Problems and Barriers in the Transition to ICD-10-CM/PCS: A Qualitative Study of Medical Coders’ Perceptions

Author(s):  
Vera Alonso ◽  
João Vasco Santos ◽  
Marta Pinto ◽  
Joana Ferreira ◽  
Isabel Lema ◽  
...  
Keyword(s):  
2020 ◽  
Author(s):  
Reza Assadi ◽  
Nasim Lotfinejad ◽  
Amir Hosein Ziae ◽  
Baran Ganjali

AbstractIntroductionEmojis have surpassed facial expressions and they are now widely used to deliver complex concepts by representing graphical expressions in the digital platform. In this study, we endeavored to develop medical emojis for clinical signs and symptoms to be used as tools for text-based counselling.MethodsThe present study was conducted using the Delphi method with medical studnets and general practitioners, drawing and discussing in several repeated rounds. For this purpose, about 100 clinical signs/symptoms were considered using the ICD-10 website.ResultsIn the present study, from one hundred signs and symptoms we reached to 85 signs/symptoms that after first round of sessions were illustrated. Out of these 85 eligible emojis, 4 cases were removed due to the lack of consensus. The rest of the emojis were finalized and prepared by the graphic designer. These emojis then were published online to collect online votes.ConclusionIn this study, we could design up to 81 medical emojis presenting clinical sign and symptoms with acceptable consensus between the participants. These emojis were reasonably acceptable by our panelists in presenting the established clinical concepts.


Author(s):  
Le Meizhao ◽  
Ye Ming ◽  
Song Xiaoming ◽  
Xu Jiazhang

“Hydropic degeneration” of the hepatocytes are often found in biopsy of the liver of some kinds of viral hepatitis. Light microscopic observation, compareted with the normal hepatocytes, they are enlarged, sometimes to a marked degree when the term “balloning” degeneration is used. Their cytoplasm rarefied, and show some clearness in the peripheral cytoplasm, so, it causes a hydropic appearance, the cytoplasm around the nuclei is granulated. Up to the present, many studies belive that main ultrastructural chenges of hydropic degeneration of the hepatocytes are results of the RER cristae dilatation with degranulation and disappearance of glycogen granules.The specimens of this study are fixed with the mixed fluid of the osmium acidpotassium of ferricyanide, Epon-812 embed. We have observed 21 cases of biopsy specimens with chronic severe hepatitis and severe chronic active hepatitis, and found that the clear fields in the cytoplasm actually are a accumulating place of massive glycogen. The granules around the nuclei are converging mitochondria, endoplasm reticulum and other organelles.


2019 ◽  
Vol 4 (5) ◽  
pp. 936-946
Author(s):  
Dawn Konrad-Martin ◽  
Neela Swanson ◽  
Angela Garinis

Purpose Improved medical care leading to increased survivorship among patients with cancer and infectious diseases has created a need for ototoxicity monitoring programs nationwide. The goal of this report is to promote effective and standardized coding and 3rd-party payer billing practices for the audiological management of symptomatic ototoxicity. Method The approach was to compile the relevant International Classification of Diseases, 10th Revision (ICD-10-CM) codes and Current Procedural Terminology (CPT; American Medical Association) codes and explain their use for obtaining reimbursement from Medicare, Medicaid, and private insurance. Results Each claim submitted to a payer for reimbursement of ototoxicity monitoring must include both ICD-10-CM codes to report the patient's diagnosis and CPT codes to report the services provided by the audiologist. Results address the general 3rd-party payer guidelines for ototoxicity monitoring and ICD-10-CM and CPT coding principles and provide illustrative examples. There is no “stand-alone” CPT code for high-frequency audiometry, an important test for ototoxicity monitoring. The current method of adding a –22 modifier to a standard audiometry code and then submitting a letter rationalizing why the test was done has inconsistent outcomes and is time intensive for the clinician. Similarly, some clinicians report difficulty getting reimbursed for detailed otoacoustic emissions testing in the context of ototoxicity monitoring. Conclusions Ethical practice, not reimbursement, must guide clinical practice. However, appropriate billing and coding resulting in 3rd-party reimbursement for audiology services rendered is critical for maintaining an effective ototoxicity monitoring program. Many 3rd-party payers reimburse for these services. For any CPT code, payment patterns vary widely within and across 3rd-party payers. Standardizing coding and billing practices as well as advocacy including letters from audiology national organizations may be necessary to help resolve these issues of coding and coverage in order to support best practice recommendations for ototoxicity monitoring.


