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Billing and Coding

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https://www.readbyqxmd.com/read/28731893/validity-of-administrative-data-in-identifying-cancer-related-events-in-adolescents-and-young-adults-a-population-based-study-using-the-impact-cohort
#1
Sumit Gupta, Paul C Nathan, Nancy N Baxter, Cindy Lau, Corinne Daly, Jason D Pole
BACKGROUND: Despite the importance of estimating population level cancer outcomes, most registries do not collect critical events such as relapse. Attempts to use health administrative data to identify these events have focused on older adults and have been mostly unsuccessful. We developed and tested administrative data-based algorithms in a population-based cohort of adolescents and young adults with cancer. METHODS: We identified all Ontario adolescents and young adults 15-21 years old diagnosed with leukemia, lymphoma, sarcoma, or testicular cancer between 1992-2012...
July 20, 2017: Medical Care
https://www.readbyqxmd.com/read/28715295/prevalence-of-home-parenteral-and-enteral-nutrition-in-the-united-states
#2
Manpreet S Mundi, Adele Pattinson, Megan T McMahon, Jacob Davidson, Ryan T Hurt
BACKGROUND: Malnutrition is highly prevalent and associated with increased morbidity and mortality. Studies continue to reveal significant clinical benefits with nutrition support, including improved wound healing, reduction in complications and length of stay, and mortality. Due to these benefits, the prevalence of home parenteral and enteral nutrition (HPEN) continues to increase worldwide. In the United States, given our healthcare insurance landscape, it has been very difficult to ascertain the true prevalence of HPEN...
July 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28712922/utilization-of-manipulative-treatment-for-spine-and-shoulder-conditions-between-different-medical-providers-in-a-large-military-hospital
#3
Daniel Rhon, Tina Greenleee, Julie Fritz
OBJECTIVE: Describe the use of manipulative treatment for shoulder and spine conditions between various provider types. DESIGN: Retrospective observational cohort SETTING: Single military hospital PARTICIPANTS: Consecutive sample of 7,566 patients seeking care for an initial spine or shoulder condition from 1 January to 31 December 2009. INTERVENTIONS: Manipulative treatment (e.g. manual therapy, spinal and joint manipulation, etc). MAIN OUTCOME MEASURE: Manipulation treatment was identified with procedure billing codes in medical records...
July 13, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28710646/-outpatient-emergency-treatment-of-nursing-home-residents-analysis-of-insurance-claims-data
#4
Insa Seeger, Andres Luque Ramos, Falk Hoffmann
BACKGROUND: Utilization of outpatient emergency services by nursing home residents is increasing; however, out of hours medical care (OOHC) in Germany has not yet been studied. OBJECTIVE: In Bremen the used billing codes enabled a comparison between the use of outpatient emergency care in the year before and the year after admission to a nursing home stratified by emergency departments and OOHC. MATERIAL AND METHODS: In this retrospective cohort study we used insurance claims data of residents in Bremen, who were insured in a large German statutory health insurance (DAK-Gesundheit)...
July 14, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28706426/healthcare-utilization-and-costs-associated-with-gastroparesis
#5
Vaibhav Wadhwa, Dhruv Mehta, Yash Jobanputra, Rocio Lopez, Prashanthi N Thota, Madhusudhan R Sanaka
AIM: To use a national database of United States hospitals to evaluate the incidence and costs of hospital admissions associated with gastroparesis. METHODS: We analyzed the National Inpatient Sample Database (NIS) for all patients in whom gastroparesis (ICD-9 code: 536.3) was the principal discharge diagnosis during the period, 1997-2013. The NIS is the largest publicly available all-payer inpatient care database in the United States. It contains data from approximately eight million hospital stays each year...
June 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28703341/esophageal-function-testing-billing-and-coding-update
#6
REVIEW
A Khan, B Massey, S Rao, J Pandolfino
Esophageal function testing is being increasingly utilized in diagnosis and management of esophageal disorders. There have been several recent technological advances in the field to allow practitioners the ability to more accurately assess and treat such conditions, but there has been a relative lack of education in the literature regarding the associated Common Procedural Terminology (CPT) codes and methods of reimbursement. This review, commissioned and supported by the American Neurogastroenterology and Motility Society Council, aims to summarize each of the CPT codes for esophageal function testing and show the trends of associated reimbursement, as well as recommend coding methods in a practical context...
July 13, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28701222/how-well-do-icd-9-physician-claim-diagnostic-codes-identify-confirmed-pertussis-cases-in-alberta-canada-a-canadian-immunization-research-network-cirn-study
#7
Sumana Fathima, Kimberley A Simmonds, Steven J Drews, Lawrence W Svenson, Jeffrey C Kwong, Salaheddin M Mahmud, Susan Quach, Caitlin Johnson, Kevin L Schwartz, Natasha S Crowcroft, Margaret L Russell
BACKGROUND: Rates of Bordetella pertussis have been increasing in Alberta, Canada despite vaccination programs. Waning immunity from existing acellular component vaccines may be contributing to this. Vaccine effectiveness can be estimated using a variety of data sources including diagnostic codes from physician billing claims, public health records, reportable disease and laboratory databases. We sought to determine if diagnostic codes from billing claims (administrative data) are adequately sensitive and specific to identify pertussis cases among patients who had undergone disease-specific laboratory testing...
