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Billing and Coding

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https://www.readbyqxmd.com/read/28634503/monitoring-the-diagnostic-process-on-an-inpatient-neurology-service
#1
Amar Dhand, Robert Bucelli, Arun Varadhachary, Michael Tsiaklides, Gabriela de Bruin, Gurpreet Dhaliwal
The Institute of Medicine report Improving Diagnosis in Health Care called for tools to monitor physicians' diagnostic process. We addressed this need by developing a tool for clinicians to record and analyze their diagnostic process. The tool was a secure web application in which clinicians used a structured grading system to assess the relative impact of clinical, laboratory, and neuroimaging data for every new diagnosis. Four neurohospitalists used the tool for 6.5 months on a general neurology ward service at a single tertiary-level teaching hospital...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28629385/administrative-algorithms-to-identify-avascular-necrosis-of-bone-among-patients-undergoing-upper-or-lower-extremity-magnetic-resonance-imaging-a-validation-study
#2
Medha Barbhaiya, Yan Dong, Jeffrey A Sparks, Elena Losina, Karen H Costenbader, Jeffrey N Katz
BACKGROUND: Studies of the epidemiology and outcomes of avascular necrosis (AVN) require accurate case-finding methods. The aim of this study was to evaluate performance characteristics of a claims-based algorithm designed to identify AVN cases in administrative data. METHODS: Using a centralized patient registry from a US academic medical center, we identified all adults aged ≥18 years who underwent magnetic resonance imaging (MRI) of an upper/lower extremity joint during the 1...
June 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28625502/a-computable-phenotype-improves-cohort-ascertainment-in-a-pediatric-pulmonary-hypertension-registry
#3
Alon Geva, Jessica L Gronsbell, Tianxi Cai, Tianrun Cai, Shawn N Murphy, Jessica C Lyons, Michelle M Heinz, Marc D Natter, Nandan Patibandla, Jonathan Bickel, Mary P Mullen, Kenneth D Mandl
OBJECTIVES: To compare registry and electronic health record (EHR) data mining approaches for cohort ascertainment in patients with pediatric pulmonary hypertension (PH) in an effort to overcome some of the limitations of registry enrollment alone in identifying patients with particular disease phenotypes. STUDY DESIGN: This study was a single-center retrospective analysis of EHR and registry data at Boston Children's Hospital. The local Informatics for Integrating Biology and the Bedside (i2b2) data warehouse was queried for billing codes, prescriptions, and narrative data related to pediatric PH...
June 15, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28624641/text-mining-applied-to-electronic-cardiovascular-procedure-reports-to-identify-patients-with-trileaflet-aortic-stenosis-and-coronary-artery-disease
#4
Aeron M Small, Daniel H Kiss, Yevgeny Zlatsin, David L Birtwell, Heather Williams, Marie A Guerraty, Yuchi Han, Saif Anwaruddin, John H Holmes, Julio A Chirinos, Robert L Wilensky, Jay Giri, Daniel J Rader
BACKGROUND: Interrogation of the electronic health record (EHR) using billing codes as a surrogate for diagnoses of interest has been widely used for clinical research. However, the accuracy of this methodology is variable, as it reflects billing codes rather than severity of disease, and depends on the disease and the accuracy of the coding practitioner. Systematic application of text mining to the EHR has had variable success for the detection of cardiovascular phenotypes. We hypothesize that the application of text mining algorithms to cardiovascular procedure reports may be a superior method to identify patients with cardiovascular conditions of interest...
June 14, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28622808/characterizing-and-predicting-rates-of-delirium-across-general-hospital-settings
#5
Thomas H McCoy, Kamber L Hart, Roy H Perlis
OBJECTIVE: To better understand variation in reported rates of delirium, this study characterized delirium occurrence rate by department of service and primary admitting diagnosis. METHOD: Nine consecutive years (2005-2013) of general hospital admissions (N=831,348) were identified across two academic medical centers using electronic health records. The primary admitting diagnosis and the treating clinical department were used to calculate occurrence rates of a previously published delirium definition composed of billing codes and natural language processing of discharge summaries...
