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https://www.readbyqxmd.com/read/28228501/acl-tears-in-school-aged-children-and-adolescents-over-20-years
#1
Nicholas A Beck, J Todd R Lawrence, James D Nordin, Terese A DeFor, Marc Tompkins
BACKGROUND: Anterior cruciate ligament (ACL) tears are thought to occur with increasing frequency in young patients. No study has shown increased incidence over time. We hypothesized the incidence of ACL tears in young patients has increased over the past 20 years. METHODS: This descriptive epidemiology study is a retrospective review of insurance billing data of all patients aged 6 to 18 years with Current Procedural Terminology, Fourth Revision codes for ACL tear and reconstruction or International Classification of Diseases, Ninth Revision, Clinical Modification codes from 1994 to 2013...
February 22, 2017: Pediatrics
https://www.readbyqxmd.com/read/28224943/medicare-telehealth-services-and-nephrology-policies-for-eligibility-and-payment
#2
REVIEW
Stephanie Frilling
The criteria for Medicare payment of telehealth nephrology services, and all other Medicare telehealth services, are set forth in section 1834(m) of the Social Security Act. There are just over 80 professional physician or practitioner services that may be furnished via telehealth and paid under Medicare Part B, when an interactive audio and video telecommunication system that permits real-time communication between a beneficiary at the originating site and the physician or practitioner at the distant site substitutes for an in-person encounter...
January 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28222112/genome-wide-study-of-resistant-hypertension-identified-from-electronic-health-records
#3
Logan Dumitrescu, Marylyn D Ritchie, Joshua C Denny, Nihal M El Rouby, Caitrin W McDonough, Yuki Bradford, Andrea H Ramirez, Suzette J Bielinski, Melissa A Basford, High Seng Chai, Peggy Peissig, David Carrell, Jyotishman Pathak, Luke V Rasmussen, Xiaoming Wang, Jennifer A Pacheco, Abel N Kho, M Geoffrey Hayes, Martha Matsumoto, Maureen E Smith, Rongling Li, Rhonda M Cooper-DeHoff, Iftikhar J Kullo, Christopher G Chute, Rex L Chisholm, Gail P Jarvik, Eric B Larson, David Carey, Catherine A McCarty, Marc S Williams, Dan M Roden, Erwin Bottinger, Julie A Johnson, Mariza de Andrade, Dana C Crawford
Resistant hypertension is defined as high blood pressure that remains above treatment goals in spite of the concurrent use of three antihypertensive agents from different classes. Despite the important health consequences of resistant hypertension, few studies of resistant hypertension have been conducted. To perform a genome-wide association study for resistant hypertension, we defined and identified cases of resistant hypertension and hypertensives with treated, controlled hypertension among >47,500 adults residing in the US linked to electronic health records (EHRs) and genotyped as part of the electronic MEdical Records & GEnomics (eMERGE) Network...
2017: PloS One
https://www.readbyqxmd.com/read/28213057/utilization-of-sentinel-lymph-node-biopsy-for-uterine-cancer
#4
Jason D Wright, Stephanie Cham, Ling Chen, William M Burke, June Y Hou, Ana I Tergas, Vrunda Desai, Jim C Hu, Cande V Ananth, Alfred I Neugut, Dawn L Hershman
BACKGROUND: To limit the potential short and long-term morbidity of lymphadenectomy, sentinel lymph node (SLN) biopsy has been proposed for endometrial cancer. The principle of SLN biopsy relies on removal of a small number of lymph nodes that are the first drainage basins from a tumor and thus the most likely to harbor tumor cells. While the procedure may reduce morbidity, efficacy data is limited and little is known about how commonly the procedure is performed. OBJECTIVE: We examined the patterns and predictors of use of SLN biopsy and outcomes of the procedure in women with endometrial cancer who underwent hysterectomy...
