The Moon Phases and the Symbological / Spiritual Analogy of the Growth of the Seed

We have all looked up at the moon at some point of our lives and been in a state of awe at its powerful, majestical presence and magnitude. The moon illuminates the sky and appears as a beacon of light and mystery. It is always there, constant and intriguing in its changing forms.We know that not only does the moon affect the tides on earth, but also female menstruation. It has also been reported that the moon can affect human mental state, behaviour, and emotions. Natal, psychiatric, and general hospital wards are often busier on a full moon.

Scientific research has curiously found that as all matter has frequencies, including the moon, sun, planets etc, and these frequencies have the ability to affect humans and animals, even if it is on a subtle level. The frequencies of the moon can affect and influence the thoughts and impressions in our sub-conscious mind and cause things to surface to the conscious mind and thus bring them to our awareness. When there is a full moon, the frequencies are much more active, and so there is a heightened activity and intensity of the mind as well as behavioural tendencies.

Moon Phases

Every moon phase has its own special energy and magic. The constantly changing cycle of the moon can be analogised with the process of a seed sprouting into a full flower in bloom. See the chart below to understand the phases of the moon and its spiritual and symbological significance. By understanding the energy of each phase, you can begin to connect and work with the cycles and have a better understanding of how they affect you.


New Moon

At this part of the moon’s cycle, it has no illumination and so appears dark and not visible (except during a solar eclipse). As it is dark, it denotes the beginning, with a primal instinct for birthing. The seed, as a symbol, is beneath the ground. So this is the germination stage, where you can initiate the emergence of something new by setting your intentions for what you wish to grow. A good time for starting anything new such as a project, idea, business venture etc.

Waxing Crescent

The moon is now partly illuminated by less than one-half, and increasing. The seed is now sprouting. Things are moving forward and there is the hope of more to come.

First Quarter

The moon is one-half exposed, and increasing in illumination. The seed is now presenting a root and plant structure on its way to growing and moving forward. This symbolises a period of decision, action and commitment.

Waxing Gibbous

More than one-half of the waxing of the moon is showing and increasing in illumination, therefore it represents the sense of gaining and attaining. So this can be applied to what you wish to gain and develop, such as friends, wealth, skills etc. Now the buds are preparing to bloom. This is the developmental stage where ideas and plans can be cultivated and fine-tuned before the next stage of manifestation.

Full Moon

The moon is full and round in all its glory. It appears to be completely illuminated by direct sunlight (this lasts for three days before and after the full moon date). As the moon is fully luminated, it represents fertility, abundance, transformation and completion. The seed is in full bloom. It is a potent and powerful time for healing, guidance and magic, as well as any positive intentions, including improving your psychic abilities. The moon will act in your favour and you will achieve good results. As the sun and moon are directly opposite each other, it causes tension or polarity. There are associations with the Goddess mother aspect, so you can honour and connect with Goddesses such as Isis, Cerridwen etc.

Waning Gibbous

The moon is more than one-half showing, but not fully illuminated, and decreasing. As the moon appears to be getting smaller, this is a good time to focus on ridding something such as bad habits, stresses or negative thinking.

Last Quarter

One-half is showing and it is decreasing in illumination. This is like a half-way point, a kind of contemplative time of introspect & (re)evaluation. The seed has now planted fully and all harvests have been reaped. There is a sense of shedding of the old before the new can come into place.

Waning Crescent

The moon is partly illuminated with less than one-half showing, and it is decreasing in illumination. The old cycle ends and the new one is near. This is the final releasing & purging stage, completing anything remaining, and banishing anything not required, before the birth of the new seed.


Take time to observe the moon and pay attention to it’s changing cycles. Think about taking an inventory of how the moon may be affecting your life. Are you in sync with its natural rhythms and symbological cues, or fighting them? Learn to honour and work with the moon’s energies.

See my related article: “Moon Ceremonies & Rituals”.

Symptoms of Testicular Cancer – Could You Have the Most Common Cancer Among Young Men?

Symptoms of testicular cancer are easy to spot if you know what to look out for. In this article, I’ll take you through the steps you need to take to check yourself for possible symptoms so that you can get fast treatment.

Know Your Testicles

First of all, you should get familiar with your own testicles. Many guys do not even know the anatomy of their testicles and have never explored them before. I suggest you find a good self-examination video on Youtube.

But basically, each testis is an smooth ovoid shape. Attached to the back of the testis is the epididymis. This is a loose, tubular structure adhered to the back and ending at the top and bottom of the testis. The testis also has a spermatic cord attached to the top of it.


The classic symptom of testicular cancer is a small lump. Tumors originate from inside the testicle itself so you need to push and feel the testis (without causing pain) to look for one.

When you feel your testis there should be a little “give” and this is quite normal. Palpate the testis like this and if you feel anything like a hard pea or peanut then it could be a tumor.


Some guys don’t get the classic lump. Instead, the entire testis becomes harder over a short space of time.


Sometimes the entire testis can swell to as much as three times the size. Definitely get this checked out.


Most testicular tumors are painless. Therefore many guys think that if they have a lump that hurts then it is not cancer. This is not true. Sometimes, there can be pain associated with the tumor.

Unusual Changes

Basically, know your testicles and check them once per month. If anything changes then get them checked out immediately. Your doctor will probably order an ultrasound and this should give a reliable diagnosis.

