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Billing and Coding

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https://www.readbyqxmd.com/read/27898159/interagency-partnership-to-deliver-veteran-directed-home-and-community-based-services-interviews-with-aging-and-disability-network-agency-personnel-regarding-their-experience-with-partner-department-of-veterans-affairs-medical-centers
#1
Kali S Thomas, Susan M Allen
Veteran-Directed Home and Community-Based Services (VD-HCBS) is a consumer-directed program that began in 2009 and is jointly administered in a partnership between the Veterans Health Administration and the Administration for Community Living. The objective of this article is to describe the Aging and Disability Network agency (ADNA) personnel's perceptions of the implementation of the VD-HCBS program with partner Department of Veterans Affairs medical centers (VAMCs). Qualitative interviews with 26 ADNA VD-HCBS personnel across the country were transcribed, coded, and analyzed...
2016: Journal of Rehabilitation Research and Development
https://www.readbyqxmd.com/read/27896978/development-and-performance-of-text-mining-algorithms-to-extract-socioeconomic-status-from-de-identified-electronic-health-records
#2
Brittany M Hollister, Nicole A Restrepo, Eric Farber-Eger, Dana C Crawford, Melinda C Aldrich, Amy Non
Socioeconomic status (SES) is a fundamental contributor to health, and a key factor underlying racial disparities in disease. However, SES data are rarely included in genetic studies due in part to the difficultly of collecting these data when studies were not originally designed for that purpose. The emergence of large clinic-based biobanks linked to electronic health records (EHRs) provides research access to large patient populations with longitudinal phenotype data captured in structured fields as billing codes, procedure codes, and prescriptions...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27891780/icd-10-based-expanded-code-set-for-use-in-cleft-lip-palate-research-and-surveillance
#3
Alexander C Allori, Janet D Cragan, Cynthia H Cassell, Jeffrey R Marcus
BACKGROUND: On October 1, 2015, the United States required use of the Clinical Modification of the International Classification of Diseases, 10(th) Revision (ICD-10-CM) for diagnostic coding. The ICD-10-CM code set is limited to gross categories for cleft lip and/or cleft palate (using only four of a possible seven characters). METHODS: Herein, a clinically useful expansion of the ICD-10-CM code set is proposed to improve the diagnostic accuracy necessary for individual clinical, research, and statistical projects that require it...
November 2016: Birth Defects Research. Part A, Clinical and Molecular Teratology
https://www.readbyqxmd.com/read/27891525/a-validation-study-of-administrative-claims-data-to-measure-ovarian-cancer-recurrence-and-secondary-debulking-surgery
#4
Jennifer Livaudais-Toman, Natalia Egorova, Rebeca Franco, Monica Prasad-Hayes, Elizabeth A Howell, Juan Wisnivesky, Nina A Bickell
OBJECTIVE: Administrative claims data offer an alternative to chart abstraction to assess ovarian cancer recurrence, treatment and outcomes. Such analyses have been hindered by lack of valid recurrence and treatment algorithms. In this study, we sought to develop claims-based algorithms to identify ovarian cancer recurrence and secondary debulking surgery, and to validate them against the gold-standard of chart abstraction. METHODS: We conducted chart validation studies; 2 recurrence algorithms and 1 secondary surgery among 94 ovarian cancer patients treated at one hospital between 2003-2009...
2016: EGEMS
https://www.readbyqxmd.com/read/27886974/evaluating-coding-accuracy-in-general-surgery-residents-accreditation-council-for-graduate-medical-education-procedural-case-logs
#5
REVIEW
Fadi Balla, Tabitha Garwe, Prasenjeet Motghare, Tessa Stamile, Jennifer Kim, Heidi Mahnken, Jason Lees
INTRODUCTION: The Accreditation Council for Graduate Medical Education (ACGME) case log captures resident operative experience based on Current Procedural Terminology (CPT) codes and is used to track operative experience during residency. With increasing emphasis on resident operative experiences, coding is more important than ever. It has been shown in other surgical specialties at similar institutions that the residents' ACGME case log may not accurately reflect their operative experience...
November 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27882831/quantifying-differences-in-health-care-consumption-for-the-management-of-multiple-sclerosis-within-privately-and-publicly-insured-health-care-programs
#6
Terrie Livingston, Monica Fay, Ravi Iyer, Wendy Wells, Michael W Pill
BACKGROUND: Multiple sclerosis (MS) is a chronic and debilitating disease of the central nervous system that affects more than 570,000 persons in the United States and 2.3 million worldwide. Since most individuals experience initial symptoms between the ages of 20 and 40 years, MS can have a significant effect on health care consumption, quality of life, productivity, and employment over the long-term disease course. Opportunities exist to better understand how benefit design and other nonclinical factors can affect health care delivery and associated costs...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27881130/electronic-reminders-to-facilitate-longitudinal-care-a-mixed-methods-study-in-general-practices
#7
Christine Kersting, Birgitta Weltermann
BACKGROUND: Longitudinal, patient-centered care represents a challenge for general practitioners (GPs), and in this context, reminder systems can offer targeted support. This study aimed to identify details of such reminders: (1) contents of care addressed, (2) their mode of display in the electronic health record (EHR), (3) their visual appearance, (4) personnel responsibilities for editing and applying reminders, and (5) use of reminders for patient recall. METHODS: This mixed-methods study comprised (1) a cross-sectional survey among 185 GP practices from a German university network, and (2) structured observations of reminder utilization in six practices based on a clinical vignette describing a multimorbid senior with 26 care needs...
