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Emergency medicine billing

M Kennedy Hall, Jane Hall, Cary P Gross, Nir J Harish, Rachel Liu, Sean Maroongroge, Christopher L Moore, Christopher C Raio, R Andrew Taylor
OBJECTIVES: Point-of-care ultrasound is a valuable tool with potential to expedite diagnoses and improve patient outcomes in the emergency department. However, little is known about national patterns of adoption. This study examined nationwide point-of-care ultrasound reimbursement among emergency medicine (EM) practitioners and examined regional and practitioner level variations. METHODS: Data from the 2012 Center for Medicare and Medicaid Services Fee-for-Service Provider Utilization and Payment Data include all practitioners who received more than 10 Medicare Part B fee-for-service reimbursements for any Healthcare Common Procedure Coding System code in 2012...
October 3, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Alberto J Panero, Alan M Hirahara
Ultrasound is becoming an increasingly accessible modality for its easy and accurate evaluation of shoulder pathology. In Part 1 of our series (Am J Orthop. 2016;45(3):176-182), we showed how musculoskeletal ultrasound can be properly coded and reimbursed and can be as effective in evaluating the shoulder as magnetic resonance imaging, yet more economical. With more physicians beginning to incorporate this technology into their practice, we describe the physics of ultrasound and our methods for evaluating the shoulder with ultrasound...
May 2016: American Journal of Orthopedics
Suresh Bada Math, Sydney Moirangthem, Naveen C Kumar, Maria Christine Nirmala
Recent changes in policies allowing practitioners of Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) to integrate into the mainstream of healthcare and also allowing practitioners of Ayurveda and Homoeopathy to perform medical termination of pregnancy (MTP) under the proposed amendment to the MTP bill have brought crosssystem practice into the limelight. We evaluate cross-system practice from its legal and ethical perspectives. Across judgments, the judiciary has held that cross-system practice is a form of medical negligence; however, it is permitted only in those states where the concerned governments have authorized it by a general or special order...
November 2015: National Medical Journal of India
Resa E Lewiss, Jessica Cook, Allison Sauler, Nicholas Avitabile, Nicole L Kaban, Jeffrey Rabrich, Turandot Saul, Sebastian D Siadecki, Dan Wiener
BACKGROUND: Emergency point-of-care ultrasound (POC u/s) is an example of a health information technology that improves patient care and time to correct diagnosis. POC u/s examinations should be documented, as they comprise an integral component of physician decision making. Incomplete documentation prevents coding, billing and physician group compensation for ultrasound-guided procedures and patient care. We aimed to assess the effect of directed education and personal feedback through a task force driven initiative to increase the number of POC u/s examinations documented and transferred to medical coders by emergency medicine physicians...
December 2016: Critical Ultrasound Journal
Mara Buchbinder, Dragana Lassiter, Rebecca Mercier, Amy Bryant, Anne Drapkin Lyerly
Much of the debate on conscience has addressed the ethics of refusal: the rights of providers to refuse to perform procedures to which they object and the interests of the patients who might be harmed by their refusals. But conscience can also be a positive force, grounding decision about offering care.
March 2016: Hastings Center Report
Robert W Derlet, Robert M McNamara, Scott H Plantz, Matthew K Organ, John R Richards
BACKGROUND: Health care delivery in the United States has evolved in many ways over the past century, including the development of the specialty of Emergency Medicine (EM). With the creation of this specialty, many positive changes have occurred within hospital emergency departments (EDs) to improve access and quality of care of the nation's de facto "safety net." The specialty of EM has been further defined and held to high standards with regard to board certification, sub-specialization, maintenance of skills, and research...
June 2016: Journal of Emergency Medicine
Ceara Tess Cunningham, Nathalie Jetté, Bing Li, Ravneet Robyn Dhanoa, Brenda Hemmelgarn, Tom Noseworthy, Cynthia A Beck, Elijah Dixon, Susan Samuel, William A Ghali, Carolyn DeCoster, Hude Quan
BACKGROUND: There are concerns that alternate payment plans for physicians may be associated with erosion of data quality, given that physicians are paid regardless of whether claims are submitted. Our objective was to determine the proportion of claims submitted by physician specialists using fee-for-service and alternative payment plans, and to identify and compare the validity of information coded in physician billing claims submitted by these specialists in Calgary. METHODS: We conducted a survey of physician specialists to determine their plan status and obtained consent to use physicians' claims data from 4 acute care hospitals in Calgary...
