Tag Archives: Loss

43255 Good Bet For Coding For Excessive Blood Loss

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When you are coding for excessive blood loss, modifier 22 may not be what you are looking for. The answer may depend on more appropriate CPTs such as 43255 and critical care codes.

Think about endoscopy with injection as option

Scenario 1:

The physician injects epinephrine into a duodenal ulcer to control active bleeding during endoscopy with biopsy. 43239, Upper gastrointestinal endoscopy including esophagus, stomach and either the duodenum and/or jejunum as apt; with biopsy, single or multiple).

Previously, you may opt to use 43239 appended with modifier 22 (Increased procedural services) if the doctor required effort to control the patient’s bleeding.

However this option would need you to submit additional paper documentation to support your modifier 22 claim. Instead of submitting yourself to potential hassles, you can accurately describe the session by reporting 43239 for the biopsy and 43255 for the control of bleeding provided that the bleeding was not caused by the biopsy.

As is obvious from 43255’s descriptor, this procedure describes control of bleeding by any method including injection.

Requirement: On your claim, you should append modifier 59 to 43255, and then report 43239. Omitting the modifier would give payers the impression that the biopsy (or physician) caused the bleeding and bundle 43255 into 43239.

Extraordinary bleeding requires critical care coding

Scenario 2: When the gastroenterologist is about to carry out an upper GI endoscopy, the patient experiences gastrointestinal bleeding so severe that the doctor must suspend the endoscopy and spend 40 minutes lavaging blood from the gastro-intestinal tract before continuing.

Code it: This time, the critical code 99291 is your best choice.

Here’s why” If the gastroenterologist caused the bleeding, you cannot bill for the control of bleeding procedure. You should call on control-of- bleeding codes only when treatment is required to control bleeding that occurs spontaneously, or as a consequence of traumatic injury (noniatrogenic), and not as a result of another type of operative intervention, the CPT Assistant states.

Remember that the time spent at the bedside carrying out services including lavage of gastric blood isn’t included in the performance of a subsequent endoscopic procedure and is not part of the E&M service that might be carried out on the same day.

Nevertheless, you should not report a critical care code carelessly for an excessive bleeding situation that’s not out of the ordinary. Additional time for emergency bedside services less than 30 minutes does not count as billable critical care service. For prolonged critical care services, the physician should specifically note the amount of time in his notes.

We provide you simple, instant connection to official code descriptors & guidelines and other tools for 2010 CPT code, HCPCS lookup that help coders and billers to excel in the work they do every day.

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Americas Hearing Loss Population Grows to More than 34 Million, New Study by Better Hearing Institute Finds

Washington, DC (PRWEB) February 19, 2010

The number of Americans with hearing loss has grown to more than 34 millionroughly 11 percent of the U.S. populationaccording to a new study of close to 50,000 homes published by the Better Hearing Institute (BHI). The study found that over the last generation, hearing loss among Americans has increased at a rate of 160 percent of U.S. population growth and is one of the most commonly unaddressed health conditions in America today. The prevalence of hearing loss over the last 20 years has grown from 266 to 295 people per thousand U.S. households.

More Americans than ever before are suffering with hearing loss, says Sergei Kochkin, PhD, executive director of BHI. But we treat hearing loss like a neglected orphan in todays healthcare system.

He adds: Our healthcare gatekeepers continue to overlook the importance of hearing health. We still dont have a universal hearing loss screening program for children or adults in America. And the historical incidence of physician screening for hearing loss has been low.

According to the survey, fewer than 15 percent of those who received a physical exam in the last year said they received a hearing screening by their physician or nurse during that exam.

Untreated hearing loss reduces earning power, disrupts relationships, and causes a wide array of psychological problems, says Kochkin. Yet, the vast majority of doctors in todays healthcare system dont include hearing health as a routine part of annual examsdespite the fact that more than 95 percent of those with hearing loss could benefit from hearing aids.

According to the study, only 4 in 10 people with moderate-to-severe hearing loss use hearing aids. Even fewer with mild hearing loss use themjust 1 in 10. In fact, most people surveyed who use hearing aids waited nearly seven years after they initially learned about their hearing loss to obtain a hearing aid, and that was after theyd lost so much hearing that their quality of life was affected.

The study found that for those who do choose to use hearing aids, the most common reasons cited were the perception that their hearing loss was getting worse (55.4%) and the influence of family members (51%). Fewer than 7 percent said their family doctor influenced their decision to use a hearing aid.

According to the survey, hearing aid users are more likely to have hearing loss in both ears (87%), difficulty hearing in noise (66%), difficulty hearing normal speech across a room without visual cues (64%), and perceive that their hearing loss is severe or profound (40%). (For hearing loss populations by state, see Appendix A.)

