Introduction to 2013 CPT Code Changes Webinar Slides-
Valant covers the expected 2013 CPT Code changes for behavorioal health billing. Slides include resources and lionks
This document provides instructions for reserving and using equipment in the Rack Room lab for practice exams for the CPT275 senior project course. It details how to set up and configure networking equipment including Linux and Windows servers, routers, and addressing schemes. Students are expected to physically cable the network, install and configure operating systems, set up services like DNS and DHCP, and configure routing protocols. The document also specifies how students should cleanup and reset all equipment after their practice session.
DEVNET-1120 Intercloud Fabric - AWS and Azure Account Setup and UtilizationCisco DevNet
The document provides an agenda and overview for a session on setting up accounts with Intercloud Fabric on AWS and Azure. It discusses the steps required to set up accounts on each platform, including creating credentials, configuring policies and permissions, and connecting Intercloud Fabric. The conclusion encourages participants to ask questions and provides information on related sessions at Cisco Live.
This document summarizes changes to CPT codes for 2011, focusing on changes to evaluation and management codes, integumentary system codes, and new codes related to annual wellness visits and H1N1 immunizations. New codes were added for subsequent observation care and annual wellness visits. Codes for debridement were revised and codes for H1N1 immunization administration and pandemic vaccine were added.
Cisco Carrier Packet Transport System: Foundation for Next-Generation Transport Cisco Canada
The Cisco Carrier Packet Transport (CPT) System is the first Packet-Optical Transport System (P-OTS) built on standards-based Multiprotocol Label Switching Transport Profile (MPLS-TP) technology. It unifies both packet and transport technologies, giving service providers a strong foundation for the transport technologies, giving service providers a strong foundation for the next generation of transport. This P-OTS platform supports DWDM, OTN, Ethernet, and MPLS-TP integrated in a single system. And it smoothly interoperates with existing deployed IP MPLS networks.
Understanding Mental Health Telehealth Billing.pptxRichard Smith
In recent years, the healthcare landscape has witnessed a significant shift towards telehealth services, and the field of mental health is no exception. With the advent of mental health telehealth, it has become increasingly important for mental health providers to be well-informed about the intricate process of billing for such services.
Understanding Mental Health Telehealth Billing.pdfRichard Smith
In recent years, the healthcare landscape has witnessed a significant shift towards telehealth services, and the field of mental health is no exception. With the advent of mental health telehealth, it has become increasingly important for mental health providers to be well-informed about the intricate process of billing for such services.
The document summarizes changes to CPT codes for 2014, focusing on new codes, deleted codes, and code revisions. Key changes included 107 new Category I codes, 40 deleted Category I codes, and 103 revised Category I codes. There were also changes to codes related to evaluation and management, integumentary procedures, musculoskeletal procedures, and cardiovascular procedures. Physicians are responsible for understanding coding changes and ensuring accurate billing.
This document provides instructions for reserving and using equipment in the Rack Room lab for practice exams for the CPT275 senior project course. It details how to set up and configure networking equipment including Linux and Windows servers, routers, and addressing schemes. Students are expected to physically cable the network, install and configure operating systems, set up services like DNS and DHCP, and configure routing protocols. The document also specifies how students should cleanup and reset all equipment after their practice session.
DEVNET-1120 Intercloud Fabric - AWS and Azure Account Setup and UtilizationCisco DevNet
The document provides an agenda and overview for a session on setting up accounts with Intercloud Fabric on AWS and Azure. It discusses the steps required to set up accounts on each platform, including creating credentials, configuring policies and permissions, and connecting Intercloud Fabric. The conclusion encourages participants to ask questions and provides information on related sessions at Cisco Live.
This document summarizes changes to CPT codes for 2011, focusing on changes to evaluation and management codes, integumentary system codes, and new codes related to annual wellness visits and H1N1 immunizations. New codes were added for subsequent observation care and annual wellness visits. Codes for debridement were revised and codes for H1N1 immunization administration and pandemic vaccine were added.
Cisco Carrier Packet Transport System: Foundation for Next-Generation Transport Cisco Canada
The Cisco Carrier Packet Transport (CPT) System is the first Packet-Optical Transport System (P-OTS) built on standards-based Multiprotocol Label Switching Transport Profile (MPLS-TP) technology. It unifies both packet and transport technologies, giving service providers a strong foundation for the transport technologies, giving service providers a strong foundation for the next generation of transport. This P-OTS platform supports DWDM, OTN, Ethernet, and MPLS-TP integrated in a single system. And it smoothly interoperates with existing deployed IP MPLS networks.
Understanding Mental Health Telehealth Billing.pptxRichard Smith
In recent years, the healthcare landscape has witnessed a significant shift towards telehealth services, and the field of mental health is no exception. With the advent of mental health telehealth, it has become increasingly important for mental health providers to be well-informed about the intricate process of billing for such services.
Understanding Mental Health Telehealth Billing.pdfRichard Smith
In recent years, the healthcare landscape has witnessed a significant shift towards telehealth services, and the field of mental health is no exception. With the advent of mental health telehealth, it has become increasingly important for mental health providers to be well-informed about the intricate process of billing for such services.