Kennel Cough Causes and Treatment

Kennel cough is a fairly common disease and is also called the dog common cold. Dogs who are frequently boarded or are exposed to humid conditions have a higher susceptibility to catch kennel cough. Many vets recommend that dogs be immunized with bordetella vaccine once every six months. Kennel cough is not transmitted to humans but rabbits, pigs and cats can contact this infection very easily. Dogs who are boarded frequently have a higher risk of developing this infection. This is not a hard and fast rule but don’t be surprised if your dog catches kennel cough even after a walk in the park.


The onset of the infection starts with dry and harsh cough. As the infection progresses the dog may develop gagging and retching cough. This is mainly due to the irritation in the air pipe and dryness of the trachea. Many people suggest giving their pets a lot of fluids to combat cough but this has very less effect on the overall condition on the situation. Generally after the first strike of the infection it takes about 3 – 4 days for the infection to fully develop and show full symptoms. In some cases the progress can even be faster. Puppies develop this infection faster than adult dogs. The severity of this infection can be attributed to contributing factors like immunity, ventilation and improper nutrition. The Kennel cough symptoms are more or less similar to that you would see in humans, The difference being the gagging and choking noise. Unlike humans where the flu virus is destroyed within a couple of weeks. The kennel cough pathogen stays embedded in the tissue linings even after 2 months.


Kennel cough is generally not fatal but in some cases it can be a cause of a much bigger disease which can turn fatal. Many vets have reported dogs developing pneumonia due to kennel cough. Many people resort to giving their pets cough syrup meant for humans. Well this can prove fatal as dogs are not tolerant to pheniramine and Guaifenesin. These two ingredients are found in almost all of the cough medications available today. Guaifenesin can cause increased heartbeats, palpitations and even liver failure in dogs. The best way to deal with a kennel cough infection is by a combination of holistic and natural approach. Here are a few pointers –

1. Insulate the pet from other dogs. This ensures that others do not catch the infection.

2. Ensure proper ventilation and cleanliness

3. Humidity only makes the condition worse. Keep your pet in a damp free environment.

4. Feed your pet at regular intervals and ensure adequate liquid intake. Chicken soup or even watery boiled rice with veggies/ meat is a good option.

5. Milk with a little turmeric power works wonders in soothing dry cough.

The Bottom line:

While your vet might suggest giving your dog antibiotics and a cocktail of chemicals, but the truth is that the best way in dealing this problem is a natural approach. Dogs just like other animals by instinct seek natural cures. Animals in the wild have been known to sniff out herbs and plants that would help them to get rid of the ailment. It is important to remember that the root cause of the infection to spread is due to low immunity. Immunity can be boosted not by allopathic cocktails but only by natural ways.

Just like humans, animals too show a remarkable response to natural healing treatments, such as homeopathy.Contrary to the popular belief that homeopathy works slow, Many people have actually reported excellent results just after the first dose.

So the next time your pet falls sick or is a victim of kennel cough. Give homeopathy a try.

What Are the Hidden Symptoms of an Asthma Attack?

How will you know if you or a loved one is having sudden attack of asthma? There are different attacks of asthma symptoms. These can be any of the following:


This is one of the common symptoms of asthma. You or your loved ones may experience coughing which gets worse during the night. Take note of the pattern in your coughing as this can be the key in diagnosis and in identifying your asthma triggers.


This is also one of the most common asthma symptoms. If you hear a whistling sound especially when you breathe out, that is wheezing.

Chest tightness or pain

If you feel as if a rope if tied around your chest and it gets tighter as you breathe, you are experiencing chest tightness or pain.

Shortness of breath or difficult breathing

This symptom of asthma attacks is identified as catching your breath, or the sense of breathing through a straw, or difficulty in breathing out.

These four are the overt symptoms of asthma attacks. Since asthma is an inflammation of the air passages, you will most definitely experience these symptoms of asthma attacks. Incidentally, there are also hidden symptoms of asthma attacks. And these hidden symptoms can also help you identify the attack of asthma.

Anxiety or panic.

This hidden symptom is usually triggered by the gradual constriction of your bronchial tubes which will decrease the amount of oxygen in your body. Since you feel that something is wrong but you cannot really identify what it is, you may feel anxious or panicky during or even before the attack of asthma.

Pallor and sweat.

These hidden symptoms of asthma attacks are really early warning signs of the attacks of asthma. When you come into contact with your asthma triggers, your airway passages will start constricting. As the amount of oxygen in your body is decreased, your face starts turning pale and you may also experience breaking out into a cold sweat.


This is one of the hidden symptoms of asthma attacks that people often overlook. If you feel tired even after sufficient amount of rest, you must consult your doctor. Aside from being a symptom of asthma, fatigue can also be a symptom of other diseases.

If you start experiencing these over and hidden symptoms of the asthma attacks, you must consult your doctor immediately. Your doctor will run some tests to rule out the possibility of other diseases since these symptoms of asthma attacks can also be symptoms of other diseases. Once proper diagnosis is made, appropriate treatment can also be prescribed.

In managing asthma, identifying the triggers is very important to prevent the attacks of asthma from recurring. Always observe the time, environment, and activity before and during an asthma attack.

Acid Reflux Cough – How to Identify and Put an End to It

One of the symptoms of acid reflux that’s often overlooked is a chronic cough. This is because at first glance there appears to be little or no relationship between the two. It can also be attributed to the fact that a cough is a relatively common occurrence and the result of numerous other causes, such as a cold, the flu, bronchitis, etc.

The truth, however, is that acid reflux is the third leading cause of a chronic cough, following on the heels of bronchial asthma and post-nasal drip (when the sinuses produce too much mucus).