By the time someone has lost speech communication, theyve already lost less audible sounds such as the more subtle sounds of nature and musiclike singing birds, croaking frogs, childrens voices, and the intricacies of classical music. (To experience how sensorineural hearing losses affect hearing, visit BHIs Hearing Loss Simulator at http://www.betterhearing.org/sound/index.cfm.)

Unaddressed hearing loss silently creeps into virtually every aspect of daily living and seriously erodes quality of life, explains Kochkin. The issue of moving a person from admission of their hearing loss, to recognition of the problems hearing loss causes in their lives, to positive action to treat their hearing loss, is extremely complex and multi-dimensional. Early education to achieve recognition of hearing loss and information on the value of hearing healthcare must remain priorities for the foreseeable future.

The effects of untreated hearing loss can be especially devastating for children. Even a mild hearing loss can have a negative impact on language competence, cognitive development, social and emotional well-being, and academic achievement.

Numerous studies have linked untreated hearing loss to a wide range of physical and emotional conditions, including irritability, negativism, anger, fatigue, tension, stress, depression, avoidance or withdrawal from social situations, social rejection and loneliness, reduced alertness and increased risk to personal safety, impaired memory and ability to learn new tasks, reduced job performance and earning power, and diminished psychological and overall health. Six out of ten Americans with hearing loss are below retirement age.

Findings from the study, MarkeTrak VIII: 25-Year Trends in the Hearing Health Market, were based on a screening survey sent to 80,000 households in the National Family Opinion panel; detailed survey information was completed in early 2009 by 3,174 hearing aid owners and by 4,345 people with hearing loss who had not yet adopted hearing aids. The study covers 25-year trends in the hearing-impaired population including hearing loss prevalence, hearing aid adoption rates, hearing loss screenings during a physical exam, distribution of hearing aids, hearing loss characteristics of hearing aid owners and non-adopters, new hearing aid adopters, and the demography of hearing aid owners and non-adopters.

A full copy of the study can be downloaded at http://www.betterhearing.org (under publications).

Founded in 1973, the BHI conducts research and engages in hearing health education with the goal of helping people with hearing loss to benefit from proper treatment.


www.zylascope.com | |Relaxation Music

Holistic Weight Loss is Key to Depression Relief

New York City, NY (Vocus/PRWEB) January 04, 2011

Patients Medical, a leading integrative medical center in New York City, will reveal effective ways to ease depression through natural weight loss in a January 20th webinar at 6:30pm Eastern Time.

The holidays are a very challenging time for those who struggle with depression. The odds are really against you especially if patients are overweight or have other chronic health conditions, explains Dr. Rashmi Gulati, Medical Director of Patients Medical.

Many scientific studies have been published confirming the link between obesity and depression. Scientists noted that people classified as obese (body mass index of 30 or more) have a 50-150% greater chance of depression.

Losing weight is difficult for patients who are depressed. The task seems insurmountable, no matter how badly they say they want to lose weight. Thats why holistic treatment is essential. By balancing hormones, thyroid and brain chemistry for depression relief, along with supplements to support weight loss, a healthy diet and exercise, the whole body is addressed and you see results in all areas. This is inspiring to the patient and makes it easier to succeed in losing weight and keeping it off.

Dr. Gulati and her staff of holistic medical doctors recommend a complete health evaluation, after which a customized treatment plan will be prescribed, possibly including bio-identical hormone replacement therapy and all-natural, stimulant-free weight loss supplements such as MetabTrim. These recommendations and more will be revealed during the free webinar, Cure Your Depression with All-Natural Weight Loss hosted by Dr. Gulati and nutritionist, Judy Penta.

With over a decade of experience, Dr. Rashmi Gulati is a leader in internal and integrative medicine, having appeared as a medical expert on Good Morning America, CNN, FOX 5 and WCBS in addition to a variety of national publications, speaking about depression, thyroid disease, hormonal health, cancer and holistic medicine. Dr. Gulati is also featured as an innovative doctor in Suzanne Somers books Breakthrough and Ageless.

About Patients Medical

Patients Medical (http://www.patientsmedical.com) is a unique integrative medicine center in Manhattan that combines the best of traditional and holistic medicine with modern technology to provide comprehensive care. Established in 1974, the center employs a multi-disciplinary staff including board certified internists, licensed practitioners and nutritionists. The practice specializes in diagnosing the root cause of an ailment, then healing the whole person with personalized protocols that draw upon ancient healing techniques alongside Western Medical perspectives. Patients Medical offers free seminars each month on bio-identical hormones, weight loss, thyroid, chronic fatigue, nutrition and more.


www.zylascope.com | |Relaxation Music