's Hand Society is actively working on government affairs to address these changes.

P1 Phalanx Fracture Treatment Challenges

Christopher and Charles discussed challenges in treating P1 phalanx fractures with rotational deformities, agreeing that evaluation and careful reduction techniques are crucial but not always straightforward. They also addressed the limited utility of CT scans for distal radius fractures, preferring traditional X-rays and clinical assessment for surgical planning. The conversation concluded with a discussion about preparing for board certification, particularly the importance of collecting and formatting case data for Part 2 of the exam.

Orthopedic Surgery Board Preparation

Charles and Christopher discussed board preparation for orthopedic surgery, emphasizing the importance of thorough patient documentation, collecting the right data, and justifying clinical decisions with current literature. 

Hypermobility Discussion (Ehlers Danlos Syndrome)

They addressed treating patients with hypermobility, noting higher surgical failure risks and recommending bony procedures when possible, while advising careful counseling about potential complications. 

The conversation concluded with plans for future podcast episodes focusing on tips for new fellows and hand surgery spotlights.