The document summarizes changes to CPT codes for 2014, focusing on new codes, deleted codes, and code revisions. Key changes included 107 new Category I codes, 40 deleted Category I codes, and 103 revised Category I codes. There were also changes to codes related to evaluation and management, integumentary procedures, musculoskeletal procedures, and cardiovascular procedures. Physicians are responsible for understanding coding changes and ensuring accurate billing.
IA Scoor bij je klant. Klantentevredenheid; hoe begin je eraan. Paul Gemmel S...Ikinnoveer
This document discusses key aspects of improving customer satisfaction. It covers 5 sessions on customer satisfaction that address: experiences and segmentation; employees and different channels; errors, complaints, recovery, learning, and improvement; and extra engagement behaviors. The sessions are organized into parts with breaks and evaluations. Case studies are also discussed on how organizations can position themselves to improve collaboration and measure performance. Key elements of the service concept and long-term partnership are examined. The document emphasizes creating a positive service climate through leadership, HR practices, support systems, and employee engagement to improve customer experience and satisfaction.
This document provides an overview and summary of medicine codes in CPT. It discusses several categories of medicine codes including evaluations and management, modifiers, immunizations, psychiatry, end-stage renal disease, cardiology, pulmonary, and more. Codes are organized by specialty and service type, with notes on proper use and billing.
Presented at "Big Data and the complexity of Labour Market policies"
Annual meeting of the European Network on Regional Labour Market Monitoring
15th - 16th October 2015, University of Milano-Bicocca, Milan, Italy during L’European Network on Regional Labour Market Monitoring (EN RLMM) è stato costituito nel 2006 ed ha come obiettivo la valorizzazione e l’attuazione di ricerche sul mercato del lavoro con attenzione ai territori regionali e locali, alle politiche pubbliche e ai sistemi di servizi per l’impiego e la formazione. Vi partecipano enti e istituzioni (pubbliche e private) di 27 paesi europei. Le attività dell’EN RLMM si sviluppano ogni anno attorno ad un argomento principale (Big Data and the Complexity of Labour Market Policies per il 2015). Negli anni, più di 400 persone sono state coinvolte nelle attività dell’EN RLMM, attraverso il trasferimento di conoscenze derivanti da studi e ricerche svolte in campo scientifico e la condivisione di ricerche sulle best practice degli osservatori sul mercato del lavoro europeo. Il network è diventato negli anni un punto di riferimento per policy-makers di livello regionale e locale ed ha in corso stabili contatti con organizzazioni Europee come la DG Employment, Cedefop, OECD LEED e EESC.
Chronic Care Management - Implemented By TimeDoc - May 2018Dan Wellisch
This is May's presentation of the Chicago Technology For Value-Based Healthcare Meetup - https://www.meetup.com/Chicago-Technology-For-Value-Based-Healthcare-Meetup/
Project Source offers a complete solution to help trusts manage their Referral to Treatment (RTT) pathways and improve performance. Their solution includes:
1) Validating pathways to reduce backlogs and improve data quality using experienced validators who can process over 60 pathways per day.
2) Analyzing Patient Tracking Lists to identify areas for focus and direct validators.
3) Auditing validations and providing training to help staff properly apply RTT rules and reduce future issues.
4) Developing standard operating procedures and providing ongoing support through an RTT helpdesk.
5) Creating dashboards to monitor performance, data quality, and predict outcomes over time.
The document discusses using metrics and analytics to improve physician practice management at ENT and Allergy Associates. It provides examples of key metrics tracked such as cash collections, charges entered, days in accounts receivable. Metrics are reviewed daily, monthly, and quarterly and shared with staff. The practice uses analytics to evaluate processes, set benchmarks and goals. Physician productivity reports aggregate data on procedures, office visits, audio collections and compare individuals to practice averages. Benchmarking and peer grouping allows practices to track growth and identify opportunities.
Presentation to Mass Neurologic AssociationDaniel Hoch
This document summarizes a presentation given by Dr. Daniel Hoch on remaining relevant in changing healthcare payment and delivery systems. The presentation discusses new payment models like pay for reporting and pay for performance. It also discusses methods of delivery like accountable care organizations. The goals of the presentation are to help physicians assess readiness for new systems, understand available data, find quality measures, and understand potential roles in medical homes/neighborhoods.
In this MTBC Brochure you can find all information about MTBC medical billing services and all products related to electronic health record , patient management, and other mhealth apps etc.
Sure Path Labs is a medical laboratory company located in Delhi, India that is committed to providing accurate, reliable test results through innovative technologies and a well-trained staff. The company aims to enhance human life and contribute to a healthy society. It has experienced over 40% annual growth and processes over 30,000 tests annually. Sure Path Labs has obtained NABL certification and provides a range of laboratory and medical services.
