MULTIPLE SPECIAL STUDIES (2*) Medical: US right upper quadrant abdomen followed by CT abdomen/pelvis with oral and IV contrast CT non-contrasted study of abdomen followed by contrasted CT CT abdomen/pelvis followed by US of pelvis or vice versa 38
MULTIPLE NEBULIZERS VS . MULTIPLE NEBULIZER MEDS Each medication used has various clinical actions and side effects Clinician must be discerning when ordering each medication and not “shotgun” the use of various combinations Two or more nebulizer medications lean to high moderate risk and severity 39
CPR Code used to describe management under ACLS™ protocols Copyright issues with using ACLS™ vs. CPR If CPR throughout, no CC allowed If CPR after start of evaluation, or if successful, most groups combine with 99285 “Decision not to resuscitate” under High Risk Acuity Caveat 40
ADMISSIONS AND TRANSFERS (1) Most are Level Five-type cases Usually high risk, high severity and high complexity cases Usually an immediate threat to either life or physiologic function Always ask why not at highest level 41
ADMISSIONS AND TRANSFERS (2*) Not Level Five Cases: Poor documentation Voluntary psych admissions without work-ups such as drug or alcohol rehab Admit to OR for repair of tendon, nerve, or isolated fracture of extremity Those patients sent from another facility who have been totally worked up Isolated hip fractures with no work-up or therapy 42
EMS OR RESCUE ARRIVAL Trauma EMS can elect not to bundle and transport At scene and look for items that mandate transport Examples of what they look for… At hospital, clinician provides ATLS™ protocols to all Usually high moderate cases Medical Most groups start these cases as low moderate Secondary to some patients who use EMS as transport only 43
EKG INTERPRETATION BILLING (1) Not “WNL” Consider use of EKG copy with “agree” and signature Acute or chronic changes Comparison to prior EKGs 44
Rate Rhythm Axis Interval Lengths (PR, QRS, ST, QTc) Q waves? ST Segment changes T wave changes Heart blocks (RBBB, LBBB, LAHB, LPHB) Comparison to prior EKG 45 EKG INTERPRETATION BILLING (2*)
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- Fall '16
- Professor M. Vargas
- urinary tract infection, Urinary catheterization, Prostatic Stent, Lymphangitis