July 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28700736/short-term-rehospitalization-across-the-spectrum-of-age-and-insurance-types-in-the-united-states
#8
Jordan B Strom, Daniel B Kramer, Yun Wang, Changyu Shen, Jason H Wasfy, Bruce E Landon, Elissa H Wilker, Robert W Yeh
Few studies have examined rates and causes of short-term readmissions among adults across age and insurance types. We compared rates, characteristics, and costs of 30-day readmission after all-cause hospitalizations across insurance types in the US. We retrospectively evaluated alive patients ≥18 years old, discharged for any cause, 1/1/13-11/31/13, 2006 non-federal hospitals in 21 states in the Nationwide Readmissions Database. The primary stratification variable of interest was primary insurance. Comorbid conditions were assessed based on Elixhauser comorbidities, as defined by administrative billing codes...
2017: PloS One
https://www.readbyqxmd.com/read/28697724/early-characteristics-of-infants-with-pulmonary-hypertension-in-a-referral-neonatal-intensive-care-unit
#9
Shilpa Vyas-Read, Usama Kanaan, Prabhu Shankar, Jane Stremming, Curtis Travers, David P Carlton, Anne Fitzpatrick
BACKGROUND: Approximately 8-23% of premature infants develop pulmonary hypertension (PH), and this diagnosis confers a higher possibility of mortality. As a result, professional societies recommend PH screening in premature infants. However, the risk factors for and the outcomes of PH may differ depending on the timing of its diagnosis, and little evidence is available to determine at-risk infants in the referral neonatal population. The objective of this study was to define clinical and echocardiographic characteristics of infants with pulmonary hypertension during the neonatal hospital course and at or near-term...
July 11, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28696957/association-of-inflammatory-bowel-disease-and-urolithiasis-in-hospitalized-pediatric-patients
#10
Christopher M Stark, Gregory H Gorman, Cade M Nylund
BACKGROUND: Urolithiasis is rare in pediatric patients. All patients with inflammatory bowel disease (IBD) have an increased risk of urolithiasis, but this risk is poorly quantified in children. The objective of this study is to evaluate the association of IBD with urolithiasis, assess surgical outcomes, and analyze the financial burden for children hospitalized with urolithiasis and comorbid IBD. METHODS: The triennial Healthcare Cost and Utilization Project Kids' Inpatient Database for years 1997 to 2012 was used to evaluate the association between urolithiasis and IBD in hospitalized, nonpregnant children ages 5 to 20 years old...
July 10, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28696857/use-of-radiology-procedure-codes-in-health-care-the-need-for-standardization-and-structure
#11
Kenneth C Wang, Jigar B Patel, Bimal Vyas, Michael Toland, Beverly Collins, Daniel J Vreeman, Swapna Abhyankar, Eliot L Siegel, Daniel L Rubin, Curtis P Langlotz
Radiology procedure codes are a fundamental part of most radiology workflows, such as ordering, scheduling, billing, and image interpretation. Nonstandardized unstructured procedure codes have typically been used in radiology departments. Such codes may be sufficient for specific purposes, but they offer limited support for interoperability. As radiology workflows and the various forms of clinical data exchange have become more sophisticated, the need for more advanced interoperability with use of standardized structured codes has increased...
July 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28689696/implementing-a-systematic-approach-to-improve-governance-and-deployment-of-imaging-codes-in-radiology
#12
Carolina V Guimaraes, Laura A Smith, Jo A Garza, Maria E Blado, Crystal S Lokey, Lane F Donnelly
Unlike medical procedure (Current Procedural Terminology [CPT]) and diagnostic (International Classification of Diseases [ICD]) codes, imaging (IMG) codes are defined at the local, institutional level. IMG codes are used within an organization to define IMG procedures and how they are routed between information systems. Our purpose is to describe the implementation of a reorganization (referred to as the IMG code cleanup) and governance structure deployed at a large children's hospital and the initial effects of that implementation...
June 6, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28687379/moderate-sedation-changes-for-bronchoscopy-in-2017
#13
REVIEW
Michael E Nelson
The reimbursement for procedures using moderate (conscious) sedation has changed significantly as of January 1, 2017. Due to the increasing use of anesthesia services to provide moderate sedation during endoscopy, the Centers for Medicare & Medicaid Services made the decision to remove work relative value units from many of the services requiring moderate sedation, including the bronchoscopy codes. If a bronchoscopist provides moderate sedation to a patient without using anesthesia services or another qualified provider, that work (and revenue) can be reclaimed by using the relevant codes...