This document provides an overview of Total Quality Management (TQM). It defines TQM as a management approach centered on quality that involves participation from all organization members. The document outlines TQM principles like management commitment, employee empowerment, and continuous improvement. It also discusses TQM levels from company-wide implementation to ensuring quality meets customer expectations. The conclusion emphasizes that TQM is a management philosophy and lifestyle focused on continual improvement.
This document outlines information from a webinar about getting paid in 2017. It discusses upcoming Medicare payment changes, including specialty-specific rate adjustments and new codes for chronic care management and collaborative care. It also covers the Quality Payment Program, which replaces previous programs and involves either improving quality through MIPS or participating in an Advanced APM for a payment bonus. The webinar concluded with information about how the medical practice software company Kareo can help practices manage billing, coding and other operations.
MM PsychoTools (Psychomotor assessments) Presentationkenneth mashele
MM PsychoTools provides psychomotor assessments to evaluate employees' suitability for operating earth moving equipment. Their Vienna Test System assesses attention, coordination, reaction time and other factors. It identifies potential risk areas to minimize workplace injuries. The proposal offers this service to clients to ensure safe and productive operations in compliance with legal requirements. A report provides individual scores against industry norms with recommendations. Feedback is provided by a registered psychometrist. The goal is to prevent accidents through proper employee evaluation and training.
The path to a better bottom line is paved by large numbers of operational decisions made by people, by processes and by software applications. Systematically improving each operational decision – at scale – is at the core of Decision Management. Business Architects and Analysts identify, describe and model operational decisions in Decision Discovery.
In this webinar, James Taylor, CEO of Decision Management Solutions, and Dr. Juergen Pitschke, Founder and Managing Director at BCS, will show you how to get started with Decision Management on your next application development or business process improvement project with Decision Discovery. Learn how to:
Identify decisions, sub-decisions and information and knowledge resources (including rules and analytics)
Describe decisions in detail (Decision Tables and other Metaphors)
Model decisions in a DMN-conformant decision modeling tool for communication and documentation
Link to execution environments
Costing for Hospitals - How to arrive at service level cost ?Manivannan S
Costing hospital Services poses serious challenges in identifying the basis of allocation of costs and the allocation itself. This PPT gives you the entire methodology
1) Waterbury Hospital integrated TigerText with their EMR system to improve communication between physicians and the hospital. Alerts from the EMR would be sent via TigerText to notify doctors about patient issues like lab results or new consult orders.
2) An analysis found that integrating TigerText reduced the average consult turnaround time from 1.56 to 0.68 days and reduced patient length of stay from 7.75 to 5.91 days. This saved the hospital over $200,000.
3) Challenges included getting physicians to use the secure messaging on personal devices and determining who messages should be routed to. Future plans include sending discharge notifications and image results to physicians' mobile devices.
NJ-HITEC is a federally designated Regional Extension Center that helps healthcare providers in New Jersey select and implement electronic medical record (EMR) systems, provides training and support to achieve meaningful use of EMRs, and assists providers in qualifying for federal incentive payments for adopting EMRs. NJ-HITEC offers discounted EMR vendors that have been rigorously vetted, helps providers navigate the complex EMR adoption and meaningful use requirements, and acts as an unbiased resource and dispute resolution body for its members.
With the implementation of teleradiology services, the discipline of radiology has seen considerable changes as healthcare continues to develop thanks to technological breakthroughs. Diagnoses may be made more quickly and precisely thanks to teleradiology services, which provide healthcare professionals remote access to radiology pictures and patient data. But picking the best teleradiology provider can be difficult. You'll offer advice in this post to assist you in selecting the Best teleradiology services for your medical business.
Cognosante’s ICD-10 Policy Transformation and Remediation solution helps our customers make the ICD-10 transition smoothly by reducing potential risks and preventing oversights.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
IA Scoor bij je klant. Klantentevredenheid; hoe begin je eraan. Paul Gemmel S...Ikinnoveer
This document discusses key aspects of improving customer satisfaction. It covers 5 sessions on customer satisfaction that address: experiences and segmentation; employees and different channels; errors, complaints, recovery, learning, and improvement; and extra engagement behaviors. The sessions are organized into parts with breaks and evaluations. Case studies are also discussed on how organizations can position themselves to improve collaboration and measure performance. Key elements of the service concept and long-term partnership are examined. The document emphasizes creating a positive service climate through leadership, HR practices, support systems, and employee engagement to improve customer experience and satisfaction.
This document provides an overview and summary of medicine codes in CPT. It discusses several categories of medicine codes including evaluations and management, modifiers, immunizations, psychiatry, end-stage renal disease, cardiology, pulmonary, and more. Codes are organized by specialty and service type, with notes on proper use and billing.