Gastroesophageal reflux disease (GERD) is the medical term for what we know as acid reflux. Acid reflux occurs when the stomach releases its liquid back into the esophagus, causing inflammation and damage to the esophageal lining. The regurgitated acid most often consists of a few compounds: acid, bile, and pepsin. Stomach acid is used in the digestion of food and can be a major irritant to the esophagus due to its tendency to damage tissues.

The symptoms of acid reflux include nausea, belching, a sore throat, wheezing, difficulty swallowing, a pain in the chest that’s often mistaken for a heart attack, and in some cases chronic coughing. In fact, nearly three out of every four sufferers experience night time symptoms (such as coughing, snoring, and chest pain) that are not generally thought of as typical acid reflux symptoms. An acid reflux cough is one of these. It’s caused when acid reaches the vocal cords and is passed to the lower airway.

Even in relatively small quantities, this can trigger coughing. Since such small quantities can initiate an acid reflux cough, sufferers are often unaware that they even have GERD. In fact, they may not have heartburn in the traditional sense, considering that there’s little or no damage to the lining of the esophagus when the acid level is so limited.

So, how can you be sure that your nagging cough is not cold or flu related? If you have none of the other typical symptoms, such as the sniffles, a slight fever, throat irritation, heaviness in the chest, etc., accompanying your cough, then you need to consider other causes. Though you can experience an acid reflux cough without experiencing any of the other symptoms of GERD, if you’re experiencing both, then it’s time to visit with your doctor. He can help you determine whether or not your cough is acid reflux related.

There’s another clue that you might want to consider as well. Most people will turn to cough syrup when they have a nagging cough. Surprisingly, an acid reflux cough probably won’t respond to cough syrup. However, it may very well respond to an antacid. If you find that’s the case in your situation, then that’s a big time clue of the cause behind your cough.

Beyond antacids, your physician may want to prescribe something stronger. If your acid reflux is severe, this may include a proton pump inhibitor such as Nexium, Prevacid, Prilosec, Protonix, or Aciphex. These medications are designed to block acid production, which allows the lining of the esophagus an opportunity to heal. Side effects, however, can include abdominal pain, diarrhea and headaches.

If your acid reflux is relatively mild, all it may take to put an end to your chronic cough is some lifestyle changes. For instance, you’ll want to eat more often throughout the day, with your meals being smaller. You’ll want to allow at least three hours after your last meal before you go to bed (this reduces the odds that stomach acid will rise into the esophagus). You’ll want to avoid foods that are commonly associated with GERD, such as chocolate, dairy products, fried foods, and citrus fruits. These little changes may very well be all you need to put an end to your acid reflux cough.

Natural Ways To Get Rid Of Joint Pain And Inflammation

Joint pain, in truth, is more of a symptom than a disease. Joint pain may be accompanied by fever, chills, nausea and vomiting, fatigue and irritability. At times the pain may be so debilitating that it may cause one to toss and turn in bed and spend sleepless nights. The causes of pain in the joint may be listed as follows:

1. Autoimmune disorders like rheumatoid arthritis and lupus

2. Osteoarthritis occurring due to cartilage degeneration and formation of bony spurs or osteophytes

3. Gout

4. Septic arthritis or pyarthrosis

5. Sprain and over-strains

6. Fibromyalgia

7. Bursitis or inflammation of bursae or fluid-filled sacs that couch or cushion joint structure

8. Tendonitis or inflammation of tendons supporting the joint

9. Chondromalacia patellae

10. Osteomyelitis

11. Aseptic necrosis

12. Plant thorn synovitis

13. Steroid drug withdrawal

14. Torn ACL

15. Sickle cell disease

16. Siogren’s syndrome

17. Illiotibial band syndrome

18. Sacroiliac joint dysfunction

19. Dengue fever

20. Synovial sarcoma

21. Fracture

22. Bone tumor

23. Infectious diseases like influenza, hepatitis, measles, mumps, parvovirus, lyme disease, rheumatic fever, rubella, varicella or chicken pox etc.

Natural Ways to Lessen Joint Pain and Inflammation

1. A warm water shower can ease joint pain. One may also soak the affected joint in warm water with little bit of Epsom salt added to it. This gives much relief from pain in the joint and inflammation.

2. One may apply eucalyptus oil on the aching joint and after some time place a warm moist towel on the joint. This treatment fetches good results against pain and inflammation.

3. Performing hot and cold fomentations of the aching joint provides immediate relief from the ache.

4. A cup of papaya seed tea may be taken 6-7 times all through the day. This is a very helpful treatment for pain and inflammation.

5. A glass of warm milk with one tablespoon turmeric relieves joint pain effectively.

6. Consumption of garlic roasted with butter effectively reduces pain in the joint and inflammation.

7. One may take apple cider vinegar. It fetches good results in alleviating pain in the joint.

8. Regular stretching exercises check the occurrence and recurrence of pain in the joint and inflammation. Exercises also check obesity which is one leading cause of pain and inflammation. Yogic exercises like gomukh asana are also very helpful in alleviating pain in the joint.

9. Proper posture while sitting, standing, walking or lying keeps joint pain at bay.

10. Massaging hot vinegar on painful and inflamed joints at bed time yields good results.

11. Massaging aching joints with warm olive oil or camphorated mustard oil/coconut oil reduces pain in the joint and inflammation effectively.

12. Banana fruit consumption is recommended in this case, for banana effectively restores lost nutrients in the joint and greases the joint.

13. One may take carrot juice for it sufficiently strengthens ligaments.

14. Increased intake of fluids flushes out toxins from one’s system and reduces joint pain and inflammation.

15. Increased intake of omega 3 fatty acid rich oil and vitamins effectively tackle painful conditions.

16. Herbal supplements and pain relief oil Rumatone Gold can also be used effectively to reduce joint pain and inflammation.