July 4, 2017: Chest
https://www.readbyqxmd.com/read/28686612/evaluating-phecodes-clinical-classification-software-and-icd-9-cm-codes-for-phenome-wide-association-studies-in-the-electronic-health-record
#14
Wei-Qi Wei, Lisa A Bastarache, Robert J Carroll, Joy E Marlo, Travis J Osterman, Eric R Gamazon, Nancy J Cox, Dan M Roden, Joshua C Denny
OBJECTIVE: To compare three groupings of Electronic Health Record (EHR) billing codes for their ability to represent clinically meaningful phenotypes and to replicate known genetic associations. The three tested coding systems were the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes, the Agency for Healthcare Research and Quality Clinical Classification Software for ICD-9-CM (CCS), and manually curated "phecodes" designed to facilitate phenome-wide association studies (PheWAS) in EHRs...
2017: PloS One
https://www.readbyqxmd.com/read/28679914/perceived-benefits-of-implementing-and-using-hospital-information-systems-and-electronic-medical-records
#15
Mohamed Khalifa
Hospital information systems (HIS) and electronic medical records (EMR) are currently considered a major part of the healthcare system, on which all the processes of care delivery depend. They have the potential to provide substantial benefits to healthcare professionals, patients and healthcare organizations. The study used quantitative survey methods through a questionnaire to collect data and information directly from different categories of healthcare professionals of four Saudi hospitals. Valid responses were 153 and ten perceived benefits were validated and ranked, these are; 1) Improved information access, 2) Increased healthcare professionals productivity, 3) Improved efficiency and accuracy of coding and billing, 4) Improved quality of healthcare, 5) Improved clinical management (diagnosis and treatment), 6) Reduced expenses associated with paper medical records, 7) Reduced medical errors, 8) Improved patient safety, 9) Improved patient outcomes and 10) Improved patient satisfaction...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28675136/policy-content-and-stakeholder-network-analysis-for-infant-and-young-child-feeding-in-india
#16
Seema Puri, Sylvia Fernandez, Amrita Puranik, Deepika Anand, Abhay Gaidhane, Zahiruddin Quazi Syed, Archana Patel, Shahadat Uddin, Anne Marie Thow
BACKGROUND: Over the last decade, infant and young child feeding (IYCF) indicators in India have improved. However, poor IYCF practices are still apparent, associated with pervasive high rates of child under-nutrition. Interventions to improve IYCF need augmentation by appropriate policy support to consolidate gains. The aim of this study was to identify opportunities to strengthen and support IYCF policies through a policy content and stakeholder network analysis. METHODS: IYCF policies and guidelines were systematically mapped and coded using predetermined themes...
June 13, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28670401/the-clinical-correlations-between-diabetes-cigarette-smoking-and-obesity-on-intervertebral-degenerative-disc-disease-of-the-lumbar-spine
#17
Ande M Jakoi, Gurpal Pannu, Anthony D'Oro, Zorica Buser, Martin H Pham, Neil N Patel, Patrick C Hsieh, John C Liu, Frank L Acosta, Raymond Hah, Jeffrey C Wang
STUDY DESIGN: Retrospective analysis of a nationwide private insurance database. Chi-square analysis and linear regression models were utilized for outcome measures. PURPOSE: The purpose of this study was to investigate any relationship between lumbar degenerative disc disease, diabetes, obesity and smoking tobacco. OVERVIEW OF LITERATURE: Diabetes, obesity, and smoking tobacco are comorbid conditions known to individually have effect on degenerative disc disease...
June 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28669379/the-prevalence-of-gestational-diabetes
#18
Hanne Melchior, Diana Kurch-Bek, Monika Mund
BACKGROUND: Gestational diabetes mellitus (GDM) is defined as a glucose tolerance disorder that arises during pregnancy. Estimates of its prevalence vary widely because of varying threshold values. Screening of all pregnant women with a two-step test has been available in Germany since 2012. This study is the first population-based, nationwide analysis of the screening coverage and the resulting one-year prevalence. METHODS: Billing data from the outpatient sector were analyzed for all persons covered by statutory health insurance in the two-year period 2014-2015...
July 16, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28666693/effect-of-severity-of-illness-on-cesarean-delivery-rates-in-washington-state
#19
Jane Hitti, Suzan Walker, Thomas J Benedetti
BACKGROUND: Hospitals and providers are increasingly held accountable for their cesarean delivery rates. In the perinatal quality improvement arena, there is vigorous debate about whether all hospitals can be held to the same benchmark for an acceptable cesarean rate regardless of patient acuity. However, the causes of variation in hospital cesarean delivery rates are not well understood. OBJECTIVE: We sought to evaluate the association and temporal trends between severity of illness at admission and the primary term singleton vertex cesarean delivery rate among hospitals in Washington State...
June 27, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28666437/olfactory-coding-from-the-periphery-to-higher-brain-centers-in-the-drosophila-brain
#20
Yoichi Seki, Hany K M Dweck, Jürgen Rybak, Dieter Wicher, Silke Sachse, Bill S Hansson
BACKGROUND: Odor information is processed through multiple receptor-glomerular channels in the first order olfactory center, the antennal lobe (AL), then reformatted into higher brain centers and eventually perceived by the fly. To reveal the logic of olfaction, it is fundamental to map odor representations from the glomerular channels into higher brain centers. RESULTS: We characterize odor response profiles of AL projection neurons (PNs) originating from 31 glomeruli using whole cell patch-clamp recordings in Drosophila melanogaster...
June 30, 2017: BMC Biology
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