Presented at "Big Data and the complexity of Labour Market policies"
Annual meeting of the European Network on Regional Labour Market Monitoring
15th - 16th October 2015, University of Milano-Bicocca, Milan, Italy during L’European Network on Regional Labour Market Monitoring (EN RLMM) è stato costituito nel 2006 ed ha come obiettivo la valorizzazione e l’attuazione di ricerche sul mercato del lavoro con attenzione ai territori regionali e locali, alle politiche pubbliche e ai sistemi di servizi per l’impiego e la formazione. Vi partecipano enti e istituzioni (pubbliche e private) di 27 paesi europei. Le attività dell’EN RLMM si sviluppano ogni anno attorno ad un argomento principale (Big Data and the Complexity of Labour Market Policies per il 2015). Negli anni, più di 400 persone sono state coinvolte nelle attività dell’EN RLMM, attraverso il trasferimento di conoscenze derivanti da studi e ricerche svolte in campo scientifico e la condivisione di ricerche sulle best practice degli osservatori sul mercato del lavoro europeo. Il network è diventato negli anni un punto di riferimento per policy-makers di livello regionale e locale ed ha in corso stabili contatti con organizzazioni Europee come la DG Employment, Cedefop, OECD LEED e EESC.
Chronic Care Management - Implemented By TimeDoc - May 2018Dan Wellisch
This is May's presentation of the Chicago Technology For Value-Based Healthcare Meetup - https://www.meetup.com/Chicago-Technology-For-Value-Based-Healthcare-Meetup/
Project Source offers a complete solution to help trusts manage their Referral to Treatment (RTT) pathways and improve performance. Their solution includes:
1) Validating pathways to reduce backlogs and improve data quality using experienced validators who can process over 60 pathways per day.
2) Analyzing Patient Tracking Lists to identify areas for focus and direct validators.
3) Auditing validations and providing training to help staff properly apply RTT rules and reduce future issues.
4) Developing standard operating procedures and providing ongoing support through an RTT helpdesk.
5) Creating dashboards to monitor performance, data quality, and predict outcomes over time.
The document discusses using metrics and analytics to improve physician practice management at ENT and Allergy Associates. It provides examples of key metrics tracked such as cash collections, charges entered, days in accounts receivable. Metrics are reviewed daily, monthly, and quarterly and shared with staff. The practice uses analytics to evaluate processes, set benchmarks and goals. Physician productivity reports aggregate data on procedures, office visits, audio collections and compare individuals to practice averages. Benchmarking and peer grouping allows practices to track growth and identify opportunities.
Presentation to Mass Neurologic AssociationDaniel Hoch
This document summarizes a presentation given by Dr. Daniel Hoch on remaining relevant in changing healthcare payment and delivery systems. The presentation discusses new payment models like pay for reporting and pay for performance. It also discusses methods of delivery like accountable care organizations. The goals of the presentation are to help physicians assess readiness for new systems, understand available data, find quality measures, and understand potential roles in medical homes/neighborhoods.
In this MTBC Brochure you can find all information about MTBC medical billing services and all products related to electronic health record , patient management, and other mhealth apps etc.
Sure Path Labs is a medical laboratory company located in Delhi, India that is committed to providing accurate, reliable test results through innovative technologies and a well-trained staff. The company aims to enhance human life and contribute to a healthy society. It has experienced over 40% annual growth and processes over 30,000 tests annually. Sure Path Labs has obtained NABL certification and provides a range of laboratory and medical services.
This document provides an overview of Total Quality Management (TQM). It defines TQM as a management approach centered on quality that involves participation from all organization members. The document outlines TQM principles like management commitment, employee empowerment, and continuous improvement. It also discusses TQM levels from company-wide implementation to ensuring quality meets customer expectations. The conclusion emphasizes that TQM is a management philosophy and lifestyle focused on continual improvement.
This document outlines information from a webinar about getting paid in 2017. It discusses upcoming Medicare payment changes, including specialty-specific rate adjustments and new codes for chronic care management and collaborative care. It also covers the Quality Payment Program, which replaces previous programs and involves either improving quality through MIPS or participating in an Advanced APM for a payment bonus. The webinar concluded with information about how the medical practice software company Kareo can help practices manage billing, coding and other operations.
MM PsychoTools (Psychomotor assessments) Presentationkenneth mashele
MM PsychoTools provides psychomotor assessments to evaluate employees' suitability for operating earth moving equipment. Their Vienna Test System assesses attention, coordination, reaction time and other factors. It identifies potential risk areas to minimize workplace injuries. The proposal offers this service to clients to ensure safe and productive operations in compliance with legal requirements. A report provides individual scores against industry norms with recommendations. Feedback is provided by a registered psychometrist. The goal is to prevent accidents through proper employee evaluation and training.
The path to a better bottom line is paved by large numbers of operational decisions made by people, by processes and by software applications. Systematically improving each operational decision – at scale – is at the core of Decision Management. Business Architects and Analysts identify, describe and model operational decisions in Decision Discovery.
In this webinar, James Taylor, CEO of Decision Management Solutions, and Dr. Juergen Pitschke, Founder and Managing Director at BCS, will show you how to get started with Decision Management on your next application development or business process improvement project with Decision Discovery. Learn how to:
Identify decisions, sub-decisions and information and knowledge resources (including rules and analytics)
Describe decisions in detail (Decision Tables and other Metaphors)
Model decisions in a DMN-conformant decision modeling tool for communication and documentation
Link to execution environments
Costing for Hospitals - How to arrive at service level cost ?Manivannan S
Costing hospital Services poses serious challenges in identifying the basis of allocation of costs and the allocation itself. This PPT gives you the entire methodology
1) Waterbury Hospital integrated TigerText with their EMR system to improve communication between physicians and the hospital. Alerts from the EMR would be sent via TigerText to notify doctors about patient issues like lab results or new consult orders.