What is Botox and What’s the Use

Botox is an injectable substance that is a medical grade form of the botulinum toxin, most often used to soften and relax forehead/scowl lines as well as crows feet around the eye area.

Botulin toxin or botox is the toxic compound produced by the bacterium Clostridium botulinum. It is an enzyme that breaks down one of the fusion proteins that allow neurons to release acetylcholine at a neuromuscular junction. By interfering with nerve impulses in this way, it causes paralysis of muscles in botulism. The toxin is a two-chain polypeptide with a 100 kDa heavy chain joined by a disulphide bond to a 50-kD light chain. It is possibly the most toxic substance known, with a lethal do

Botox is most commonly used to smooth out wrinkles but can be used to help in many other cases. It’s been found that botox injections can help children with cerebral palsy from agravating and suffering some other side effects. Muscle tension that often occurs with cerebral palsy has been seen to ameliorate while using botox. A side effect is a dry mouth, but in the case of neurological conditions, such as cerebral palsy, where excessive drooling is a problem, this is actually helpful.

It’s been found that BT, the botulinum toxin, injected into the prostate reduces the levels of prostate-specific antigen and the prostatic hyperplasia symptoms while being well tolerated. These results have been observed in a preliminary trial that was placebo controlled. The trial went great with no systemic adverse effects or any complications.

The botulinum toxin type A can be deadly, paralyzing muscles needed for breathing, but only very small doses are given in medical or cosmetic treatments.

Botox works by blocking the signal that nerves are trying to pass to the muscles.

How Your Hot Tub Can Kill You

What a gruesome title! But if you own a hot tub or spa this article might be one of the most important things you could read.

If you start considering all the dangers of a hot tub you might talk yourself right out of using yours or of buying a tub if you are considering owning one. Like most any physical activity, using a hot tub can be dangerous.

The U.S. Consumer Product Safety Commission (CPSC) keeps records of different kinds of accidents that occur in the U.S. each year, including accidents that occur because of hot tubs.

As you might expect, the main hazard from hot tubs is drowning. Since 1990 more than 800 people have died this way. So how does an adult drown in 3 feet of water? Here are a few of the ways.

  • If you heat the water too hot or stay in too long you might pass out. 104 degrees should be the warmest the water is ever heated and the recommended time to soak is about 20 minutes.
  • If you drink too much alcohol you could pass out in the water.
  • If you leave the hot tub cover on and lift only one side and don’t remove the cover then – clunk – it can fall and hit you on the head, possibly knocking you unconscious.
  • If you use an older model spa without certain safety features in the way the drains are positioned or covered, long hair can get sucked into the drains, holding your head under water. Also, the strong suction on older spas, again without safety drains, can suck against your body and hold you against the bottom drain. The CPSC has a nasty sounding name for this – body part entanglement – and people using hot tubs have died from it.
  • If you fail to maintain or wire the electrical parts properly electrocution can result.

In addition to watching the temperature, the amount of time you soak, and your alcohol consumption, the CPSC recommends that:

  • You know where the cut-off switch is and how to operate it quickly so that you can shut down your spa in an emergency.
  • If anything breaks or you suspect that there is any problem with your hot tub, hot tub cover, or electrical system, have a trained professional check it out before using the tub again.
  • If you have an older hot tub, have your drains checked and if you don’t have two dome shaped inlets then do not use the spa until this has been corrected.
  • You don’t use the hot tub alone. This doesn’t mean that someone has to be in there with you, just that they are close by in case of a problem.

Of the deaths reported by the Consumer Product Safety Commission over 160 of them were children. The dangers to children are the same as listed above for adults and in addition children have poor judgment about safety issues. That’s why it’s extremely important to keep the hot tub cover locked down so that children will not have access to it without adult supervision. If your tub is inside you might have less of a concern unless there are young children living in or visiting your home. If your hot tub is outside a cover lock is almost a necessity.

There are millions of hot tubs safely in use today, and this article is meant to help you protect yourself, not frighten you from one of the most relaxing and satisfying experiences you can have. Follow some simple rules, use good judgment, and you can have a lifetime of safe and fun times in your hot tub.

Get $125 Extra in Vasectomy-Related Payment With This 4-Step Coding Process

Turn to V25.x for your diagnosis code option.

Vasectomies are very common in most urology practices. But choosing the proper codes to report can sometimes prove very challenging, right from the pre-vasectomy “consultation” visit that most urologists perform. You could be costing your practice hundreds over the course of one year if you’re not billing out each piece of the vasectomy process. Here are four steps to ensure that you capture all the reimbursement your urologist deserves.

1. Don’t be in a hurry to assign consult codes for the first visit

Prior to performing a vasectomy process a urologist meets with the patient to discuss the procedure and makes sure that the patient understands the outcome of the procedure and then undergo this elective sterilization. You should report this office visit using the appropriate E/M code, says Kelly Young, a coder with Scottsdale Center for Urology in Scottsdale, Ariz.

The real challenge comes when you try to figure out whether you should report an office visit E/M code or a consultation code.

Depending on your urologist’s documentation, you can choose from the consultation codes (99241-99245, Office consultation for a new or established patient…), a new patient (99201-99205, Office or other outpatient visit for the evaluation and management of a new patient…), or established patient (99211-99215, Office or other outpatient visit for the evaluation and management of an established patient…) codes.