February 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28210648/utilization-of-platelet-rich-plasma-for-musculoskeletal-injuries-an-analysis-of-current-treatment-trends-in-the-united-states
#5
Joanne Y Zhang, Peter D Fabricant, Chad R Ishmael, Jeffrey C Wang, Frank A Petrigliano, Kristofer J Jones
BACKGROUND: Platelet-rich plasma (PRP) has emerged as a popular biologic treatment for musculoskeletal injuries and conditions. Despite numerous investigations on the efficacy of PRP therapy, current utilization of this treatment within the United States is not widely known. PURPOSE: To investigate the national utilization of PRP, including the incidence and conditions for which it is used in the clinical setting, and to determine the current charges associated with this treatment...
December 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28210537/multilevel-predictors-of-colorectal-cancer-testing-modality-among-publicly-and-privately-insured-people-turning-50
#6
Stephanie B Wheeler, Tzy-Mey Kuo, Anne Marie Meyer, Christa E Martens, Kristen M Hassmiller Lich, Florence K L Tangka, Lisa C Richardson, Ingrid J Hall, Judith Lee Smith, Maria E Mayorga, Paul Brown, Trisha M Crutchfield, Michael P Pignone
Understanding multilevel predictors of colorectal cancer (CRC) screening test modality can help inform screening program design and implementation. We used North Carolina Medicare, Medicaid, and private, commercially available, health plan insurance claims data from 2003 to 2008 to ascertain CRC test modality among people who received CRC screening around their 50th birthday, when guidelines recommend that screening should commence for normal risk individuals. We ascertained receipt of colonoscopy, fecal occult blood test (FOBT) and fecal immunochemical test (FIT) from billing codes...
June 2017: Preventive Medicine Reports
https://www.readbyqxmd.com/read/28181058/analysis-of-reimbursement-of-genetic-counseling-services-at-a-single-institution-in-a-state-requiring-licensure
#7
Jennifer R Leonhard, Paul J Munson, Jason D Flanagan, Kristen L De Berg, Paul A Thompson, Lori W Dean, Quinn P Stein
Reimbursement for genetic counseling services was examined at a single institution. Patient encounters utilizing the 96040 CPT® code from 7/31/2009 through 7/31/2013 were reviewed. Exclusion criteria included billing records of patients seen by a physician the same day, self-pay, Medicaid, and Medicare patients. Of the 8,630 encounters with a genetic counselor, 582 encounters were eligible for review. Descriptive statistics (i.e., percentage of encounters receiving some level of reimbursement, average reimbursement rate, number of third party payors providing any level of reimbursement, and number of ICD-9 codes receiving any level of reimbursement) depicted reimbursement of the 96040 CPT® code for the encounters analyzed...
February 8, 2017: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/28159379/factors-affecting-visits-to-the-emergency-department-for-urgent-and-nonurgent-ocular-conditions
#8
Brian C Stagg, Muazzum M Shah, Nidhi Talwar, Dolly A Padovani-Claudio, Maria A Woodward, Joshua D Stein
PURPOSE: To determine the frequency of emergency department (ED) visits for nonurgent and urgent ocular conditions and risk factors associated with ED use for nonurgent and urgent ocular problems. DESIGN: Retrospective, longitudinal cohort analysis. PARTICIPANTS: All enrollees aged 21 years or older in a United States managed care network during 2001-2014. METHODS: We identified all enrollees visiting an ED for ocular conditions identified by International Classification of Diseases, billing codes...