2) An analysis found that integrating TigerText reduced the average consult turnaround time from 1.56 to 0.68 days and reduced patient length of stay from 7.75 to 5.91 days. This saved the hospital over $200,000.
3) Challenges included getting physicians to use the secure messaging on personal devices and determining who messages should be routed to. Future plans include sending discharge notifications and image results to physicians' mobile devices.
NJ-HITEC is a federally designated Regional Extension Center that helps healthcare providers in New Jersey select and implement electronic medical record (EMR) systems, provides training and support to achieve meaningful use of EMRs, and assists providers in qualifying for federal incentive payments for adopting EMRs. NJ-HITEC offers discounted EMR vendors that have been rigorously vetted, helps providers navigate the complex EMR adoption and meaningful use requirements, and acts as an unbiased resource and dispute resolution body for its members.
With the implementation of teleradiology services, the discipline of radiology has seen considerable changes as healthcare continues to develop thanks to technological breakthroughs. Diagnoses may be made more quickly and precisely thanks to teleradiology services, which provide healthcare professionals remote access to radiology pictures and patient data. But picking the best teleradiology provider can be difficult. You'll offer advice in this post to assist you in selecting the Best teleradiology services for your medical business.
Cognosante’s ICD-10 Policy Transformation and Remediation solution helps our customers make the ICD-10 transition smoothly by reducing potential risks and preventing oversights.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
3. Overview
• 2012 vs. 2013 behavioral health codes
– What’s new in 2013
– What’s been deleted in 2013
• What’s changed about reporting location of services rendered
• What’s changed about time
– Determining what code to use when your time is somewhere in between
the definitions
– What does “face-to-face” mean now?
• What remains the same
– Evaluation and Management definitions and documentation
requirements are the same
– Prescribers have always been eligible to use E&M codes
Please Note: This information is presented for educational purposes only, according to our
understanding of available information, and is not meant as a directive to the viewer. 3
4. Contact information
Vālant Medical Solutions #ValantCPT
Carol Storch Heather Grube
Practice Management Services Director of Billing
(888) 774-0532 (888) 774-0532
www.valant.com www.valant.com
4
5. About Vālant
Vālant’s EMR for Behavioral Health
• Founded in 2005
• Developed by Behavioral Heath Professionals
• 1000+ Daily Behavioral Health Clinicians Using
• Certified for Meaningful Use
• Attestations & Payments Received From 2011!
Sales: sales@valantmed.com
5
7. First steps
• Order AMA 2013 CPT** book
– AMA https://catalog.ama-assn.org/Catalog/product/product_detail.jsp?productId=prod1990006
– APA http://www.apa.org/
– AAPC http://www.aapc.com/
• CMS Evaluation and Management Services Guide. This contains the 1995
and 1997 Documentation Guidelines for Evaluation and Management
Services, two of three main parts of your E&M resource base
– http://
www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/eval_mgmt_serv_
• Contact your payers
*Current Procedural Terminology (CPT®) copyright 2012 American Medical Association.
7
9. New codes for 2013
Diagnostic Psychotherapy Psychotherapy Other Pharmacologic
Assessment with E/M Psychotherapy Management
90791 90832 90833 + E/M 90839 E/M code
90792 90834 90836 + E/M 90840 90863**
90837 90838+ E/M 90785
**for therapists eligible to prescribe in LA and NM.
9
10. 1:1 Crosswalk for Psychotherapy
2012 2013
90801 – initial psychiatric assessment 90791 – initial psychiatric assessment
90802 – interactive initial assessment 90791 + 90785
90804 – 20-30 min therapy session 90832 – 30 min
90806 – 45-50 min therapy session 90834 – 45 min
90808 – 75-80 min therapy session 90837 – 60 min
These are the Psychotherapy CPT codes for non-prescribers
10
11. 2013 Psychotherapy and Time
Time values used to
Code Defined Time
determine code
90832 30 minutes 16-37 minutes
90834 45 minutes 38-52 minutes
90837 60 minutes 53+ minutes
CPT Time Rule will be used to determine the appropriate CPT code for the
session. Think of the 15 minute time block between time definitions; anything 7
minutes or less will be “rounded down” and anything 8 minutes or greater will
be “rounded up.”