2019 ◽  
Vol 4 (5) ◽  
pp. 1148-1161
Author(s):  
Camilo Maldonado ◽  
Alejandro Ashe ◽  
Kerri Bubar ◽  
Jessica Chapman

Background American educational legislation suggests culturally competent speech and language services should be provided in a child's native language, but the number of multilingual speech-language pathologists (SLPs) is negligible. Consequently, many monolingual English-speaking practitioners are being tasked with providing services to these populations. This requires that SLPs are educated about cultural and linguistic diversity as well as the legislation that concerns service provision to non-English or limited English proficiency speakers. Purpose This qualitative study explored the experiences of monolingual, American, English-speaking SLPs and clinical fellows who have worked with immigrant and refugee families within a preschool context. It investigated what training SLPs received to serve this population and what knowledge these SLPs possessed with regard to federal legislation governing the provision of services to culturally and linguistically diverse (CLD) communities. Method Ten American clinicians with experience treating CLD children of refugee and immigrant families in the context of preschool service provision participated in the study. Semistructured interviews were utilized to better understand the type of training clinicians received prior to and during their service delivery for CLD populations. Additionally, questions were asked to explore the degree to which practitioners understood federal mandates for ethical and effective service provision. The data collected from these interviews were coded and analyzed using the principles of grounded theory. Findings The results of this study revealed that there was a general sense of unpreparedness when working with CLD clients. This lack of training also attributed to a deficiency of knowledge surrounding legislation governing service provision to CLD populations.


2008 ◽  
Vol 11 (2) ◽  
pp. 76-82 ◽  
Author(s):  
Sarah M. Ginsberg

Abstract This qualitative study examined student perceptions regarding a hybrid classroom format in which part of their learning took place in a traditional classroom and part of their learning occurred in an online platform. Pre-course and post-course anonymous essays suggest that students may be open to learning in this context; however, they have specific concerns as well. Students raised issues regarding faculty communication patterns, learning styles, and the value of clear connections between online and traditional learning experiences. Student concerns and feedback need to be addressed through the course design and by the instructor in order for them to have a positive learning experience in a hybrid format course.


2015 ◽  
Vol 18 (1) ◽  
pp. 16-31 ◽  
Author(s):  
Flora Keshishian ◽  
Rebecca Wiseheart

There is a growing demand for bilingual services in speech-language pathology and audiology. To meet this growing demand, and given their critical role in the recruitment of more bilingual professionals, higher education institutions need to know more about bilingual students' impression of Communication Sciences and Disorders (CSD) as a major. The purpose of this qualitative study was to investigate bilingual and monolingual undergraduate students' perceptions of the CSD major. One hundred and twenty-two students from a large university located in a highly multicultural metropolitan area responded to four open-ended questions aimed at discovering students' major areas of interest (and disinterest) as well as their motivations for pursuing a degree in CSD. Consistent with similar reports conducted outside the United States, students from this culturally diverse environment indicated choosing the major for altruistic reasons. A large percentage of participants were motivated by a desire to work with children, but not in a school setting. Although 42% of the participants were bilingual, few indicated an interest in taking an additional course in bilingual studies. Implications of these findings as well as practical suggestions for the recruitment of bilingual students are discussed.


ASHA Leader ◽  
2012 ◽  
Vol 17 (2) ◽  
pp. 3-8
Author(s):  
Janet McCarty ◽  
Neela Swanson
Keyword(s):  

ASHA Leader ◽  
2016 ◽  
Vol 21 (1) ◽  
pp. 30-32
Author(s):  
Kate Ogden ◽  
Neela Swanson ◽  
Janet McCarty
Keyword(s):  

ASHA Leader ◽  
2015 ◽  
Vol 20 (8) ◽  
pp. 36-37
Author(s):  
Neela Swanson ◽  
Janet McCarty
Keyword(s):  

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