Don’t lose out on your Dollars: You would be sacrificing on your Dollars if you skip reporting the pre-vasectomy office visit. Suppose, your urologist performs a level-three new patient visit (99203), you’ll earn $91.97 (the unadjusted fee for 99203, 2.55 RVUs, times the 2009 conversion rate of $36.0666) in addition to the procedure code, and if your urologist performs a level-three consultation, you’ll earn $125.15 (the unadjusted fee for 99203, 3.47 RVUs, times the 2009 conversion rate of $36.0666) in addition to the procedure code.

Remember: If the patient is new to your office, report a new patient visit using codes 99201-99205. However, if the urologist (or another urologist in the same practice) has seen the patient within the past three years, report an established patient office visit (99211-99215), and not a new patient visit.

Beware: Don’t let the term “consultation” in the physician’s documentation trick you. Often practices, physicians, and even patients refer to the pre-vasectomy visit as a consultation. However, to report a consultation code (99241-99245), the visit must meet the requirements of a consultation. There must be a documented request from the requesting physician; a record of the urologist stating his findings, opinions, and advice in the patient’s chart; and a report that’s sent back to the requesting doctor.

Michael A. Ferragamo MD, FACS, clinical assistant professor of urology, State University of New York, Stony Brook says, “Since the recent rule changes for consultations come from Medicare 2006 policy changes (Transmittal 788) and since most men seeking vasectomies for sterilization do not have Medicare as their primary insurance carrier, the patients sent to urologists by physicians most often represent consultation requests, hence, they should be billed and coded accordingly if all criteria for a consultation are met.”

Diagnosis aid: The most appropriate ICD-9 code for the pre-vasectomy examination, whether it’s a consultation or a new/established patient visit is V25.09 (Encounter for contraceptive management; general counseling and advice; other).

Important point: Many payers have a perception that code V25.09 is a “family planning advice,” and pertain only to the female partner, and hence, they will deny payment for any pre-vasectomy examination of the male when you use this diagnosis. So use V25.2 (Encounter for contraceptive management; sterilization, admission for interruption of…vas deferens) in its place, with this you can expect payment for a pre-vasectomy service in most cases.

Check, which diagnostic code is preferred by your payer. The Scottsdale Center for Urology uses V25.2 as the diagnosis code. However, “we bill… with V25.09,” says Kim Kerckhoff, CCA, coder for Alpine Urology in Anchorage, Alaska.

2. Use modifier 57 for Same-Day E/M and Procedure

If your urologist performs the vasectomy procedure on the same day as the pre-vasectomy office visit make sure that you append modifier 57 (Decision for surgery) to the E/M code you report. Also ensure that the urologist’s documentation supports a separate E/M code, the E/M service must go above and beyond the E/M that’s inherent to the procedure.

Avoid bundled payment: Your urologist can conduct the service on separate days if you want to make sure that your payer will not bundle the pre-vasectomy visit with the vasectomy procedure. Many urologists do this anyway to give the patient time to review his options and make the final decision about surgery. Above that, your office will have time to review the patient’s benefits.

Alice Kater, CPC, PCS, coder for Urology Associates of South Bend, Ind says, “We never perform the procedure the same day as the vas consultation. The patient and wife/partner will come in for the consult, view a movie, and speak extensively with the physician following the examination and review of systems. When they leave the physician, they schedule their procedure for the next available, and convenient, vas opening.”

3. Select a Code Based on the Type of Procedure

You’ll have to go through the documentation to see which technique your urologist used, so that you can report the actual vasectomy procedure. Then choose one of these three codes:

  • 55250 – Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s). “This CPT Codes is the most common code used for vasectomy for voluntary sterilization,” Ferragamo explains.
  • 55450 – Ligation (percutaneous) of vas deferens, unilateral or bilateral (separate procedure). “Coders rarely use this code for a vasectomy for voluntary sterilization,” Ferragamo says.
  • 55559 – Unlisted laparoscopy procedure, spermatic cord for a laparoscopic vasectomy.

Add V25.2 to the vasectomy procedure, says Kerckhoff.

Clue: You should report 55250, 55450, or 55559 just once per patient regardless of whether the urologist performs the procedure on one or both sides. The urologist usually, but not always, performs the procedure, cutting the vas deferens and suturing the ends, on both the left and right sides. So don’t change your urology coding even if your urologist cuts and sutures only one side (for a patient having only one testicle).

Note: These codes also include the local or regional anesthesia that the urologist administers, so do not code any local anesthesia administered for those services separately.

Surgical trays: Use the HCPCS code A4550 (Surgical trays) or CPT code 99070 (Supplies and materials [except spectacles], provided by the physician over and above those usually included with the office visit or other services rendered [list drugs, trays, supplies, or materials provided]) for private or commercial payers, few of them reimburse for a surgical tray/supplies.

“Medicare will not reimburse for anesthesia administered by the surgeon or urologist, or for tray charges,” Ferragamo warns. “However, there are a few commercial carriers that will still reimburse for local anesthesia administered by the urologist and for a tray charge. Check with the specific carrier. One may bill private or commercial carriers HCPCS code S0020 (Injection, bupivicaine HCL, 30 ml) for reimbursement of the anesthetic agent used,” he adds.

There is no CPT code for laparoscopic vasectomy so when your urologist performs this procedure, usually at the same time a general surgeon is performing a laparoscopic hernia repair, report the unlisted code 55559.

Hint: Make sure that you submit a detailed report to your payer and compare, or benchmark, the laparoscopic vasectomy to 55550 (Laparoscopy, surgical, with ligation of spermatic veins for varicocele), with respect to the surgical work, technology, equipment used, and time involved.