New definition of face-to-face time
‘Psychotherapy times are for face-to-face services with patient and/or family
members. Patients must be present for all or some of the service’.*
11
12. 2013 Interactive Complexity
‘interactive complexity (list separately in
90785 addition to the primary procedure code)’*
In 2012 there were designated CPT codes for interactive complexity as
determined by time
In 2013 interactive complexity is a single code which can be added on
to any therapy code
12
13. Place of Service
2012 2013
90816 – 20-30 min inpatient therapy 90832 – 30 min therapy with POS 21
90832 + 90785 – 30 min interactive
90823 – 20-30 min interactive IP therapy
therapy with POS 21
In 2012 the therapy code definitions included Place Of Service (POS)
In 2013 there is one list of therapy codes and location is reported using
the POS code as it would correspond to box 24b on the CMS-1500
form
13
14. 1:1 Crosswalk Psychotherapy with E/M
2012 2013 Interactive
(E/M code) Any of the following Complexity
90805
90807 Appropriate E/M code 90833
90809 (99201-99215) 30 min therapy
POS 11, 22, etc.
90811
90813 Appropriate E/M code 90836
90785
90815 (99201-99215) 45 min therapy
POS 11, 22, etc.
90817
90819 Appropriate E/M code 90838
90822 (99218-99239) 60 min therapy
POS 21
90824
90827 Appropriate E/M code
90785
90829 (99218-99239)
POS 21
14
15. E/M codes
All duly, appropriately licensed providers of any specialty have always
been eligible to use E/M codes
Most typical E/M codes used are 99201-99205 and 99211-99215
The 1997 Evaluation and Management Services Guidelines outline the
requirements for a psychiatric examination with clearly defined bullet
points that can be easily counted to determine the level of examination.
One of the bullet points is the mental status exam, already used
regularly by psychiatrists.
– https://
www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNEdWebGu
15
16. Choosing the Appropriate E/M
E/M documentation requirements are unchanged
Two ways to choose the level of E/M
1. Counseling and coordination of care consideration where >50% of total
time in session is devoted to counseling and coordination of care with
patient/ caregivers (in this description, counseling does not mean
therapy)
• Time is considered the key factor ~i.e. you must note the start and
end time of the entire session and carefully note how much time is
devoted to counseling and/or coordination of care. Documentation
should explicitly describe the plan of care.
2. Based on 3 key components (history, exam, and medical decision
making) of 7 elements. Many educational resources exist for E/M
coding. Your 2013 CPT guidebook and the 1997 CMS publication are
the place to start.
16
17. Outpatient Therapy with E/M
2012 2013 (E/M code) Any of the following
90805 90833 – 30 min therapy
Appropriate E/M code
90807 90836 – 45 min therapy
(99201-99215)
90809 90838 – 60 min therapy
In 2012 therapy with medical evaluation and management services was
reported by a single code based on face-to-face time
In 2013 therapy with medical evaluation and management services can
only be reported as an add-on code to the appropriate E/M code
If time is your controlling factor for determining E/M code (counseling
and coordination of care consideration) you may not bill a therapy add-
on code
17
18. 2013 Psychotherapy with E/M and Time
Time values used to
Code Defined Time determine therapy
code
90833 30 minutes 16-37 minutes
90836 45 minutes 38-52 minutes
90838 60 minutes 53+ minutes
All therapy codes on this page are add-on codes that must be use
with the appropriate E/M code
Time spent on E/M is separate from time spent in therapy
E/M codes billed with therapy add-on codes must be chosen
according to medical complexity, history and the exam. They are not
based on the amount of time spent on the E/M portion of service.
18
19. E/M and Therapy example
9:00AM 9:45AM
Appropriate E/M code 90833 – 30 min
90836 – 45 min
19
20. E/M and Therapy example
11:00AM 11:30AM
Appropriate E/M code
90833 – 30 min
Do not report psychotherapy of <16 minutes 20
21. Psychotherapy for Crisis
90839 first 60 minutes
+90840 each additional 30 minutes
New category in 2013
Do not report psychotherapy for crisis of less than 30 minutes total
duration
21
22. Pharmacologic Management
90862 is no more !!
To report pharmacologic management, you must use the appropriate E/M
code based on medical complexity or time
You might find the E/M code falls in the middle of 99211-99215 when choosing
the appropriate code for medication management only (no therapy time
calculated)
99212 - need 2 of 3 99213 – need 2 of 3
Problem focused history Expanded problem-focused
history
Problem focused exam Expanded problem-focused
examination
Straightforward medical Medical decision making of
decision making low complexity
22
23. 3 things to do now!
1. Order 2013 CPT book
2. Review or learn how to use E/M coding and the
documentation requirements
3. Contact your payers and ask if the E/M codes you are
likely to bill are included in your contract, and ask for
fee schedules for the new 2013 codes
23
24. Resources
• Order AMA 2013 CPT** book
– AMA https://catalog.ama-assn.org/Catalog/product/product_detail.jsp?productId=prod1990006
– APA http://www.apa.org/
– AAPC http://www.aapc.com/
• CMS Evaluation and Management Services Guide. This contains the 1995
and 1997 Documentation Guidelines for Evaluation and Management
Services, two of three main parts of your E&M resource base
– http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-
MLN/MLNProducts/downloads/eval_mgmt_serv_guide-ICN006764.pdf
– https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-
MLN/MLNEdWebGuide/Downloads/97Docguidelines.pdf
• Your local, state, and national associations
• CMS.gov
– Medicare Learning Network: http://www.cms.gov/Outreach-and-Education/Medicare-Learning-
Network-MLN/MLNGenInfo/index.html
**Current Procedural Terminology (CPT®) copyright 2012 American Medical Association.
24
25. Q/A
Q/A
Submit questions using the text tool on your screen
Editor's Notes
Thank you Kate and Heather for that lovely introduction. We’re going to review the new 2013 CPT code changes from the perspective of a biller, while focusing on the concerns of a provider who is doing their own billing. We’ll be spending an hour together today and going over about 20 slides. Please feel free to submit any questions you have during the presentation but we will answer all questions at the end. If we don’t have time to get to your question we will follow up with you via email later today. You can submit a question in the text entry box in the bottom right corner of your screen. Now, let’s begin!
