Mar 26, 2021 | Uncategorized
Burnout has been the reality for millions of people this past year. Whether it is a change in lifestyle or working too much, it can change the way we approach and do things in our everyday lives. What is burnout exactly and how can we approach these emotions going forward? Read below to learn more.nnHow are you doing? This simple question gets asked a lot these days, and for some of us our standard answer is “ok”. We are asked this at work, by friends, by family, and even strangers in limited interactions while at the grocery store. But what does it really mean? Does the person asking us really care? When it comes to our work life, are we truly aware of how we are doing? Burnout is nothing new.nnWorld Health Organization (WHO) defines burnout as an occupational phenomenon.nIt is included in ICD-10 and identified by code Z73.0. With the release of ICD-11, Burnout received a more detailed definition.nnAccording to the WHO’s website, Burnout is characterized by three dimensions:n1) feelings of energy depletion or exhaustion.n2) increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job.n3) reduced professional efficacy.nnPersonally, this is not something I ever thought about. Until I listened to a recent episode of NPR’s Life Kit, host Rhitu Chatterjee spoke with professionals regarding burnout and how it affected them personally and psychiatrist on ways to cope with this in your own lives.
Mar 22, 2021 | Uncategorized
The webinar training has been announced for the 2021 E/M technical corrections! Join Welter Healthcare Partners in a webinar training event to go over the newest changes in E/M guidelines and stay up to date on the newest coding changes. Check below for times and dates for the upcoming webinar training and register your practice/organization! nnBy Ginger Avery, CPC, CPMA, CRC nMarch 17, 2021nnSince the release of the January 1, 2021 updated E/M guidelines for office or other outpatient (CPT codes 99202-99215) and prolonged services (CPT codes 99354, 99355, 99356, 99417), the AMA has received an abundance of feedback from clinicians on areas of confusion. The AMA’s CPT Editorial Panel has made several technical corrections to add clarity to these exciting updates. These technical corrections were released March 9th and are effective January 1, 2021.nnThe summary of updates listed below reveals that most of the new information is concentrated on medical decision making (MDM) definitions:nn
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- Total Encounter Time Reporting: Clarification has been made when to NOT count time.
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- Five new MDM definitions added:n
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- Analyzed – referred to in the data element of Table 2 of the guidelines
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- Combination of data elements
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- Discussion
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- Unique Test and Unique Source
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- Surgery: minor vs. major
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- Revised Definitions have been created to clarify the following terms:n
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- Drug therapy requiring intensive monitoring for toxicity
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- Independent Historian
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- Risk
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- Test
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- Clarification provided for separately reported tests and interpretation.
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nMake sure your organization is up-to-date with these recent revisions and has a solid understanding of the new 2021 E/M Guidelines for office visit services. These monumental changes cannot go unnoticed! Register below for a one-hour webinar presented by Welter Healthcare Partners on these crucial updates. If you have any submission issues with the contact form, please email Cody at cwhitworth@rtwelter.com to register. nnAll webinar registrants will receive 5 of Welter Healthcare Partners’s 2021 Office Visit E/M Coding Tools!nn[dt_divider style=”thin” /]nn[gravityform id=”18″ title=”false” description=”false”]nnThese unpredictable updates to our ever-changing healthcare environment should serve as a reminder to visit AMA’s Errata & Technical Corrections regularly for any noted changes. nn
Mar 18, 2021 | Uncategorized
Several technical corrections have been made in the recently released 2021 E/M guidelines. With feedback from clinicians to clarify these new guidelines, new summary updates have been presented to clear up any confusion. Stay updated with the clarified E/M guidelines today. Continue reading below to learn more.nnBy Ginger Avery, CPC, CPMA, CRCnMarch 17, 2021nnSince the release of the January 1, 2021, updated E/M guidelines for office or other outpatient (CPT codes 99202-99215) and prolonged services (CPT codes 99354, 99355, 99356, 99417), the AMA has received an abundance of feedback from clinicians on areas of confusion. The AMA’s CPT Editorial Panel has made several technical corrections to add clarity to these exciting updates. These technical corrections were released March 9th and are effective January 1, 2021.nnThe summary of updates listed below reveals that most of the new information is concentrated on medical decision making (MDM) definitions:n
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- Total Encounter Time Reporting: Clarification has been made when to NOT count time.
n
- Five new MDM definitions added:n
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- Analyzed – referred to in the data element of Table 2 of the guidelines
n
- Combination of data elements
n
- Discussion
n
- Unique Test and Unique Source
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- Surgery: minor vs. major
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n
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- Revised Definitions have been created to clarify the following terms:n
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- Drug therapy requiring intensive monitoring for toxicity
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- Independent Historian
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- Risk
n
- Test
n
n
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- Clarification provided for separately reported tests and interpretation.
