Featured on ted.com, Richard St. John shares his life story and how he rose to success…nnIn his typically candid style, Richard St. John reminds us that success is not a one-way street, but a constant journey. He uses the story of his business’ rise and fall to illustrate a valuable lesson — when we stop trying, we fail.n
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n nnInformation and article originally published on ted.com.
Telemedicine refers to remote clinical services that utilize electronic communications and software to facilitate health care without an in-person visit. Telemedicine technology can be used for a number of different services include medication management, management of chronic health conditions, consultations, and follow-up visits. These services are conducted via secure video and audio connections, typically on a mobile device or computer.nnTraditionally used to treat patients in remote places, telehealth is now used in many different healthcare settings, including convenient care facilities. Within healthcare, one of the most hot-button topics is patient expectation. Patients may not be privy to this discussion very often but, it is likely on every doctor’s mind.nnNow that about 77% of Americans own smartphones and can use their mobile devices to do a nearly endless number of tasks and activities, people are expecting more from healthcare. In fact, many patients expect their experience at a healthcare facility to live up to their experience with brands, restaurants, and retail stores. One of the most common demands patients have of their healthcare providers is convenient, more affordable care. To meet this demand, doctors and their staff have begun to adopt telemedicine technology.nnAre you implementing telemedicine in your practice and want help to ensure you navigate the changes correctly? Contact Welter Healthcare Partners to help!nnInformation originally published on solvhealth.com.
Exciting new opportunities have emerged for virtual check-in services. CMS is now stating there are coverage and reimbursement opportunities for providers that render, document, and bill for the virtual check-in services. There are some specific communication technology requirements that organizations will need to implement prior to claims submission. These new codes reflect the key role non-verbal communication technology plays in care coordination between consulting and treating physicians, according to the AMA.nnThe new codes are:nnHCPCS Code G2012 – Virtual Check-InnA physician or other qualified health care professional conducts a virtual check-in, lasting five to 10 minutes, for an established patient using a telephone or other telecommunication device to determine whether an office visit or other service is needed. The service may be provided when a related evaluation and management (E/M) service has not been provided in the previous seven days and it may not lead to an E/M service within the next 24 hours or soonest available appointment.nnHCPCS Code G2010 – Remote Evaluation of recorded video and/or images submitted by an established patientnPhysicians or other qualified practitioners review photos or video information submitted by the patient to determine if a visit is required. The service may be provided to an established patient when a related evaluation and management (E/M) service has not been provided in the previous seven days and may not lead to an E/M service within the next 24 hours or soonest available appointment.
Spotlight analysis finds progress made on numerous fronts, recommends next steps for policymakers, insurers and physiciansnnThe American Medical Association (AMA), Colorado Medical Society (CMS) and Manatt Health released a report today that shows Colorado has implemented meaningful reforms in response to the opioid epidemic though further steps are needed to save even more lives.nnThe Colorado spotlight analysis found that progress is being made to increase access to evidence-based treatment for substance use disorders, several pilot projects have improved care for patients with pain, and increased access to the opioid overdose-reversing drug naloxone has resulted in thousands of lives saved.nn“We conducted this analysis because it’s essential that policymakers know what is working, and where additional progress can be made,” said AMA President-elect Dr. Patrice A. Harris, who also chairs the AMA Opioid Task Force. “Colorado has implemented many important policies that are impacting patients’ access to care. Using this momentum, we think Colorado can go even further to save lives of those affected by opioid use disorder.”nnColorado is the second in a series of individual state studies. The AMA released a study on Pennsylvania last month.nnBased on available data, review of policies, and discussions with key policymakers, the analysis found four key areas where Colorado is succeeding:n
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n“This analysis comes at an important time for Colorado,” said Dr. Debra Parsons, CMS President. “Over the last six years, Colorado has developed policies, enacted laws and made important strides to have all stakeholders work together to reverse the opioid epidemic. While we continue these successful initiatives, we must closely evaluate how they are working so we can ensure we are putting our efforts in the right places.”nn
nnThe analysis also highlighted the work of the Colorado Consortium for Prescription Drug Abuse Prevention, which has brought together several hundred stakeholders and continues to develop a data-driven, county- and state-level data dashboard that can be used to help direct resources to areas of greatest need.nnThe analysis also found areas where additional progress could be made:n
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n“Many of the recommendations in this report related to commercial insurance—such as strengthening our market conduct examinations to better enforce mental health parity and more comprehensive front-end reviews of the number of addiction professionals in insurers’ networks—are fair and reasonable approaches that are within our authority to immediately tackle,” said Michael Conway, Colorado Insurance Commissioner and head of the state’s Division of Insurance. “We look forward to working with Colorado’s health insurers and physicians to implement solutions that help ensure consumers receive the care that they need to help end our state’s opioid epidemic.”nnClick here to read original article published on cms.org.