It has been many years since the American Medical Association has made significant changes to the CPT codes used by behavioral health providers. Change is uncomfortable, but these new codes don’t need to be a cause for alarm. We’ll go over the biggest changes today, but there are many resources available to you. In fact, the first resource you want to take advantage of is the 2013 CPT code book. If you haven’t already ordered a copy please do so today. The book holds the entire CPT code set and includes instructions on how to use each code. Once you receive your book, read the introduction. It’s only four pages long and includes valuable information. Every practice should order the current CPT book every year. They are available directly through the AMA, and several other organizations. If you’re a member of an organization that sells the book you can usually get it at a great discount. This is your first and most important step in preparing for the 2013 procedure changes. The next step is to review, or learn, how to bill E/M codes. E/M stands for Evaluation and Management, and these codes are located in the red section at the beginning of the CPT book. While physicians and mid-level practitioners have always been eligible to bill E/M codes, the existence of procedure codes that capture both therapy and medication management, such as 90805 and 90862, have allowed behavioral health providers to effectively bill for their services without utilizing this code set. Prescribers who provide medication management will need to familiarize themselves with E/M billing before January 1 st . In conjunction with this, providers should reach out to their insurance payers and find out if the E/M codes they are likely to bill are already part of their contracts. We anticipate that all behavioral health payers will need to add E/M codes to their reimbursable procedure list, but if they are not currently part of your contract you will want to reach out to your provider services representative and confirm that they will be added, and ask about the reimbursement rates. You also want to ask about the reimbursement rates for the new medical CPT codes for 2013. They should be comparable to their 2012 predecessors.
Here we have a grid of all the behavioral health CPT codes that have been discontinued beginning January 1 st . Note that you will no longer use these codes for all services beginning in January – if after the first of the year you find that you need to bill for an appointment from December or November or earlier, then you will need to use the 2012 code set. A noteworthy feature in our current code set is that a different code is chosen based on outpatient versus inpatient therapy, and interactive psychotherapy has its own set of codes. We will review the replacements for each of these codes shortly.
Here we have a list of all the new behavioral health codes. You’ll notice it’s a much smaller chart! Billing for psychotherapy should be even simpler than before, with just one set of codes to choose from. However, medication management can now only be captured with the use of E/M codes. Before we cover medication management we are going to briefly review the new psychotherapy codes and go over changes in the definition of time.
We have a very straightforward crosswalk for the new psychotherapy codes in 2013 that do not involve medication management. Previous codes will be replaced with one of four new therapy codes, and up to one add on code demonstrating interactive complexity in the session. For example, 90801 (the initial psychiatric assessment) is now 90791, and 90802 (an interactive psychiatric assessment) is now 90791 and 90785. Add on codes are CPT codes that can never be billed on their own. They can only be bill in addition to a primary CPT code. A 90801 was considered a primary CPT code because it could be billed on its own, without any other codes on that day, and the new 90791 is also a primary code. The other primary therapy codes are 90832, 90834, and 90837. The time definitions for each therapy code have changed for 2013. Previously there was a range attached to each code; for example, a 90806 was 45-50 minutes of therapy. Now there is a defined time for each procedure. We’ll go over what this means next.
90832 is defined as 30 minutes of psychotherapy, 90834 is 45 minutes of therapy and 90837 is 60 minutes of therapy. I think we can all agree that sessions rarely, if ever, last exactly 30, 45 or 60 minutes. Because there is a set time defined for each code you will use the CPT time rule to determine what the most appropriate procedure code is for your session based on the time you actually spent face to face with the patient or their family. The time rule is covered in the introduction of the CPT book, but to summarize, it states that you should choose the procedure code closest to the actual length of the session. The AMA was kind enough to specify exactly what they meant, so we’ve listed the time ranges for each new procedure code. If your therapy session was between 16 and 37 minutes then you will bill 90832. If it was between 38 and 52 minutes you will bill 90834. If it was greater than 53 minutes you will bill 90837. The instructions specify that you should not report psychotherapy of 15 minutes or less. There is one more important definition change in the 2013 book. Starting in January, psychotherapy times are now for face-to-face services with the patient and/or their family members. Currently services are defined by time spent face-to-face with just the patient. In 2013 the patient must still be present for at least some of the service, otherwise you would continue to bill 90846 (family psychotherapy without the patient present).
