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https://www.readbyqxmd.com/read/29777125/development-of-an-algorithm-to-identify-patients-with-physician-documented-insomnia
#1
Uri Kartoun, Rahul Aggarwal, Andrew L Beam, Jennifer K Pai, Arnaub K Chatterjee, Timothy P Fitzgerald, Isaac S Kohane, Stanley Y Shaw
We developed an insomnia classification algorithm by interrogating an electronic medical records (EMR) database of 314,292 patients. The patients received care at Massachusetts General Hospital (MGH), Brigham and Women's Hospital (BWH), or both, between 1992 and 2010. Our algorithm combined structured variables (such as International Classification of Diseases 9th Revision [ICD-9] codes, prescriptions, laboratory observations) and unstructured variables (such as text mentions of sleep and psychiatric disorders in clinical narrative notes)...
May 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29773640/health-care-utilization-and-burden-of-diabetic-ketoacidosis-in-the-u-s-over-the-past-decade-a-nationwide-analysis
#2
Dimpi Desai, Dhruv Mehta, Priyanka Mathias, Gopal Menon, Ulrich K Schubart
OBJECTIVE: Diabetes is one of the most common chronic diseases and a leading cause of morbidity and mortality in the U.S. Although our ability to treat diabetes and its associated complications has significantly improved, presentation with uncontrolled diabetes leading to ketoacidosis remains a significant problem. RESEARCH DESIGN AND METHODS: We aimed to determine the incidence and costs of hospital admissions associated with diabetic ketoacidosis (DKA). We reviewed the National Inpatient Sample Database for all hospitalizations in which DKA (ICD-9 codes 250...
May 17, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29766728/-euthanasia-legal-comparison-in-selected-european-countries
#3
Adam Doležal
This article deals with the subject of euthanasia (all its forms) and other end-of-life decisions, such as assisted suicide, withdrawing and whithholding life-sustaining treatments. Among other things, the article will also deal with the issue of the offense of Homicide by the Victims Request. Based on an empirical historical method, the article compares the various selected legal orders. From this analysis, it draws some conclusions that have an impact on ethical discourse. First of all, the terminology is defined in the article, which is very important in this area...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29764166/chimeric-antigen-receptor-t-cells-a-savior-with-a-high-price
#4
Gilberto de Lima Lopes, George R Nahas
Chimeric antigen receptor (CAR) T cells represent a medical and scientific breakthrough that may represent a paradigm for the future of personalized medicine in the age of cancer immunotherapy. As with many new cancer agents, such novel and incredible results come with a high price. At the time of the writing of this article, there are two CAR T cells available, Kymriah, produced by Novrtis with a price tag of US$475,000 and Yescarta produced by Gilead Pharmaceuticals with a price tag of US$373,000, neither price including the required hospital admission in order to administer the agent in addition to potential treatment of side effects...
April 2018: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/29762291/profiles-of-practicing-female-orthopaedists-caring-for-medicare-patients-in-the-united-states
#5
Talia R Chapman, Benjamin Zmistowski, James J Purtill, Antonia F Chen
BACKGROUND: The increase in the percentage of women in orthopaedics in the United States over the last half century has been substantially slower than in every other surgical specialty. While this percentage has improved recently, the current demographic and practice characteristics of female orthopaedic surgeons are not well known. This study defines the landscape of practicing female orthopaedic surgeons caring for Medicare patients. METHODS: Publicly available Medicare billing data sets from 2012 to 2014 were utilized to identify practicing orthopaedic surgeons...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29762153/increased-mortality-and-reoperation-rates-after-treatment-for-septic-arthritis-of-the-knee-in-people-who-inject-drugs-nationwide-inpatient-sample-2000-2013
#6
David Hyung Won Oh, Alysse Gail Wurcel, David Joseph Tybor, Deirdre Burke, Mariano E Menendez, Matthew Joseph Salzler
BACKGROUND: The United States has a growing opioid epidemic impacting all aspects of health care including orthopaedic surgery. Septic arthritis of the knee is a condition commonly encountered by orthopaedic surgeons related to opioid and injection drug use (IDU). Changes in the frequency of hospitalizations for IDU-related septic arthritis and differences in septic arthritis patient outcomes according to IDU status in the setting of the burgeoning opioid epidemic are unknown. QUESTIONS/PURPOSES: (1) What proportion of patients with septic arthritis of the knee use injection drugs? (2) Are there any differences in complications, reoperations, length of stay, and leaving against medical advice among patients with septic arthritis of the knee with and without IDU? (3) What are the age and racial trends in IDU-related septic arthritis of the knee from 2000 to 2013? METHODS: The Healthcare Cost and Utilization Project, Nationwide Inpatient Sample database of years 2000 to 2013 was utilized for patients between ages 15 and 64 years with a principal discharge diagnosis of native septic arthritis of the lower leg, the vast majority of which represents the knee...
