Monthly Archive for March, 2007

Considering Cosmetic or Reconstructive surgery in North Carolina?

The skin is the most important organ of the human body to protect and manage. So, therefore the best thing you can do is to find out the truth about what causes skin problems or diseases and how they can be treated. You need to make it your mission to study facts about acne and skin from un-bias sources like dermatologists, doctors or skin care specialists, none of whom sell their own products. Blue Cross Blue Shield of North Carolina (BCBSNC) Corporate Medical Policy for Cosmetic and Reconstructive Surgery.

Cosmetic procedures are those services intended to improve appearance, and not primarily to restore bodily function or to correct significant deformity resulting from disease, trauma, or previous therapeutic process. Reconstructive procedures are performed on structures of the body for the purpose of improving/restoring bodily function or correcting significant deformity resulting from disease, trauma, or previous therapeutic process. BCBSNC will not provide coverage for cosmetic procedures as defined above. BCBSNC will provide coverage for Reconstructive Procedures when they are determined to be medically necessary because the medical criteria and guidelines shown below are met.

Benefits Application

Please refer to Certificate for availability of benefits. Benefits may vary according to benefit design, therefore certificate language should be reviewed before applying the terms of the policy. Some certificates limit coverage of reconstructive surgery following trauma or injuries occurring while a member.

When Cosmetic or Reconstructive surgery is covered

Cosmetic surgery is not covered, however reconstructive surgery is covered for either of the following indications:

  1. The procedure is intended primarily to improve/restore bodily function or to correct significant deformity resulting from disease, trauma, or previous therapeutic process.
  2. The procedure is intended to correct congenital or developmental anomalies that have resulted in significant functional impairment.

Colon Health and Screenings

The first step to better colon health is good hygiene which actually begins outside of our bodies. One common cause for some toxins entering the intestinal tract comes from having a nasal drip from some kind of sinus infection or cold which can introduce toxins to the intestinal tract. Another issue of course is washing our hands before we eat, any germ that is on our hands can be introduced to our intestinal tract.

In regards to the intestinal tract itself one of the biggest causes for illness is the build up of undigested food in the small intestine. While a small amount of undigested food is normal, when there is a large amount of undigested food the danger of it becoming a breeding ground for bacteria increases tremendously.

The next step in the process is the colon which removes water from the intestinal contents coming from the small intestine. If the colon is healthy it will only absorb water but if not it will absorb toxins as well. Feces is the result of this process and consists of about one third solids while the rest is water. Bacteria make up about a third of the dry weight. There should be a bowel movement every 24 hours.

For someone suffering from intestinal toxemia the result will be diarrhea because the toxins irritate the intestines and the body is doing its best to get rid of them.

There are three main types of toxins that may be in the intestinal tract, the first of which is putrefaction caused by protein spoilage which can result in the formation of organic toxins such as guanidine and histamine. The next is rancidity from the spoilage of fats which can occur in the intestine or come from rancid fats that are ingested. Fermentation comes from the production of gas by bacterial action primarily from carbohydrates.

One of the most common causes of absorption problems in the intestine is from the improper digestion of gluten which is found in wheat. Some people do not digest it well. Gluten, by the way, is what gives wallpaper paste its adhesive quality. That isn’t exactly the kind of thing you want in your digestive tract.

Milk can also cause the same problem in individuals who have a problem digesting it. Casein, the protein from milk is also used to make adhesives and has a similar effect as that of gluten. To find out if you have a problem with these just abstain from eating them for a couple of weeks.

According to Blue Cross Blue Shield of North Caroloina (BCBSNC) a Colon Cancer Screening or a Colonoscopy may be appropriate for any nonsymptomatic individual who is:

  1. At least 50 years of age, or
  2. Less than 50 years of age and at increased or high risk for colorectal cancer according to the most recently published colorectal cancer screening guidelines of the American Cancer Society or guidelines adopted by the North Carolina Advisory Committee on Cancer Coordination and Control. According to the American Cancer Society Guidelines on Screening and Surveillance for the Early Detection of Colorectal Adenomas and Cancer (refer to CA Cancer J Clin 2006;56;16) for average-risk women and men ages 50 and older, the following tests are recommended options for colorectal cancer screening:
    • Fecal Occult Blood Test or Fecal immunochemical Test (FOBT or FIT and Flexible Sigmoidoscopy)
    • FOBT or FIT annually and flexible sigmoidoscopy every 5 years. Flexible sigmoidoscopy
      together with FOBT or FIT is preferred compared with FOBT or FIT or flexible sigmoidoscopy alone.
    • Flexible Sigmoidoscopy – Every 5 years;
    • Fecal Occult Blood Test or Fecal Immunochemical Test- Annually;
    • Colonoscopy – Every 10 years;
    • Double Contrast Barium Enema – Every 5 years.

Based on the American Cancer Society Guidelines on Screening and Surveillance for the Early Detection of Colorectal Adenomas and Cancer (refer to CA Cancer J Clin 2006;56;16-17), patients at increased or high risk for colorectal cancer include:
Women or men at increased risk:

  • People with a single, small (less than 1 cm) adenoma. 3 – 6 years after the initial polypectomy, recommend colonoscopy. If the exam is normal, the patient can thereafter be screened as per average risk guidelines.
  • People with a large (1 cm +) adenoma, multiple adenomas, or adenomas with high-grade dysplasia or villous change. Within 3 years after the initial polypectomy, recommend colonoscopy. If normal, repeat examination in 3 years; if normal then, the patient can thereafter be screened as per standard guidelines for the risk category.
  • Either colorectal cancer or adenomatous polyps, in any first-degree relative before age 60, or in two or more first-degree relatives at any age (if not a hereditary syndrome). Age 40, or 10 years before the youngest case in the immediate family, recommend colonoscopy every 5 – 10 years. Colorectal cancer in relatives more distant than first-degree does not increase risk substantially above the average risk group
  • People with a diagnosis of hereditary nonpolyposis colorectal cancer (HNPCC) or those people who are at risk for HNPCC should have a colonoscopy every one-two years. It is recommended that screening should begin at the age of 20 – 25 years old or 10 years prior to the youngest family member diagnosed with colon cancer, whichever comes first.