January 31, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28157755/coding-in-stroke-and-other-cerebrovascular-diseases
#9
Pearce J Korb, William Jones
Accurate coding is critical for clinical practice and research. Ongoing changes to diagnostic and billing codes require the clinician to stay abreast of coding updates. Payment for health care services, data sets for health services research, and reporting for medical quality improvement all require accurate administrative coding. This article provides an overview of coding principles for patients with strokes and other cerebrovascular diseases and includes an illustrative case as a review of coding principles in a patient with acute stroke...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28152838/a-schematic-case-episode-format-to-aid-in-choosing-wisely
#10
B Brooke Mann, Jad Hayes, Lalan S Wilfong, Marcus A Neubauer
: 181 Background: The recommendations of the Choosing Wisely campaign are evidence -based strategies to reduce cost without sacrificing outcomes. Yet tying the recommendations to indicators of use at the physician and case level has been challenging. As practices become responsible for total cost of care, an easy to use analytic method to determine appropriate use will be critical. We here describe a tool for rapid assessment of individual cases to achieve that objective. METHODS: The population was a payer defined cohort of lung cancer patients treated at Texas Oncology (TxO)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152824/treatment-prices-at-the-point-of-care-pilot
#11
Rebecca W Lau, Leah Tuzzio, Matthew Alan Christianson, Eric Y Chen, Thanh-Hien Phan
: 4 Background: People with cancer increasingly wish to discuss cancer care costs with clinicians. In our organization all price questions go to a central customer service line with limited capacity to address oncology-specific questions. We aimed to improve clinician access to treatment prices to assist them in responding to patient concerns about prices. METHODS: We developed, launched, and evaluated a pilot tool and accompanying workflow for four oncology clinics in an integrated delivery system in WA...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152676/evaluation-of-resource-utilization-using-time-derived-activity-based-costing-tdabc-to-result-in-more-effective-processes-and-cost-reduction
#12
Elizabeth A Garcia, Kai E Lang, Valerie Villanueva, Shannon Neville Westin, Nicole D Fleming, Thomas W Feeley, Karen H Lu, Larissa Meyer
: 22 Background: Current changes in health care economics have led to a focus on value-based health care. TDABC is a systematic method to assess personnel utilization and the associated cost in the delivery of medical care. Based on baseline process maps and cost estimates in our outpatient center, cancer surveillance visits (CSV) were identified as inefficient, lengthy and high cost. The purpose of this study was to determine if reallocation of personnel was feasible, resulted in decrease cost and better value care...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28135194/validation-of-a-novel-claims-based-stroke-severity-index-in-patients-with-intracerebral-hemorrhage
#13
Ling-Chien Hung, Sheng-Feng Sung, Cheng-Yang Hsieh, Ya-Han Hu, Huey-Juan Lin, Yu-Wei Chen, Yea-Huei Kao Yang, Sue-Jane Lin
BACKGROUND: Stroke severity is an important outcome predictor for intracerebral hemorrhage (ICH) but is typically unavailable in administrative claims data. We validated a claims-based stroke severity index (SSI) in patients with ICH in Taiwan. METHODS: Consecutive ICH patients from hospital-based stroke registries were linked with a nationwide claims database. Stroke severity, assessed using the National Institutes of Health Stroke Scale (NIHSS), and functional outcomes, assessed using the modified Rankin Scale (mRS), were obtained from the registries...
January 2017: Journal of Epidemiology
https://www.readbyqxmd.com/read/28127728/arteriovenous-access-does-not-perform-as-well-for-plasmapheresis
#14
Mathew Wooster, Rachel Wilson, Murray Shames, Neil Moudgill
PURPOSE: Access surgeons are occasionally asked to create arteriovenous access for non-dialysis functions. Subjectively noting overall poor results, we seek to present our experience with arteriovenous access creation for apheresis. METHODS: Billing records were reviewed using Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-9) codes to identify patients undergoing arteriovenous access creation for diseases other than renal failure from January 2007 to August 2014...
January 25, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28125437/value-in-single-level-lumbar-discectomy-surgical-disposable-item-cost-and-relationship-to-patient-reported-outcomes
#15
Benjamin P Rosenbaum, Michael T Modic, Ajit A Krishnaney
STUDY DESIGN: This is a retrospective study. OBJECTIVE: Compare improvements in health status measures (HSMs) and surgical costs to determine whether use of more costly items has any relationship to clinical outcome and value in lumbar disc surgery. SUMMARY OF BACKGROUND DATA: Association between cost, outcomes, and value in spine surgery, including lumbar discectomy is poorly understood. Outcomes were calculated as difference in mean HSM scores between preoperative and postoperative timeframes...