4. Include Semen Analysis in the Procedure Code

After the vasectomy, the urologist must examine the semen to determine the eventual absence of sperm. These examinations are included in the procedure code, so your urologist should document the service, but you should not report them separately.

If your office laboratory is not credentialed (CLIA certification) to perform these post-vasectomy semen analyses, outside laboratory evaluations will be necessary and that would result in an additional cost to the patient. However, under these circumstances your urologist should never lower his fee or modify his urology coding. Practices often make special arrangements with most laboratories for a reduced fee for a limited semen examination looking only for the presence or absence of sperm.

Discover the Medication for Treating Bulging Disc Neck Pain

Whenever you are suffering from a degenerative disease in your spine, it can cause you to feel pretty bad. You will feel intense pain all the way from your neck to your lower spine. The good news is that there are many ways in which you can get the relief you are looking for. The majority of the options available to deal with a bulging disc neck pain do not even involve surgery. More doctors are turning to medication to deal with bulge disc pain. If you are facing taking this kind of medication, it is a good idea to know what your options are.

The first thing you will need to know is whether you are dealing with a sciatic nerve pain or from a decompression in your spine. The difference between the two can mean the difference between medication that you can take on your own and something which will have to be administered to you. You will also find that there are some doctors looking to use something like a DRX 9000 to give you the relief that you covet. Before long, you will get rid of that bulged neck problem and you will be able to start enjoying life again.

Get Help Dealing with a Pinched Nerve

When you are feeling rather intense shoulder and neck pain, it is a good idea to remember that the pain you are feeling is a result of a pinched nerve. This means that the disc needs to be put back into place. There are medications which will strengthen the muscles around the spine to get everything back in alignment. Normally this means injecting steroids in the area and boosting the ability of the muscles to do their job. It may take a week or so to start to feel results, but the results are long lasting, and in many cases, it is permanent.

Get Help with a Compression

If the feeling that you are feeling is stiff along with pain, it is likely that your spine is compressed. It is possible to get relief from this bulging disc neck pain by having your spine decompressed. See a specialist which uses a DRX 9000. This is a machine which allows you to be able to have your spine pulled until it is realigned and put back into place. It can help you to feel your absolute best. Through these kinds of methods, you will be on the road to recovery in no time at all.

How to Recognize Acid Reflux in Children

Acid reflux in children is a real cause for concern. It drives us frantic when our children are sick and scrunched up in pain. We suffer as much as they do… but how on Earth can we help?

First of all, we have to find out what’s wrong… and recognizing acid reflux in children can sometimes be tricky, especially if it’s a toddler.

If a child complains of a tummy ache or sore chest, you should narrow it down by asking a few questions such as:

  • Where does it hurt?
  • Does it burn?
  • Is your throat sore?
  • Is there a bitter taste in the back of your throat?

And so on. It’s probably acid indigestion if s/he reports a burning sensation in the chest or solar plexus area, especially if it’s accompanied by a nasty taste.

Dose the child with half a teaspoon of ‘Arm and Hammer’ bicarbonate dissolved in warm water. If the pain goes away you can be sure that it is heartburn and you can relax a little… Ordinary heartburn is uncomfortable, but it’s not dangerous. However, you should be on the alert for further symptoms indicating a more serious condition, namely GERD.

Symptoms of Acid Reflux in Children

Common symptom of acid reflux in children:

  1. Chest pain (burning sensation).
  2. Regurgitation after eating, followed by a nasty taste in the back of the throat.
  3. Pickiness about food or reluctance to eat.
  4. After dinner nausea.
  5. Sore throat.
  6. Occasional gagging or choking.
  7. Wheezing, bronchitis or asthma.
  8. Hacking cough accompanied by hoarseness.
  9. Poor sleep patterns.
  10. Excessive drooling — a condition known as ‘water brash’.
  11. Toothache.
  12. Bad breath.
  13. Poor growth patterns.

If one or more of the above are presented, it’s time to introduce a few dietary and lifestyle changes… not only for the child, but also for the entire family.

Recommended Lifestyle Changes

  • Replace fizzy drinks with non-carbonated fruit juices.
  • No strenuous playing or exercise for an hour after eating.
  • Serve smaller meals and include a decent mid-morning and mid-afternoon snack in their daily diet.
  • Serve the evening meal at least three hours before bedtime.
  • Make sure they drink plenty of bottled water.
  • No water during meals.
  • No chocolate or peppermint.
  • Elevate the head of the child’s bed by placing by 6-inch high blocks or bricks under the feet.

What if the Heartburn Persists?

If the heartburn persists or worsens after making these changes, your child may have GERD and you should see your doctor ASAP.

Also, a follow-up visit to the dentist is a must. Acid reflux can sometime cause the loss of dental enamel.

Specialized treatment is absolutely essential for the small percentage of babies and young children who develop GERD. These babies and youngsters are prone to other serious diseases if the condition is left untreated, such as:

  • Damage to the lungs. If gastric juices enter the windpipe, problems such as bronchitis, pneumonia and asthma are sure to follow. In the worse case scenario, Sudden Infant Death Syndrome (SIDS) could result.
  • Esophagitis. Gastric acid continuously splashing the walls of the food pipe causes inflammation that could lead to esophagitis.

    If left untreated esophagitis becomes extremely painful making it almost impossible for the child to swallow.

    Ulcers soon appear in the food pipe… followed by scarring. These scars pucker and shrink the walls of the esophagus causing it to narrow. These strictures can block the esophagus and prevent food from reaching the stomach.

    If an ulcer ruptures, it could lead to life-threatening internal bleeding… Beware of black or bloody stools.