As most medical practices are aware, not all cases are easy to navigate using the latest medical standards. The information below highlights a complicated surgical case along with the correct CPT and ICD-10 codes. Do you have a complicated surgery case need help with coding? Welter Healthcare Partners would love to help! Please upload the operative note by clicking on the link below. Remember to remove ALL patient protected health information and organization identifiers. Welter Healthcare Partners will not use any medical records submitted in which PHI is not removed and protected.nn— Click Here To Submit Redacted Surgery Case Study —nn
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nINDICATIONS FOR PROCEDURE:nThe patient is a 52-year-old female who presented with worsening pain for several days. She was found to have significant inflammation of the descending colon with extraluminal air and early peritoneal signs on exam. Risks and benefits were discussed with the patient who understood and agreed with the treatment plan.nnDESCRIPTION OF PROCEDURE:nAfter obtaining proper informed consent, the patient was taken to the operative suite where she was prepped, draped and positioned in the usual fashion. Preoperative antibiotics were given, SCDs were placed prior to induction of general anesthesia. A timeout was performed and was correct.nnA 2 cm infraumbilical incision was made and carried through skin and subcutaneous tissue. The fascia was identified, was incised and a 12mm Hasson trocar was inserted. The abdomen was insufflated with carbon dioxide gas. Under direct vision a 12mm trocar was placed in her lower midline in the previous C section scar, and-a 5 mm was placed in the right lower quadrant. The colon was identified. There was some inflammation on the descending colon. Mobilization occurred laterally to medially, starting at the sigmoid colon. The retroperitoneal attachments were taken down. The left ureter was identified over its full course. Dissection occurred proximally up through the splenic flexure. The splenic flexure was taken down from the gastrocolic attachments and the oriental attachments, getting adequate mobilization to anastomose the distal transverse colon down to the rectum.nnDissection occurred distally to the reclosigmoid junction. The mesentery was transected with the Harmonic scalpel from the sigmoid artery, and the left colic artery were taken. This was carried down to the rectosigmoid junction. Using an Endo-GIA 45mm blue load staple, the rectosigmoid junction was transected. Dissection of the mesenteric occurred proximally through the splenic flexure. There was adequate mobilization, and it reached easily down into the pelvis.nnAt this point in lime, a 4 to 5 inch Pfannenstiel incision was made in her previous C-section scar. This was carried down through skin and subcutaneous tissue. The fascia was incised. The muscle was split in the midline. An Alexis wound protector was inserted and the Colon was externalized. There was an area of perforation with a small piece of stool that was exiting the colon. Proximal to this was normal appearing transverse colon. A 2-0 Prolene pursestring was applied. The colon was transected and the specimen was sent to pathology. A 29 EEA anvil stapler was put in the open end of the colon, and the pursestring was tied down and cut. This was then internalized again. The fascia was closed with a #1 PDS. The abdomen was reinsufflated. A 5 mm trocar was placed under direct vision in the Iower midline. Again, it was-checked to make sure there was adequate length to make a tension-free ariastomotis, and there was.nnThe EEA stapler was brought through the anus and brought up anterior to the staple line. The anvil was deployed. The 2 ends were mated and closed. The stapler was fired and removed. Two complete donuts were seen. A proctoscope was then inserted and a leak test was performed with air 3 different times with no air leak that was seen. The pelvis and the left hemi-abdomen were irrigated with a liter of normal saline. There was no other sign for any pathology. A 10 flat JP drain was placed in the pelvis and brought out through the right lower quadrant incision. The abdomen was then desufflated, trocars were removed under direct vision. The fascia of the umbilical incision was closed with an 0 Vicryl suture. Skin was closed with 4-0 Monocryl. Dermabond was applied. The patient tolerated the procedure well. She was extubated and taken to recovery in stable condition.nnCPT Codes:n
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Welter Healthcare Partners, Inc. is one of a select number of organizations in the country which provides Corporate Integrity Agreement (CIA) reviews and is designated as an Independent Review Organization (IRO) on behalf of the Office of Inspector General (OIG).nn Welter Healthcare Partners Consultants are subject matter experts with RAF coding. We have worked with payers, hospitals and physician-owned practices which are dependent on risk adjustment payment models and Hierarchical Condition Categories (HCCs).nnOur specific areas of expertise include:n
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n Welter Healthcare Partners’s RAF educational services incorporate providers own clinical documentation and one on one assistance to help them meet medical record documentation requirements and complete reporting of diagnosis coding to the highest level of specificity.nnClick here to learn more about the WHP Risk Adjustment Factor Approach and how our certified specialists can help you!