May 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28607679/proper-electronic-order-linkage-of-electrocardiograms-at-a-large-children-s-hospital-improves-reporting-and-revenue
#6
David S Spar, Wayne A Mays, David S Cooper, Lucille Sullivan, Terra Hicks, Jeffrey B Anderson
Electrocardiograms (ECGs) are performed to determine an individual's cardiac rhythm. Approximately 25,000 ECGs are performed yearly throughout our hospital system. Historically only 68% of all ECGs were performed with the proper order linked to the electronic ECG reading system (MUSE). Failure to link the orders to the electronic reading system leads to problems in patient safety, reporting and hospital revenue. Our aim was to increase the percentage of linked ECG orders in MUSE compared to total ECGs performed from 68% to 95%...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28604507/visits-to-registered-nurses-an-opportunity-to-increase-contraceptive-access-in-california
#7
Emese C Parker, Kevin Kong, Leslie A Watts, Eleanor B Schwarz, Philip D Darney, Heike Thiel de Bocanegra
BACKGROUND: In 2013, California passed Assembly Bill (A.B.) 2348, approving registered nurses (RNs) to dispense patient self-administered hormonal contraceptives and administer injections of hormonal contraceptives. The Family Planning, Access, Care and Treatment (Family PACT) program, which came into effect in 1997 to expand low-income, uninsured California resident access to contraceptives at no cost, is one program in which qualified RNs can dispense and administer contraceptives. AIMS: The aims of this study were to (a) describe utilization of RN visits within California's Family PACT program and (b) evaluate the impact of RN visits on client birth control acquisition during the first 18 months after implementation of A...
June 10, 2017: Nursing Research
https://www.readbyqxmd.com/read/28595057/hospitalization-cost-at-childbirth-health-parameters-and-colonization-with-antimicrobial-resistant-bacteria-and-methicillin-susceptible-staphylococcus-aureus
#8
Alexandra C Adler, Mihai Zamfir, Lana Hendrowarsito, Antchen Dammeyer, Lasse Schomacher, Barbara Karlin, Manuela Franitza, Lilia Nasri, Stefan Hörmansdorfer, Christian Tuschak, Giuseppe Valenza, Thomas Ewert, Wolfgang Hierl, Uta Ochmann, Caroline Herr, Stefanie Heinze
OBJECTIVE: Antimicrobial resistant bacteria (AMR) are of public health and economic relevance. However, there is a lack of data regarding AMR colonization in pregnant women and in newborns. Furthermore, there are few studies analyzing hospital's net income (revenues and costs). STUDY DESIGN: The cross-sectional study took place in two Bavarian clinics. Available data regarding women and newborns were collected using a standardized questionnaire, personal IDs and medical records in addition to AMR/MSSA screening...
May 30, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28595025/the-validity-of-using-health-administrative-data-to-identify-the-involvement-of-specialized-pediatric-palliative-care-teams-in-children-with-cancer-in-ontario-canada
#9
Kimberley Widger, Christina Vadeboncoeur, Shayna Zelcer, Ying Liu, Alisha Kassam, Rinku Sutradhar, Adam Rapoport, Katherine Nelson, Joanne Wolfe, Craig Earle, Jason D Pole, Sumit Gupta
BACKGROUND: Population-based research to identify underserviced populations and the impact of palliative care (PC) is limited as the validity of such data to identify PC services is largely unknown. OBJECTIVE: To determine the validity of using such data to identify the involvement of specialized pediatric PC teams among children with cancer. DESIGN: Retrospective cohort. SUBJECTS: Ontario children with cancer who died between 2000 and 2012, received care through a pediatric institution with a specialized PC team and a clinical PC database...