  • Barrett’s Esophagus is a fairly rare condition that occurs in a small percentage of sufferers. However, this condition is dangerous! If left untreated it could lead to a deadly form of cancer.

Your doctor may prescribe a proton pump inhibitor or an H2 blocker in order to control acid production. This may be necessary in order to allow the injured esophagus time to heal.

Make sure that your child does not take these medications for more than 8 weeks without further evaluation.

Tonsil Stones – How to Remove Tonsil Stones

Do you have chronic bad breath? Is your throat sore even when you don’t have a cold or any other type of infection? Does it feel like you have something caught in the back of your throat that you just can’t quite cough up? If so, then you might be a victim of tonsil stones. Now that you know the issue — how does one set forth to remove tonsil stones? It is, after all, quite possible that you have never heard of them.

Essentially, tonsil stones are stones of calcium, food particles, dead cells and other debris that form in the crypts or crevices of your tonsils. Similar to tartar on your teeth, tonsil stones can harden and become more and more difficult to remove as they mature. They can form on those with larger tonsils or those who produce an excess of oral bacteria.

So now you know what they are and where they come from. However, what you really want to know if how do you remove tonsil stones?

This can be a little more difficult. There are various treatments to remove tonsil stones, all of which require some digging and scraping.

First, you can try scraping the tonsil stones out yourself. You can use a toothbrush, a Q-tip, your figure, your tongue or a bobby pin. If you don’t have troubles with your gag reflex and you don’t mind sticking foreign objects down your throat, this may be your best method.

However, there is another option. You can simply try to flex your throat which can pop the tonsil stones out of place. This is an easier and effective way to remove tonsil stones without making yourself sick.

A final method to remove tonsil stones is with surgery. Removing your tonsils, or a tonsillectomy, is one method. Laser tonsillectomy is another. Laser tonsillectomy uses a carbon dioxide laser to vaporize the tonsil stones and smooth out the tonsil crevices. This prevents build up from happening in the future. Consult your doctor when considering either of these surgeries as there are risks and costs involved.

Finally, the number one strategy to avoid having to remove tonsil stones is ultimately prevention. The best way to go about preventing tonsil stones is by maintaining an excellent oral health routine. This includes daily brushing, flossing, and rinsing with non-alcoholic and sugar-free mouthwash. You should also avoid eating thirty minutes before bedtime and gargle with salt water which can help reduce the build up of debris.

Adrenal Fatigue – Your HPA Axis is the Solution

Adrenal fatigue, also known as adrenal stress, describes a set of symptoms related to the way your body manages stress. Stress is a part of your daily life. Some stress is good, some stress is bad. Some people say that stress is a killer. Well, it’s not quite correct. It’s not stress that kills us, but rather our inability to adapt to it.

We live in a fast-paced world. We constantly push our minds and bodies to the limit working long hours, fighting endless traffic on the roads, dealing with family-related issues, coping with financial problems, eating fast food on the run. The list goes on.

With the combined effects of a decrease in the quality of our food sources, environmental pollution and the emotional stress induced by our fast-paced lives, our bodies are finding it harder and harder to successfully adapt and maintain metabolic equilibrium.

Cortisol is your body’s chief stress fighting hormone. This is how it’s produced.

The hypothalamus in your brain, the pituitary gland below your brain, and the adrenal glands on top of your kidneys form what is referred to as the hypothalamic-pituitary-adrenal axis (or HPA axis). Your HPA axis is the most important part of your endocrine system, and directly or indirectly controls most of the hormonal activities in your body.

When you’re under stress, your hypothalamus secretes corticotropin-releasing hormone (CRH), a hormone that gets your body into a state of readiness when a physical or emotional threat presents itself. CRH travels to your pituitary gland where it stimulates the secretion of adrenocorticotropic hormone (ACTH), which enters your bloodstream. When ACTH reaches your adrenal glands, it triggers the release of cortisol, your body’s chief stress fighting hormone.

The boost in cortisol resulting from a stressful situation leads to a cascade of reactions in your body that can help you respond quickly to a threat. We refer to this as the “fight or flight” response.

In general, cortisol is high during periods of stress and low when relaxing. Under normal circumstances a feedback loop allows your body to turn off these defenses when the threat passes, allowing your body to once again focus on healing and growth.

In some cases, if the threat is prolonged or chronic, the floodgates never close properly. The result is that cortisol levels rise too often or remain high. When you are constantly under stress the overproduction of adrenaline and cortisol interferes with the balance of hormones in your body. Clearly, this is a problem because to achieve optimal health, your body should ideally be in a state of homeostasis.

These periods of high levels of cortisol can result in blood sugar irregularities creating fatigue, immune system deficiencies, panic attacks, asthma, and increased risk of other diseases. In addition, when your body is out of balance – not in a state of homeostasis – it also accelerates the aging process.

In more extreme cases, adrenal stress is known as adrenal exhaustion (also referred to as “nervous breakdown”).

Adrenal stress will most definitely disrupt your HPA axis, the key to the strength of your “life force.” The disruption of the HPA axis is often central to most health problems, syndromes, diseases and aging. When the HPA axis is not functioning correctly, a variety of neurological symptoms develop, such as anxiety disorder, bipolar disorder, clinical depression, intolerance to stress, sleep disturbance, and mood disorder. In addition, the HPA axis is also involved in burnout and irritable bowel syndrome.

The diseases and illnesses referred to above are not due directly to adrenal stress, but rather our inability to adapt to the stress. These diseases and illness have therefore been called “diseases of adaptation.” One of the ways of coping with adrenal stress is to use a natural product called an adaptogen.