May 14, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29761740/treatment-of-cutaneous-warts-with-multiple-puncture-technique
#7
Joseph S Mclaughlin, Thomas J Fischer, Gregory A Merrell
BACKGROUND: Despite a multitude of treatment options, cutaneous warts on the hands can be a recalcitrant clinical problem. METHODS: Based on Current Procedural Terminology ( CPT) billing codes, the office database was searched for a 10-year period of warts treated with a puncture technique after institutional review board approval. Office notes were examined, and patients were contacted to assess wart resolution or the need for further treatment as well as any complications...
May 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29756475/national-survey-of-pediatric-care-providers-assessing-time-and-impact-of-coding-and-documentation-in-physician-practice
#8
Anshul Arora, Ashish Garg, Vrinda Arora, Munaza Rizvi, Ninad Desai
BACKGROUND: Documentation and billing/coding are essential to medical practice. Physicians spend significant time documenting to meet coding and medicolegal requirements, potentially reducing time for patient care and learning. We sought to assess time spent charting in pediatric practice and provider understanding and comfort level regarding billing/coding. METHODS: An anonymous web-based survey was emailed to members of American Academy of Pediatrics Section of Pediatric Trainees practicing in the United States...
May 1, 2018: Clinical Pediatrics
https://www.readbyqxmd.com/read/29751979/principles-of-billing-for-diagnostic-ultrasound-in-the-office-and-operating-room
#9
REVIEW
Beatrice L Grasu, Bruce S Wolock, Matthew D Sedgley, Michael S Murphy
Ultrasound is becoming more prevalent as physicians gain comfort in its diagnostic and therapeutic uses. It allows for both static and dynamic evaluation of conditions and assists in therapeutic injections of joints and tendons. Proper technique is necessary for successful use of this modality. Appropriate coding for physician reimbursement is required. We discuss common wrist and hand pathology for which ultrasound may be useful as an adjunct to diagnosis and treatment and provide an overview of technique and reimbursement codes when using ultrasound in a variety of situations...
May 8, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29750945/ocular-injury-in-united-states-emergency-departments-seasonality-and-annual-trends-estimated-from-a-nationally-representative-dataset
#10
David A Ramirez, Travis C Porco, Thomas M Lietman, Jeremy D Keenan
PURPOSE: To determine whether ocular trauma occurs more frequently in the summer months. DESIGN: Retrospective, cross-sectional study. METHODS: The Nationwide Emergency Department Sample (NEDS) is a large, publicly available administrative database that provides nationally representative estimates of emergency department (ED) visits in the United States. Billing codes from NEDS from 2006 to 2013 were used to identify all cases of ocular trauma, and the United States decennial census was used to estimate the population at risk for visiting an ED...
May 8, 2018: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/29747898/trends-of-the-neurosurgical-economy-in-the-united-states
#11
William C Johnson, Ali Seifi
BACKGROUND: The objective of this study was to identify the neurosurgical MS-DRGs highest national bills and to analyze economic, demographic, and patient outcome trends. METHODS: This retrospective cohort study used the Nationwide Inpatient Sample (NIS) database to achieve the results. All MS-DRG codes for the years 2014 were ranked based on total aggregate charges. The highest ranked relevant to neurosurgery were identified and retrospectively reviewed to 2008...
May 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29739338/measuring-colorectal-cancer-incidence-the-performance-of-an-algorithm-using-administrative-health-data
#12
Mamadou Diop, Erin C Strumpf, Geetanjali D Datta
BACKGROUND: Certain cancer case ascertainment methods used in Quebec and elsewhere are known to underestimate the burden of cancer, particularly for some subgroups. Algorithms using claims data are a low-cost option to improve the quality of cancer surveillance, but have not frequently been implemented at the population-level. Our objectives were to 1) develop a colorectal cancer (CRC) case ascertainment algorithm using population-level hospitalization and physician billing data, 2) validate the algorithm, and 3) describe the characteristics of cases...
May 8, 2018: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/29735302/a-physician-led-initiative-to-improve-clinical-documentation-results-in-improved-health-care-documentation-case-mix-index-and-increased-contribution-margin
#13
Francesco A Aiello, Dejah R Judelson, Jonathan M Durgin, Danielle R Doucet, Jessica P Simons, Dawn M Durocher, Julie M Flahive, Andres Schanzer
INTRODUCTION: Clinical documentation is the key determinant of inpatient acuity of illness and payer reimbursement. Every inpatient hospitalization is placed into a diagnosis related group with a relative value based on documented procedures, conditions, comorbidities and complications. The Case Mix Index (CMI) is an average of these diagnosis related groups and directly impacts physician profiling, medical center profiling, reimbursement, and quality reporting. We hypothesize that a focused, physician-led initiative to improve clinical documentation of vascular surgery inpatients results in increased CMI and contribution margin...