January 25, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28125086/utilization-of-genetic-tests-analysis-of-gene-specific-billing-in-medicare-claims-data
#16
Julie A Lynch, Brygida Berse, W David Dotson, Muin J Khoury, Nicole Coomer, John Kautter
PURPOSE: We examined the utilization of precision medicine tests among Medicare beneficiaries through analysis of gene-specific tier 1 and 2 billing codes developed by the American Medical Association in 2012. METHODS: We conducted a retrospective cross-sectional study. The primary source of data was 2013 Medicare 100% fee-for-service claims. We identified claims billed for each laboratory test, the number of patients tested, expenditures, and the diagnostic codes indicated for testing...
January 26, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28104099/coexisting-systemic-infections-in-patients-who-present-with-a-fall
#17
Alex Blair, Farrin A Manian
BACKGROUND: Although the causes of falls are legion, infectious disease-related factors are not commonly reported in the published literature. We investigated the characteristics of patients presenting to the hospital because of a fall and who were subsequently found to have a coexisting systemic infection (CSI). MATERIALS AND METHODS: This was a retrospective study performed at Massachusetts General Hospital, using the electronic database of adult patients receiving care during the period January 1, 2000 through December 31, 2014...
January 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28099763/the-effectiveness-of-a-multidisciplinary-team-based-approach-to-cesarean-hysterectomy-in-modern-obstetric-practice
#18
Caitlin Gillespie, Haleh Sangi-Haghpeykar, Uma Munnur, Maya S Suresh, Harold Miller, Shannon M Hawkins
OBJECTIVE: To examine the effectiveness of a multidisciplinary, team-based approach to management of cesarean hysterectomy. METHODS: In a retrospective chart review, data were analyzed from a quality assurance database of hysterectomies performed after cesarean delivery at one institution in the USA. Patients were identified through billing codes for cesarean delivery, cross-referenced to codes for hysterectomy. Demographic, reproductive, and outcome data were compared before (2000-2005) and after (2011-2013) implementation of a multidisciplinary team-based protocol...
January 5, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28079735/incidence-of-local-anesthetic-systemic-toxicity-in-orthopedic-patients-receiving-peripheral-nerve-blocks
#19
Eva E Mörwald, Nicole Zubizarreta, Crispiana Cozowicz, Jashvant Poeran, Stavros G Memtsoudis
BACKGROUND AND OBJECTIVES: Peripheral nerve blocks are increasingly used. However, despite low complication rates, concerns regarding local anesthetic systemic toxicity remain. Although recent studies suggest that this severe complication has decreased considerably, there is a paucity of data about it on a national level. We sought to elucidate the incidence of local anesthetic systemic toxicity on a national level and therefore provide guidance toward the need for preparedness in daily anesthetic practice...
January 9, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28067697/national-administrative-databases-in-adult-spinal-deformity-surgery-a-cautionary-tale
#20
Aaron J Buckland, Gregory Poorman, Robert Freitag, Cyrus Jalai, Eric O Klineberg, Michael Kelly, Peter G Passias
STUDY DESIGN: Comparison between national administrative databases and a prospective multicenter physician managed database. OBJECTIVES: This study aims to assess the applicability of National Administrative Databases (NADs) in Adult Spinal Deformity (ASD). Our hypothesis is that NADs do not include comparable patients as in a physician-managed database (PMD) for surgical outcomes in adult spinal deformity. SUMMARY OF BACKGROUND DATA: NADs such as National Inpatient Sample (NIS) and National Surgical Quality Improvement Program (NSQIP) provide large numbers of publications owing to ease of data access and lack of IRB approval requirement...
January 6, 2017: Spine
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