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nMake sure your organization is up-to-date with these recent revisions and has a solid understanding of the new 2021 E/M Guidelines for office visit services. These monumental changes cannot go unnoticed! Register below for a one-hour webinar presented by Welter Healthcare Partners on these crucial updates. If you have any submission issues with the contact form, please email Cody at cwhitworth@rtwelter.com to register. nnAll webinar registrants will receive 5 of Welter Healthcare Partners’s 2021 Office Visit E/M Coding Tools!nn[dt_divider style=”thin” /]nn[gravityform id=”18″ title=”false” description=”false”]nnThese unpredictable updates to our ever-changing healthcare environment should serve as a reminder to visit AMA’s Errata & Technical Corrections regularly for any noted changes. nn
Mar 18, 2021 | Uncategorized
Bartholin’s Gland Cysts treatment can come in many different forms. With treatment comes coding for the different classifications and procedures to take care of the cysts. Staying up-to-date with coding can help you organize and get ready for treatment. Continue reading below to learn more!nnBartholin’s glands are two fluid-filled swellings that lubricate the vagina prior to and during sexual intimacy. Due to their size, they can easily become blocked or obstructed by bacteria and cause a cyst or abscess Most Bartholin’s cyst are asymptomatic and resolve on their own. If ancyst does not resolve on its own, it can grow larger, swollen, and painful. nnTreatment options:nnSitz baths and time are usually the first line of treatment. In most instances, the cyst will rupture on it’s own. However, if conservative treatment does not work, an incision and drainage may be done with a word catheter inserted into the cyst space. This word catheter is left in place from four to six weeks to help with healing. Another treatment is surgical marsupialization. The physician will grasp the cyst and create a vertical incision between 1.5 and 3.0 cm long. This will drain the gland cavity. After that the cyst will be open and the physician will suture the edges of the sit to form a continuous surface from the exterior surface to the interior surface of the cyst. Clinicians also use lasers and injections to treat these cysts. It is also possible to surgically excise the gland or cyst from the vaginal area. Excision of the cyst is the most invasive treatment option. nnCPT CODING: n
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- 56420: I&D of Bartholin’s gland abscess
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- 56440: Marsupialization of Bartholin’s gland cyst
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- 56740: Excision of Bartholin’s gland cyst.
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nCPT code 56420 is used to report an I&D for a gland that is abscessed. If there was no abscess present, (the cyst was filled with clear fluid), and an I&D was performed, the coder should report one of the following:n
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- 10040: Acne surgery (ie: marsupialization, opening or removal of multiple milia, comedones, cysts, pustules)
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- 10060: I&D of abscess (ie: carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia), simple or single
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- 10061: … complicated or multiple
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nCode 56740 is used to report a complete excision. If the clinician uses a C02 laser or performs a destruction, then report CPT code 56501 (destruction of lesion(s), vulva, simple) or 56515 (…extensive)nnICD 10 CM Coding:n
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- N75.0: cyst of Bartholin’s gland
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- N75.1: abscess of Bartholin’s gland
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- N75.8: Other diseases of Bartholin’s gland
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- N75.9: disease of Bartholin’s gland, unspecified.
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nBe sure to code either a cyst or an abscess. If the clinician notes the presence of bacteria within the abscess, a laboratory code for the specific bacteria can be coded secondary to the abscess code. nn** AMA CPT 2021nn** AMA ICD-10-CM 2021nn** AMA Obstetrics and Gynecology
Mar 11, 2021 | Uncategorized
President Biden plans to address the mental health and addiction crisis after both have worsened since the start of the pandemic. He plans to split the funding for this endeavor between substance abuse and mental health services. Continue reading below to learn more.nnPresident Biden is directing $2.5 billion in funding to address the nation’s worsening mental illness and addiction crisis, an official from the U.S. Department of Health and Human Services tells Axios.nnWhy it matters: Confronting the mounting mental health and substance abuse crisis will be imperative for the Biden administration, even as its primary focus is on combating the broader COVID-19 pandemic.n
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- The funding announced today is designed to increase access to services for individual Americans.
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- The funding surge comes as the president has yet to fill several key permanent positions in agencies that would lead the charge in combating the drug epidemic, including the Food and Drug Administration and the White House Office of National Drug Control Policy.
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- His pick to lead HHS, Xavier Becerra, is expected to be confirmed by a close vote.
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nBetween the lines: The funds will be broken down into two components by the Substance Abuse and Mental Health Services Administration.n
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- $1.65 billion will go toward the Substance Abuse Prevention and Treatment Block Grant, which gives the receiving states and territories money to improve already-existing treatment infrastructure and create or better prevention and treatment programs.
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- $825 million will be allocated through a Community Mental Health Services Block Grant program, which will be used by the states to deal specifically with mental health treatment services.
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nBy the numbers: A survey conducted last year and published in August 2020 by Centers for Disease Control and Prevention showed that 41% of U.S. adults reported struggling with mental health or substance abuse related to the pandemic or its solutions, like social distancing.n
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- Before the pandemic, over 118,000 people died by suicide and overdose in 2019. An HHS official says the administration is expecting that number to increase because of the COVID-19 pandemic.
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- Preliminary data out of the CDC indicates that the number of drug overdoses through July 2020 increased by 24% from the year prior.