New to the 2013 code set is the presence of therapy add on codes. The add on code available to all behavioral health providers is 90785, which indicates interactive complexity. Previously there were different CPT codes for interactive therapy based on time and the location of service. Starting in January interactive therapy will be reported using just 90785. The definition of interactive complexity has been expanded and the CPT book now includes broader descriptions of patients who are likely to have specific communication factors that complicate delivery of care. While the complex interaction therapy codes have most commonly been used for services with children, the new definitions make it more likely that services with adults will meet the billing requirements. For example, 90785 may be billed when at least one of the four following factors are present in the session: (1) the need to manage maladaptive communication among participants that complicates delivery of care (in other words, high anxiety, high reactivity, repeated questions or disagreement), (2) disclosure of a sentinel event to a third party (such as abuse or neglect being reported to a state agency) and discussion of the event with the patient, (3) caregiver emotions or behavior interfering with their understanding and ability to help implement the treatment plan, (4) the use of play equipment, physical devices, interpreters or translators to communicate with the patient. Three out of the four factors I just listed can describe services where the patient is not a child.
Another reason there are fewer therapy codes in 2013 than previously is the change in reporting location of services. Currently, the CPT book distinguishes between therapy performed in an outpatient setting and therapy performed in an inpatient setting. Starting in January, that distinction will disappear, and 30 minutes of therapy will be reported using the same code regardless of where the service was performed. The location will continue to be reported using the two digit POS code (or Place of Service code). Common POS codes are 11 (for office visits), 12 (for home visits), 21 (for inpatient hospital visits) and 22 (for outpatient hospital visits). A complete list of POS codes is available on the first two pages of your CPT book.
Now we’re ready to discuss the new codes for prescribers in 2013. Unfortunately, we don’t have an easy 1 to 1 replacement crosswalk for services that utilized your medical training. The only way to bill for services that include medication management is to choose the most appropriate E/M code. If the service also included therapy, a therapy add on code can be billed, too. Prescribers can bill up to three codes per session; the appropriate E/M code, an add on code indicating therapy was part of the service, and 90785 to report interactive complexity.
The new 2013 CPT code set represents many changes to billing for psychiatric services, but not everything has changed. The providers who are eligible to bill E/M codes have remained the same, as has the documentation requirements and instructions on how to choose an E/M code. CMS specifies that providers should choose the documentation guidelines that are most favorable to them. The 1997 guidelines are more favorable to specialties in general, including psychiatrists. They allow for examination of a single organ system, instead of the multi-system examination. If you are unfamiliar with billing E/M services I strongly advise you to sign up for a webinar, an online class, or to buy a book that goes over the documentation requirements in detail. I particularly like the book “Procedure Coding Handbook for Psychiatrists” by Schmidt, Yowell and Jaffe. Their latest edition does not include the new 2013 907xx and 908xx codes, of course, but there have been no changes to the documentation requirements for E/M codes. While instructions on how to meet these billing requirements are outside the scope of this presentation, we will briefly discuss the two different ways to document E/M services.
Remember, therapy can only be reported with medication management as an add on code. That means the new therapy slash med management codes can only be billed if the provider includes an E/M code for that service. 90833, 90836, and 90838 cannot be billed by themselves; payers will reject the claim if they are the only CPT code from the provider for that day. Further, if you are documenting that more than 50% of the session was spent on counseling or coordination of care, and you’re choosing the E/M code with time as your controlling factor, then you cannot include a therapy add on code. You can only bill 90833, 90836 or 90838 if you used the three key components of history, exam and medical decision making to determine the appropriate E/M code.
The time requirements for the therapy with med management codes are the same as the stand alone psychotherapy codes we discussed earlier. We have one code each for 30 minutes, 45 minutes and 60 minutes, and you will select the add on code closest to the amount of time spent on therapy in the session. It is very important to remember that the amount of time you spend on meeting your E/M requirements cannot be included in the amount of time you spent on therapy. Even though you are having one face-to-face session with your patient (and/or their family members), you are going to divide that time into two categories: the amount spent on evaluation and management, and the amount spent on therapy. Let’s look at some examples.
Let’s say you have a 45 minute appointment with your patient. They showed up promptly at 9am and left at precisely 9:45am. You provided both medication management and therapy and want to bill two procedure codes to reflect this. If you spent 15 minutes on the E/M portion and 30 minutes providing therapy, you are not going to bill the 45 minute therapy add on code. You are going to use the three key components of history, exam and medical decision making to decide what the most appropriate E/M code is, and then you are going to bill 90833, the therapy add on code for 30 minutes. In our example, even though you saw your patient for 45 minutes you spent 30 minutes providing therapy. The 90836 add on code of 45 minute therapy and med management would be inaccurate. Let’s look at another example.
Let’s say you see another patient who is very good at arriving on time and leaving on time. If you have a 30 minute appointment and you spend 15 minutes on medication management and 15 minutes on therapy, what are you going to bill? If you said just the E/M code you were right! In this example you would NOT bill the 90833 30 minute therapy add on code because you provided less than 16 minutes of therapy.