November 24, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27866823/relative-risk-and-incidence-for-developmental-dysplasia-of-the-hip
#8
Virginie Pollet, Vanessa Percy, Heather J Prior
OBJECTIVE: To determine the incidence and associated risk factors of developmental dysplasia of the hip (DDH) in a modern population without universal screening. STUDY DESIGN: Children with DDH were identified from the Manitoba Centre for Health Policy's Data Repository by the use of International Classification of Diseases diagnosis codes as well as physician billing tariffs for surgical procedures for DDH for all children born between 1995 and 2012. To identify the outpatient-treated patients, ultrasound scans and radiographic imaging for DDH were reviewed for 2004-2012...
November 18, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27864915/identification-of-emergency-department-visits-in-medicare-administrative-claims-approaches-and-implications
#9
Arjun K Venkatesh, Hao Mei, Keith Kocher, Mike Granovsky, Ziad Obermeyer, Erica Spatz, Craig Rothenberg, Harlan Krumholz, Zhenqui Lin
OBJECTIVES: Administrative claims datasets are often used for emergency care research and policy investigations of healthcare resource utilization, acute care practices, and evaluation of quality improvement interventions. Despite the high profile of emergency department (ED) visits in analyses using administrative claims, little work has evaluated the degree to which existing definitions based on claims data accurately captures conventionally defined hospital-based ED services. We sought to construct an operational definition for ED visitation using a comprehensive Medicare dataset and to compare this definition to existing operational definitions used by researchers and policymakers...
November 19, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27861712/trends-in-operative-and-nonoperative-hip-fracture-management-1990-2014-a-longitudinal-analysis-of-manitoba-administrative-data
#10
Peter Cram, Lin Yan, Eric Bohm, Paul Kuzyk, Lisa M Lix, Suzanne N Morin, Sumit R Majumdar, William D Leslie
OBJECTIVES: To evaluate longitudinal trends in the use of total hip arthroplasty (THA), hemiarthroplasty (HA), internal fixation (IF), and nonoperative management and to identify individual-level factors associated with nonoperative treatment of hip fracture (HF). DESIGN: Longitudinal analysis of administrative data. SETTING: Manitoba, Canada. PARTICIPANTS: All adults who experienced nontraumatic hip fractures between 1990 and 2014 (N = 19,626; mean age 80...
November 14, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27861304/trends-in-corneal-transplantation-in-keratoconus
#11
Daniel Sarezky, Stephen E Orlin, Wei Pan, Brian L VanderBeek
PURPOSE: To determine recent trends in and sociodemographic/comorbid conditions associated with penetrating keratoplasty (PK) and lamellar keratoplasty (LK) for keratoconus (KCN). METHODS: Patients with KCN and subsequent PK and LK procedures were identified using International Classification of Diseases, 9th revision (ICD-9) and Current Procedural Terminology (CPT) billing codes. The change in surgical rates was calculated over a decade, and multivariate analysis demonstrated factors associated with undergoing surgery...
November 16, 2016: Cornea
https://www.readbyqxmd.com/read/27836482/pathway-to-pharmacist-medical-provider-status-in-washington-state
#12
Thomas K Hazlet, Tanya E Karwaki, Donald F Downing
OBJECTIVES: To describe Washington State's successful legal and legislative efforts to gain pharmacist medical provider status and major medical compensation and to compare those efforts with similar efforts in other states to identify key lessons learned. SUMMARY: Washington State Engrossed Substitute Senate Bill 5557 was enacted in 2015, securing pharmacists as medical providers and requiring compensation under major medical insurance for pharmacists providing health services (Revised Code of Washington 48...
November 8, 2016: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/27835958/identification-of-volume-overload-hospitalizations-among-hemodialysis-patients-using-administrative-claims-a-validation-study
#13
Magdalene M Assimon, Thuy Nguyen, Suzanne L Katsanos, Steven M Brunelli, Jennifer E Flythe
BACKGROUND: High rates of volume overload hospitalizations may indicate inadequate dialysis facility fluid management. Administrative claims databases are often used to study such outcomes, but these data are generated for billing purposes and may not capture clinical nuance. It is unknown if volume overload admissions can be correctly identified in administrative data and if a single claims-based definition for volume overload can be used across epidemiologic surveillance studies, observational studies of exposure-outcome associations and quality assessments...
November 11, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27834026/timing-of-cholecystectomy-following-endoscopic-sphincterotomy-a-population-based-study
#14
Brett D Mador, Avery B Nathens, Wei Xiong, O Neely M Panton, S Morad Hameed
BACKGROUND: Choledocholithiasis is commonly treated initially with endoscopic sphincterotomy, followed by cholecystectomy to definitively address the underlying problem of cholelithiasis. While the benefits of early cholecystectomy have been realized in other populations, the preferred timing for this subset of patients is less well established. We performed a large, population-based analysis to determine the frequency, benefits, and practice variance in regard to early cholecystectomy on a provincial level...