June 8, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28590797/using-the-electronic-medical-record-to-study-the-association-of-child-and-environmental-characteristics-on-the-type-of-physical-therapy-services-delivered-to-individuals-with-cerebral-palsy
#10
Amy F Bailes, Mary Gannotti, Matthew Fenchel
OBJECTIVE: The purpose of this study was to characterize the intervention type delivered to individuals with cerebral palsy (CP) in a pediatric outpatient medical setting and to identify factors associated with the total amount of service within each type. SUBJECTS: Four hundred and twenty-five individuals with CP (1-33 years) Gross Motor Function Classification System (GMFCS): Level I (n = 152); II (n = 63); III (n = 55); IV (n = 80); and V (n = 75). METHODS: Billing code data was extracted retrospectively from 2008 medical records and categorized to reflect four types: body structures and function (BSF), activity (ACT), environment (ENV), and examination (EXAM)...
June 7, 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28586563/top-tips-for-physicians-understand-the-importance-of-coding-and-billing-accuracy
#11
Nancy Clark
No abstract text is available yet for this article.
2017: MD Advisor: a Journal for New Jersey Medical Community
https://www.readbyqxmd.com/read/28579627/carriage-of-sub-microscopic-sexual-and-asexual-plasmodium-falciparum-stages-in-the-dry-season-at-navrongo-ghana
#12
Geoffrey R Atelu, Nancy O Duah, Michael D Wilson
BACKGROUND: We investigated the prevalence of sub-microscopic Plasmodium falciparum infections and gametocyte carriage in asymptomatic individuals in Navrongo in northern Ghana, an area of seasonal malaria transmission. DESIGN: A cross sectional study of 209 randomly selected participants of all age-groups was conducted in February and March, 2015. METHODS: Capillary blood samples collected from these individuals were used for the detection of both asexual and gametocyte stage parasites by microscopy, reverse transcriptase polymerase chain reaction (RT-PCR) and conventional nested PCR methods...
December 2016: Ghana Medical Journal
https://www.readbyqxmd.com/read/28570735/accuracy-of-billing-codes-used-in-the-therapeutic-care-of-diabetic-retinopathy
#13
Marisa Lau, Jonathan L Prenner, Alexander J Brucker, Brian L VanderBeek
Importance: Insurance billing claim databases represent a growing field of scientific inquiry within ophthalmology. Validating the accuracy of billing claim codes used during the care of diabetic retinopathy is a necessary precursor to fully understanding the underlying data and subsequent results of these types of studies. Objective: To determine the accuracy of diagnostic, procedural, and therapeutic billing codes used in the treatment of diabetic retinopathy...
June 1, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28558093/variation-in-emergency-department-vs-internal-medicine-excess-charges-in-the-united-states
#14
Tim Xu, Angela Park, Ge Bai, Sarah Joo, Susan M Hutfless, Ambar Mehta, Gerard F Anderson, Martin A Makary
Importance: Uninsured and insured but out-of-network emergency department (ED) patients are often billed hospital chargemaster prices, which exceed amounts typically paid by insurers. Objective: To examine the variation in excess charges for services provided by emergency medicine and internal medicine physicians. Design, Setting, and Participants: Retrospective analysis was conducted of professional fee payment claims made by the Centers for Medicare & Medicaid Services for all services provided to Medicare Part B fee-for-service beneficiaries in calendar year 2013...
May 30, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28557243/the-use-of-electronic-health-records-for-psychiatric-phenotyping-and-genomics
#15
REVIEW
Jordan W Smoller
The widespread adoption of electronic health record (EHRs) in healthcare systems has created a vast and continuously growing resource of clinical data and provides new opportunities for population-based research. In particular, the linking of EHRs to biospecimens and genomic data in biobanks may help address what has become a rate-limiting study for genetic research: the need for large sample sizes. The principal roadblock to capitalizing on these resources is the need to establish the validity of phenotypes extracted from the EHR...
