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Emergency medicine billing

Bijan J Borah, James M Naessens, Amy E Glasgow, Brent A Bauer, Tony Y Chon
OBJECTIVES: To determine whether acupuncture is a cost-effective adjunct to usual care for Mayo Clinic employees and their dependents experiencing pain symptoms. DESIGN: Retrospective review of the medical and billing records of 466 employee-patients and their dependents who had received acupuncture as part of their care and 466 propensity score-matched control patients. INTERVENTIONS: Usual care in combination with acupuncture compared with usual care alone...
April 2017: Complementary Therapies in Medicine
Brian J Yun, Stephen C Dorner, Brian M Baccari, John Brennan, Karen Smith, Ali S Raja, Benjamin A White
INTRODUCTION: In emergency medicine (EM), patient care documentation serves many functions, including supporting reimbursement. In addition, many electronic health record systems facilitate automatically populating certain data fields. As a result, in the academic model, the attending's note may now more often recapitulate many of the same elements found in the resident's or physician assistant's (PA) note. We sought to determine the value of additional attending documentation, and how often the attending documentation prevented a downcoding event...
April 14, 2017: American Journal of Emergency Medicine
Robin Lin Miller, Cherrie B Boyer, Danielle Chiaramonte, Peter Lindeman, Kate Chutuape, Bendu Cooper-Walker, Bill G Kapogiannis, Craig M Wilson, J Dennis Fortenberry
Importance: Most human immunodeficiency virus (HIV)-infected youths are unaware of their serostatus (approximately 60%) and therefore not linked to HIV medical or prevention services. The need to identify promising and scalable approaches to promote uptake of HIV testing among youths at risk is critical. Objective: To evaluate a multisite HIV testing program designed to encourage localized HIV testing programs focused on self-identified sexual minority males and to link youths to appropriate prevention services after receipt of their test results...
April 17, 2017: JAMA Pediatrics
Andrew B Rosenkrantz, Wenyi Wang, Danny R Hughes, Luke A Ginocchio, David A Rosman, Richard Duszak
OBJECTIVE: The objective of the present study is to assess the feasibility of a novel claims-based classification system for payer identification of academic radiologist subspecialties. MATERIALS AND METHODS: Using a categorization scheme based on the Neiman Imaging Types of Service (NITOS) system, we mapped the Medicare Part B services billed by all radiologists from 2012 to 2014, assigning them to the following subspecialty categories: abdominal imaging, breast imaging, cardiothoracic imaging, musculoskeletal imaging, nuclear medicine, interventional radiology, and neuroradiology...
March 16, 2017: AJR. American Journal of Roentgenology
Robert Clell Miller
46 Background: Accountable Care Organizations (ACO), as proposed by the Affordable Care Act, will change the delivery of health care in the United States. ACO serve as a network of providers with primary care providers (PCP) set up as gate-keepers for referrals to specialists. Within the next several years, many trends will emerge and drive progress of change, requiring oncologist to take a lead role to adapt to the evolving landscape of health care. METHODS: Literature search of internet-based and academic sources for oncology and the Affordable Care, with a focus on ACO formation...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Kathleen Wittels, Joshua Wallenstein, Rahul Patwari, Sundip Patel
INTRODUCTION: Electronic health records (EHR) have become ubiquitous in emergency departments. Medical students rotating on emergency medicine (EM) clerkships at these sites have constant exposure to EHRs as they learn essential skills. The Association of American Medical Colleges (AAMC), the Liaison Committee on Medical Education (LCME), and the Alliance for Clinical Education (ACE) have determined that documentation of the patient encounter in the medical record is an essential skill that all medical students must learn...
January 2017: Western Journal of Emergency Medicine
Casey B Rosen-Carole
INTRODUCTION: An emerging trend in Academic Medical Centers (AMCs) is to coordinate breastfeeding care, research, and trainee education through "medical director" positions. Little is known about their duties, supports, and challenges. OBJECTIVE: To determine the duties and challenges of directors of breastfeeding medicine in AMCs. METHODS: A survey was distributed four times over a 3-month period to three listservs with a total of 860 members...
November 28, 2016: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
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...
November 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
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