May 4, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29733229/healthcare-resource-utilization-costs-of-care-and-treatment-of-mycosis-fungoides-cutaneous-t-cell-lymphoma-patterns-in-a-large-managed-care-population-a-retrospective-us-claims-based-analysis
#14
Yuen Tsang, Tao Gu, Gaurav Sharma, Susan Raspa, Bill Drake, Hiangkiat Tan
PURPOSE: To evaluate health care utilization, treatment patterns and costs among patients with mycosis fungoides-cutaneous T-cell lymphoma (MF-CTCL). METHODS: This retrospective cohort study queried the HealthCore Integrated Research Database to identify patients ≥18 years with ≥2 diagnoses of MF-CTCL (ICD-9-CM code 202.1x, 202.2x) between 07 January 2006 and 07 January 2013. Index date was defined as first MF-CTCL diagnosis. Patients were continuously enrolled ≥6 months before and ≥12 months after index date...
May 7, 2018: Journal of Dermatological Treatment
https://www.readbyqxmd.com/read/29732927/nasal-endoscopy-billing-patterns-a-survey-of-the-american-rhinologic-society
#15
Abtin Tabaee, Charles A Riley, Seth M Brown, Edward D McCoul
Introduction Nasal endoscopy (NE) is an essential element of office-based clinical rhinology, including the evaluation of chronic rhinosinusitis. Despite the presence of guidelines, variability exists regarding coding and billing for NE especially with regard to inclusion of evaluation and management (E&M) codes and use of the 25 modifier. The goal of this survey was to assess the billing patterns for NE among American Rhinologic Society (ARS) members. Methods An invitation to participate in a web-based survey was electronically sent to all ARS members...
January 1, 2018: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29728145/transition-to-international-classification-of-disease-version-10-clinical-modification-the-impact-on-internal-medicine-and-internal-medicine-subspecialties
#16
Rachel N Caskey, Angelos Abutahoun, Anne Polick, Michelle Barnes, Pavan Srivastava, Andrew D Boyd
BACKGROUND: The US health care system uses diagnostic codes for billing and reimbursement as well as quality assessment and measuring clinical outcomes. The US transitioned to the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) on October, 2015. Little is known about the impact of ICD-10-CM on internal medicine and medicine subspecialists. METHODS: We used a state-wide data set from Illinois Medicaid specified for Internal Medicine providers and subspecialists...
May 4, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29725962/standard-lexicons-coding-systems-and-ontologies-for-interoperability-and-semantic-computation-in-imaging
#17
REVIEW
Kenneth C Wang
Standard clinical terms, codes, and ontologies promote clarity and interoperability. Within radiology, there is a variety of relevant content resources, tools and technologies. These provide the basis for fundamental imaging workflows such as reporting and billing, and also facilitate a range of applications in quality improvement and research. This article reviews the key characteristics of lexicons, coding systems, and ontologies. A number of standards are described, including International Classification of Diseases-10-Clinical Modification (ICD-10-CM), Current Procedural Terminology (CPT), Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT), Logical Observation Identifiers Names and Codes (LOINC), and RadLex...
May 3, 2018: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/29724482/physician-visits-and-the-timing-of-skeletal-related-events-among-men-newly-diagnosed-with-metastatic-prostate-cancer-a-cohort-analysis
#18
Eberechukwu Onukwugha, Husam Albarmawi, Kai Sun, C Daniel Mullins, Abdalla Aly, Arif Hussain
INTRODUCTION: Men diagnosed with metastatic prostate cancer (PCa) are at increased risk for skeletal complications which are associated with significant morbidity and mortality. Although both the urologist and the medical oncologist play important roles in the management of patients with advanced PCa, there is limited information regarding their role in the context of skeletal complications. The current study investigated these relationships among newly diagnosed metastatic patients with PCa...
April 30, 2018: Urologic Oncology
https://www.readbyqxmd.com/read/29721598/current-utilization-and-procedural-practices-in-pediatric-whole-body-mri
#19
Gary R Schooler, Joseph T Davis, Heike E Daldrup-Link, Donald P Frush
BACKGROUND: Whole-body magnetic resonance imaging (MRI) is an evolving and increasingly powerful imaging tool with a variety of applications in the pediatric patient population. Variability exists among radiology practices in how this MRI tool is used and how it performed. OBJECTIVE: Our objective was to gain an improved understanding of technical and utilization practices in pediatric whole-body MRI across North America by exploring indications for exam performance, determining referral patterns, and assessing technical protocols and procedures...
May 2, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29720535/hepatitis-c-virus-screening-among-children-exposed-during-pregnancy
#20
Catherine A Chappell, Sharon L Hillier, David Crowe, Leslie A Meyn, Debra L Bogen, Elizabeth E Krans
OBJECTIVES: Because of the opioid epidemic, hepatitis C virus (HCV) infection is increasing among pregnant women, resulting in an increased risk of perinatal transmission and HCV infection among children. Our primary objectives in this study were to determine the prevalence of HCV among pregnant women and the frequency of pediatric HCV screening. METHODS: A population-based, retrospective cohort of pregnant women who delivered between 2006 and 2014 was identified and classified as HCV infected or HCV uninfected by billing codes...
May 2, 2018: Pediatrics
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