May 30, 2017: American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics
https://www.readbyqxmd.com/read/28542524/ectopically-expressed-slc34a2a-sense-antisense-transcripts-cause-a-cerebellar-phenotype-in-zebrafish-embryos-depending-on-rna-complementarity-and-dicer
#16
Monica J Piatek, Victoria Henderson, Amy Fearn, Bill Chaudhry, Andreas Werner
Natural antisense transcripts (NATs) are complementary to protein coding genes and potentially regulate their expression. Despite widespread occurrence of NATs in the genomes of higher eukaryotes, their biological role and mechanism of action is poorly understood. Zebrafish embryos offer a unique model system to study sense-antisense transcript interplay at whole organism level. Here, we investigate putative antisense transcript-mediated mechanisms by ectopically co-expressing the complementary transcripts during early zebrafish development...
2017: PloS One
https://www.readbyqxmd.com/read/28538984/accuracy-of-medical-claims-for-identifying-cardiovascular-and-bleeding-events-after-myocardial-infarction-a-secondary-analysis-of-the-translate-acs-study
#17
Patricia O Guimarães, Arun Krishnamoorthy, Lisa A Kaltenbach, Kevin J Anstrom, Mark B Effron, Daniel B Mark, Patrick L McCollam, Linda Davidson-Ray, Eric D Peterson, Tracy Y Wang
Importance: Pragmatic clinical trial designs have proposed the use of medical claims data to ascertain clinical events; however, the accuracy of billed diagnoses in identifying potential events is unclear. Objectives: To compare the 1-year cumulative incidences of events when events were identified by medical claims vs by physician adjudication and to assess the accuracy of bill-identified events using physician adjudication as the criterion standard. Design, Setting, and Participants: This post hoc analysis of a clinical trial assessed the medical claims forms and records for all rehospitalizations at 233 US hospitals within 1 year of the index acute myocardial infarction (MI) of 12 365 patients enrolled in the Treatment With Adenosine Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome (TRANSLATE-ACS) study between April 1, 2010, and October 31, 2012...
May 24, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28534667/commentary-on-the-use-of-96119-in-billing-for-neuropsychological-services
#18
Leslie D Rosenstein
OBJECTIVE: This commentary seeks to outline the problematic issues with the use of 96119 in billing for neuropsychological evaluations. Issues covered include billing for the provider's time when using technicians as well as the use of trainees when billing Medicare. METHOD: Resources from the Centers for Medicare and Medicaid Services (CMS) were reviewed along with a search of available documentation from regional carriers and the general literature. CONCLUSIONS: There has been much confusion in the professional community regarding billing for neuropsychological evaluation services when utilizing technicians and/or trainees...
May 23, 2017: Clinical Neuropsychologist
https://www.readbyqxmd.com/read/28534228/glove-changing-practices-of-mall-food-vendors-in-new-jersey
#19
Corey H Basch, Miryam Z Wahrman, Sarah A MacLean, Alan Quisido, Carlo Ponsica, Nandish Patel
Gloves can serve as barriers to decrease the transfer of microorganisms from hands to food. Glove changing by food vendors is particularly important when handling paper currency, as bills can carry and transmit microbes from person to person. The purpose of this study was two-fold: (1) To ascertain the extent to which gloves are changed after monetary transactions in food vendors at a major mall in New Jersey; and (2) to document the level of bacterial contamination and the presence of coliform bacteria on paper currency handled by these vendors...
May 22, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28531909/racial-and-ethnic-disparities-in-interval-colorectal-cancer-incidence-a-population-based-cohort-study
#20
Stacey A Fedewa, W Dana Flanders, Kevin C Ward, Chun Chieh Lin, Ahmedin Jemal, Ann Goding Sauer, Chyke A Doubeni, Michael Goodman
Background: Interval colorectal cancer (CRC) accounts for 3% to 8% of all cases of CRC in the United States. Data on interval CRC by race/ethnicity are scant. Objective: To examine whether risk for interval CRC among Medicare patients differs by race/ethnicity and whether this potential variation is accounted for by differences in the quality of colonoscopy, as measured by physicians' polyp detection rate (PDR). Design: Population-based cohort study...
May 23, 2017: Annals of Internal Medicine
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