October 2015: CMAJ Open
Neha H Shah, Hai Jung H Rhim, Jennifer Maniscalco, Karen Wilson, Caroline Rassbach
BACKGROUND: Pediatric hospital medicine (PHM) fellowship programs have grown rapidly over the last 20 years and have varied in duration and content. In an effort to standardize training in the absence of a single accrediting body, PHM fellowship directors now meet annually to discuss strategies for standardizing and enhancing training. OBJECTIVES: To explore similarities and differences in curricular structure among PHM fellowship programs in an effort to inform future curriculum standardization efforts...
May 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Katherine J Walker, Michael Ben-Meir, David Phillips, Margaret Staples
OBJECTIVE: The present study aims to determine if a scribe in an Australian ED can assist emergency physicians to work with increased productivity and to investigate when and where to allocate a scribe and to whom. METHODS: This was a prospective observational single-centre study conducted at a private ED in Melbourne. It evaluated one American scribe and five doctors over 6 months. A scribe is a trained assistant who performs non-clinical tasks usually performed by the doctor...
June 2016: Emergency Medicine Australasia: EMA
Stephen C Dorner, Carlos A Camargo, Jeremiah D Schuur, Ali S Raja
INTRODUCTION: Under regulations established by the Affordable Care Act, insurance plans must meet minimum standards in order to be sold through the federal Marketplace. These standards to become a qualified health plan (QHP) include maintaining a provider network sufficient to assure access to services. However, the complexity of emergency physician (EP) employment practices - in which the EPs frequently serve as independent contractors of emergency departments, independently establish insurance contracts, etc… - and regulations governing insurance repayment may hinder the application of network adequacy standards to emergency medicine...
January 2016: Western Journal of Emergency Medicine
Matthew Wheatley, Christopher Baugh, Anwar Osborne, Carol Clark, Philip Shayne, Michael Ross
The role of observation services for emergency department patients has increased in recent years. Driven by changing health care practices and evolving payer policies, many hospitals in the United States currently have or are developing an observation unit (OU) and emergency physicians are most often expected to manage patients in this setting. Yet, few residency programs dedicate a portion of their clinical curriculum to observation medicine. This knowledge set should be integrated into the core training curriculum of emergency physicians...
April 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Logan Dumitrescu, Kirsten E Diggins, Robert Goodloe, Dana C Crawford
Previous candidate gene and genome-wide association studies have identified common genetic variants in LPA associated with the quantitative trait Lp(a), an emerging risk factor for cardiovascular disease. These associations are population-specific and many have not yet been tested for association with the clinical outcome of interest. To fill this gap in knowledge, we accessed the epidemiologic Third National Health and Nutrition Examination Surveys (NHANES III) and BioVU, the Vanderbilt University Medical Center biorepository linked to de-identified electronic health records (EHRs), including billing codes (ICD-9-CM) and clinical notes, to test population-specific Lp(a)-associated variants for an association with myocardial infarction (MI) among African Americans...
2016: Pacific Symposium on Biocomputing
Jeffrey D Clinkscales, Francis M Fesmire, Jacob R Hennings, Harry W Severance, David C Seaberg, Nirav Patil
OBJECTIVES: The effect of emergency medicine (EM) residents on the clinical efficiency of attending physicians is controversial. The authors hypothesized that implementing a new EM residency program would result in an increase in relative value units (RVUs) generated per hour by attending physicians and decrease staffing requirements. METHODS: This was a retrospective observational analysis of an emergency department before, during, and after the establishment of a new EM residency program...
January 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
John G Hanly, Kara Thompson, Chris Skedgel
OBJECTIVE: To determine total physician encounters, emergency room (ER) visits, and hospitalizations in an incident cohort of systemic lupus erythematosus (SLE) cases and matched control patients over 13 years. METHODS: A retrospective cohort study was performed utilizing administrative health care data from approximately 1 million people with access to universal health care. Using International Classification of Diseases, Ninth and Tenth Revisions diagnostic codes, 7 SLE case definitions were used...