The word adaptogen is used to refer to a natural herb product that increases the body’s resistance to stresses such as trauma, anxiety and bodily fatigue. Adaptogens normalize the hypothalamic-pituitary-adrenal axis.

And this is the way to beat adrenal stress: through your HPA axis. You can use a powerful adaptogen to balance your HPA axis. Your hormonal balance will improve and this will assist your body’s organs systems to once again operate at optimum efficiency.

Type 2 Diabetes – Is There A New Natural Treatment To Help Diabetic Kidney Failure?

Even though only a small percentage of Type 2 diabetics actually develop kidney failure, chronic damage to the kidneys eventually necessitating dialysis is one of the most dreaded complications of diabetes. For diabetics who are in the beginning stages of kidney failure and who do not need dialysis yet, the probiotic bacterium Bacillus coagulans may offer a helpful treatment.

Bacillus coagulans is a symbiotic, probiotic, helpful species of bacteria. It’s not like the better-known Lactobacillus acidophilus in that it easily survives passage through the acid environment of the stomach. In fact, “digesting” this kind of probiotic activates it. The acid in the stomach dissolves it’s spores, and then the spores germinate in the colon.

Once the “bug” gets into the colon, it interacts with neutrophils. These are the white blood cells that “zap” disease-causing microorganisms and zap healthy tissue at the same time. By sheer numbers, the bacteria train the immune system not to inflame and destroy healthy tissues. This keeps the neutrophils from damaging the tissues in the nose and throat when people encounter colds and flu viruses.

But that’s not all B. coagulans does. It also feeds on urea and proteins that otherwise would literally clog the filtration tubes, the glomeruli, of the kidneys. It breaks down proteins to take the amino acids it needs, freeing the other amino acids to be used by its human host. In this form, excess protein in the diet… which becomes very, very difficult to avoid in diabetic kidney disease… doesn’t create a problem for the kidneys. They don’t have to strain out the larger protein molecules, and the body can use most of the amino acids. (The rest become urea and sugar, and B. coagulans can also break down urea).

There is never going to be a time when a Type 2 diabetic with advanced kidney failure can pop a probiotic pill and skip dialysis. However, Type 2 diabetics with early stage kidney failure may be able to buy themselves time to do the things that are fundamental to reversing kidney disease, which are keeping blood sugar levels in good control and controlling high blood pressure.

Type 2 diabetics with who do not have indwelling catheters (who don’t do dialysis at home), may be able to benefit from taking capsules of this friendly bacterium, too. It’s important to let the doctor know you are taking any kind of probiotic in case your treatment changes.

And even if you have a permanent catheter, Bacillus coagulans is probably safe to take. The only way you could run into a problem is that you use a “drink” form of the product, the drink gets contaminated with other kinds of microorganisms, the spill gets on your catheter, and the bacteria get inside you. The B. coagulans itself is not likely to cause any diabetics any problems, but work with your doctors, nurses, and technicians to make sure. If this complementary treatment will work for you, it will like cost less than US $1 per day.

Liposinol For Weight Loss! Is Xenical Out Of Order?

A new obesity treatment named liposinol, which is basically a plant based cactus extract is in the offing as a suitable anti-obesity treatment. Similarly to Hoffman La Roche’s weight loss drug Xenical, this new medication is found to prevent fat breakdown by lipase enzymes and induces weight loss.

This medicine, Liposinol, made of non-soluble and soluble fibers, if taken after food it forms a bonding with body fats and as such a fat fiber complex is created. Due to its comparatively large size, this compound thus formed passes through the body without being absorbed in the small intestine and is also significantly sheltered from breaking down by lipase enzymes. The obvious result is the prevention of excess fat absorption in the body and final outcome is weight loss.

But on this foundation and on the basis of a few clinical successes, can Liposinol be placed above Xenical in terms of efficacy? Won’t it be mere foolhardiness to assume that Liposinol, the product which is not even FDA approved, can outrun Xenical efficacy and accuracy?

Xenical was approved by FDA on 23rd April, 1999 as a long-term treatment of normal obesity for people whose BMI lie in between 27-30 and more. Xenical, the diet pill is specially recommended by FDA for the treatment of obesity in certain high risk conditions like diabetes, dislipidemia and hypertension. Furthermore, Xenical is for the treatment of weight loss as well as for preventing weight gain after prior loss for which on starting off the treatment of your obesity with Xenical diet pills, the normal weight gain after the initial weight loss can be easily avoided.

Can all these multi-benefits be achieved from the cactus extract, liposinol? Not possible even in your wildest dreams. If you opt for this medicine as a suitable alternative of Xenical, you have to hold yourself responsible for slowing down your weight loss regimen and for being unable to counter the threat of obesity effectively.

All these arguments seem credible to you or there are still doubts to be cleared? If even an iota of doubt is there in your mind, apply a simple procedure and get rid of it. Browse through the net with the Xenical keyword and catch up with authentic websites that provide genuine information on the weight loss drug Xenical. You can take the help of special sites like and check the facts stated here regarding Xenical.

There are also other medicines in the pharmaceutical market that can lead to quick weight loss but since fat is mainly responsible for the prevalence of obesity across the world and Xenical targets the fat accumulation in the body, so only Roche’s Xenical is prescribed for the treatment of obesity worldwide. You just have to apply Xenical to your system along with a diet containing 30% calories from fat and regular physical exercises.

One final sermon: Throughout your Xenical usage, it would be better to visit a weight loss expert and undergo clinical checkups to measure out your weight loss progress and also by this method you would be able to know the deficiencies in your weight loss schedule and make up for those.