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nFlashback: On the campaign trail, then-candidate Biden often spoke about the need to address the mounting mental health and substance abuse crisis in America, an issue that hits close to home. His son, Hunter, has openly discussed his own struggles with addiction.nnThe National Suicide Prevention Lifeline (1-800-273-8255) provides 24/7, free and confidential support for anyone in distress, in addition to prevention and crisis resources. Also available for online chat.nnOriginal article posted on axios.com
Mar 11, 2021 | Uncategorized
This month’s operation report features Spinal Adhesion Barriers. The practice of using spinal adhesions within laminectomies is nothing new and this is considered a standard of practice that is essential for good patient recovery. When performing these operations, there are additional questions to be asked about the coding and billing involved. Continue reading below to learn more!nnDo you have a complicated surgery case that needs 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. n
– Click Here to Submit Redacted Surgery Case Study –
nQuestions to Consider:n
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- How is your spinal practice coding/billing for this additional work?
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- HCPCS code C1765 is used to bill for the device but how are your surgeons being reimbursed?
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n nnDATE OF SURGERY: 12/XX/2020nnSURGEON: D., MDnnASSISTANT SURGEON: M., SA-CnnPREOPERATIVE DIAGNOSIS: Degenerative lumbosacral spine (LS through S1).nnPOSTOPERATIVE DIAGNOSIS: Degenerative lumbosacral spine (LS through S1).nnOPERATIONS: Anterior exposure for lumbosacral spine fusion (L5-S1). Intraoperative fluoroscopy. Vessel Guard patch. Abdominal x-ray reading.nnSPINE SURGEON: Dr. G. G.nnANESTHESIA: General endotracheal.nnESTIMATED BLOOD LOSS: MinimalnnINDICATION FOR SURGERY: This is a 49-year-old male with degenerative lumbosacral spine, who needs anterior exposure £or fusion at the level of the disk LS-Sl.nn nnDESCRIPTION OF PROCEDURE:nnThe patient was brought into the operating room and placed on the table in supine position. After general anesthesia was administered, the intraoperative fluoroscopy was used to identify the level of the disk L5-S1 and the projection of the disk at the level of the anterior abdominal wall was marked with a transversal line in the suprapubic area. The abdomen was prepped and draped in the usual sterile fashion. nnA small transversal incision was done in the suprapubic area on top of the previously placed line and the incision was deepened through the subcutaneous tissue and through the fascia. The fascia flaps were elevated, and at the level of the midline between the rectus muscles, the peritoneal sac was approached and gently dissected and pushed to the left side. It was a little bit more difficult to enter the right retroperitoneal space and below the arcuate line, but it was possible to enter without any complications. The right retroperitoneal space was entered, and the peritoneal sac was further mobilized together. The ureter was pushed to the left side. The ureter was protected and visualized at all time. The vascular dissection was started between the iliac vessels using only gentle blunt dissection to avoid, injuries to the superior hypogastric plexus in this young man. Few presacral veins were identified and divided using bipolar electrocautery and middle sacral artery which was well represented partially imbedded in the soft tissue in front of the spine was divided using bipolar electrocautery, obtaining a good hemostasis. The vascular dissection was further continued using blunt dissection until both iliac vessels were mobilized, completed the right and left side of the spine obtaining a complete clearance of the entire disk space LS-S1. A needle was inserted in the disk exposed, and using intraoperative fluoroscopy, the level of the spine exposure was demonstrated. nnThe SynFrame was placed maintaining the exposure at the level of the disk LS-S1. At this point, Dr. G. came into the operating room and the case was turned to Dr. G. for the orthopedic part of the spinal fusion. After his part of surgery was completed, I came back to the operating room and I took over the case again. very good hemostasis was noted. No injury was seen. At this point, a Vessel Guard patch measuring 5 x 7.5 cm was chosen, was tailored to match the shape of the vertebral space exposed and secured in place with 2 stitches for 4-0 PDS suturing the upper part of the patch to the anterior longitudinal ligament of the vertebral body LS. The patch was able to cover completely the entire anterior aspect of the spine exposed and the hardware used for the fusion. The retractor blades were very carefully gently removed allowing the iliac vessels and the peritoneal sac to come back in a normal anatomical position on top of the patch. At the end of the procedure, very good hemostasis was noticed, very good flow through the iliac vessels. No ureteral injuries and no lymphatic leak. nnThe abdomen was closed in a standard fashion using a stitch with O Vicryl to approximate the rectus muscle below the midline and then the anterior fascia layer was closed with continuous running O loop PDS. The subcutaneous tissue was irrigated. Local anesthesia was injected. At this point, the intraoperative fluoroscopy was used to x-ray the abdomen for the instrument count and no instruments were found in the surgical field. The subcutaneous tissue was closed with continuous running 2-0 Vicryl, and the skin was closed with continuous running 3-0 Monocryl subcuticular closure. Steri-strips and sterile dressing were applied. nnThe patient tolerated the procedure well. At this point, the patient was kept under general anesthesia and turned back to Dr. G. and anesthesiologist for the posterior part of the spinal fusion.