August 2016: Arthritis Care & Research
Jason L Sanders, Vicki E Noble, Ali S Raja, Ashley F Sullivan, Carlos A Camargo
INTRODUCTION: Growing evidence supports emergency physician (EP)-performed point-of-care ultrasound (PoC US). However, there is a utilization gap between academic emergency departments (ED) and other emergency settings. We elucidated barriers to PoC US use in a multistate sample of predominantly non-academic EDs to inform future strategies to increase PoC US utilization, particularly in non-academic centers. METHODS: In 2010, we surveyed ED directors in five states (Arkansas, Hawaii, Minnesota, Vermont, and Wyoming; n=242 EDs) about general ED characteristics...
September 2015: Western Journal of Emergency Medicine
Ian R Rogers, Bill Lukin
Only recently has the potential (unmet) palliative care (PC) workload in the ED been recognised. While confident in PC symptom management, we underestimate the role of a palliative approach in non-cancer diagnoses and seek education in areas such as individual patient care pathways, ethical and legal issues and difficult conversations at the end of life. PC is best introduced early for a range of life-limiting cancer and non-cancer diagnoses. Allowing patients time to tell their story with active listening, acknowledgement of suffering and a compassionate presence leads to treatment 'success' that is not defined by cure...
November 11, 2015: Emergency Medicine Australasia: EMA
Joey Berlin
Kaufman pediatrician Charles Turner Lewis, MD, battled fraud allegations levied against him by the Office of Inspector General (OIG) from 2005 to 2008 and emerged victorious. To his dismay, he is once again on the receiving end of an OIG letter alleging Medicaid overpayment. The 2015 Texas Legislature responded to TMA's call for improvements in OIG Medicaid fraud investigations of physicians with passage of Senate Bill 207. Organized medicine hopes the law's safeguards will afford due process to doctors under investigation...
November 2015: Texas Medicine
M Kulla, M Friess, P D Schellinger, A Harth, O Busse, F Walcher, M Helm
BACKGROUND: The dataset "Emergency Department" of the German Interdisciplinary Association of Critical Care and Emergency Medicine (DIVI) has been developed during several expert meetings. Its goal is an all-encompassing documentation of the early clinical treatment of patients in emergency departments. Using the example of the index disease acute ischemic stroke (stroke), the aim was to analyze how far this approach has been fulfilled. MATERIAL AND METHODS: In this study German, European and US American guidelines were used to analyze the extent of coverage of the datasets on current emergency department guidelines and recommendations from professional societies...
December 2015: Der Nervenarzt
Timothy A Bertram, Peter C Johnson, Bill J Tawil, Mark Van Dyke, Kiki B Hellman
TERMIS-AM Industry Committee (TERMIS-AM/IC), in collaboration with the TERMIS-Europe (EU)/IC, conducted a symposium involving the European Medicines Agency and the U.S. Food and Drug Administration (FDA) toward building an understanding of the rational basis for regulatory decision-making and providing a framework for decisions made during the evaluation of safety and efficacy of TE/RM technologies. This symposium was held in August 2012 during the TERMIS-WC in Vienna, Austria. Emerging from this international initiative by the European Union and the United States, representatives from the respective agencies demonstrated that there are ongoing interagency efforts for developing common national practices toward harmonization of regulatory requirements for the TE/RM products...
October 2015: Tissue Engineering. Part A
Amir A Kimia, Guergana Savova, Assaf Landschaft, Marvin B Harper
Electronically stored clinical documents may contain both structured data and unstructured data. The use of structured clinical data varies by facility, but clinicians are familiar with coded data such as International Classification of Diseases, Ninth Revision, Systematized Nomenclature of Medicine-Clinical Terms codes, and commonly other data including patient chief complaints or laboratory results. Most electronic health records have much more clinical information stored as unstructured data, for example, clinical narrative such as history of present illness, procedure notes, and clinical decision making are stored as unstructured data...
July 2015: Pediatric Emergency Care
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