November 11, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27825395/invasiveness-index-as-a-predictor-of-surgical-site-infection-after-spinal-fusion-revision-fusion-or-laminectomy
#15
Brian L Hollenbeck, Kevin J McGuire, Andrew P White, David S Yassa, Sharon B Wright
OBJECTIVE To evaluate invasiveness index as a potential predictor of spine surgical site infection (SSI) after spinal fusion, revision fusion, or laminectomy. DESIGN Retrospective cohort study. SETTING Single, large, academic medical center. PATIENTS Adults undergoing spinal fusion, revision fusion, or laminectomy. METHODS Data were obtained from electronic hospital databases; cases of SSI were extracted from the infection control database using National Healthcare Safety Network (NHSN) definitions. For each case, an invasiveness index, determined by surgical approach, procedure, and number of spine levels treated, was calculated using current procedural terminology (CPT) billing codes...
November 9, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27816023/kinematics-and-kinetics-during-stair-ascent-in-individuals-with-gluteal-tendinopathy
#16
Kim Allison, Bill Vicenzino, Kim L Bennell, Tim V Wrigley, Alison Grimaldi, Paul W Hodges
BACKGROUND: Individuals with gluteal tendinopathy commonly report lateral hip pain and disability during stair ascent. This study aimed to compare kinematics and kinetics between individuals with and without gluteal tendinopathy during a step up task. METHODS: 35 individuals with unilateral gluteal tendinopathy and 35 pain-free controls underwent three-dimensional motion analysis of stance phase during stair ascent. An analysis of covariance was performed to compare hip, pelvis and trunk kinematic and kinetic variables between groups...
October 5, 2016: Clinical Biomechanics
https://www.readbyqxmd.com/read/27815636/-treatment-by-panel-physicians-of-patients-in-protective-institutions-and-homes-analysis-based-on-secondary-data
#17
Diana Kurch-Bek, Leonie Sundmacher, Christian Gallowitz, Bernhard Tenckhoff
BACKGROUND: According to the nursing statistics from 2014 a total of 2.6 million patients in Germany required nursing care of which 1.86 million received care at home and approximately 29 % (764,000 patients) received inpatient treatment exclusively in a nursing home. Reports on the number of long-term nursing care patients usually only include patients with a need of long-term care (according to § 14 German Social Code XI) confirmed by the statutory healthcare insurance. Currently, in Germany there is no nationwide report based on routine (billing) data estimating the number of patients in protective residential homes or institutions, nursing homes or homes for the elderly with nursing personnel (private institutions) based on routine data...
November 4, 2016: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/27813340/variation-in-treatment-of-children-hospitalized-with-antineutrophil-cytoplasmic-antibody-associated-vasculitis-in-the-united-states
#18
Karen E James, Rui Xiao, Peter A Merkel, Pamela F Weiss
OBJECTIVE: There are few reports on treatment of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) in children. This study characterizes the use of cyclophosphamide, rituximab, and plasma exchange in children hospitalized with AAV in the United States. METHODS: We conducted a retrospective cohort study of children hospitalized with AAV from 2004-2014 utilizing an administrative and billing database from 47 tertiary care pediatric hospitals. All patients had an ICD-9-CM discharge code of 446...
November 3, 2016: Arthritis Care & Research
https://www.readbyqxmd.com/read/27812365/shared-genetic-etiology-of-autoimmune-diseases-in-patients-from-a-biorepository-linked-to-de-identified-electronic-health-records
#19
Nicole A Restrepo, Mariusz Butkiewicz, Josephine A McGrath, Dana C Crawford
: Autoimmune diseases represent a significant medical burden affecting up to 5-8% of the U.S. POPULATION: While genetics is known to play a role, studies of common autoimmune diseases are complicated by phenotype heterogeneity, limited sample sizes, and a single disease approach. Here we performed a targeted genetic association study for cases of multiple sclerosis (MS), rheumatoid arthritis (RA), and Crohn's disease (CD) to assess which common genetic variants contribute individually and pleiotropically to disease risk...
2016: Frontiers in Genetics
https://www.readbyqxmd.com/read/27811008/vasectomy-and-risk-of-prostate-cancer-population-based-matched-cohort-study
#20
Madhur Nayan, Robert J Hamilton, Erin M Macdonald, Qing Li, Muhammad M Mamdani, Craig C Earle, Girish S Kulkarni, Keith A Jarvi, David N Juurlink
OBJECTIVE:  To determine the association between vasectomy and prostate cancer, adjusting for measures of health seeking behaviour. DESIGN:  Population based matched cohort study. SETTING:  Multiple validated healthcare databases in Ontario, Canada, 1994-2012. PARTICIPANTS:  326 607 men aged 20 to 65 who had undergone vasectomy were identified through physician billing codes and matched 1:1 on age (within two years), year of cohort entry, comorbidity score, and geographical region to men who did not undergo a vasectomy...
November 3, 2016: BMJ: British Medical Journal
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