Coding for Pediatrics, 2016

2015 ◽  
Author(s):  
Keyword(s):  
Nurse Practitioners ◽  
Pay For Performance ◽  
Nursing Facility ◽  
Clinical Vignettes ◽  
Icd 10 ◽  
And Performance ◽  
The Many ◽  
Coding Guidelines ◽  
Diagnosis Coding ◽  
Management Services

Published annually and currently in its 21th edition, Coding for Pediatrics is the signature publication in a comprehensive suite of coding products offered by the American Academy of Pediatrics (AAP). This AAP exclusive complements standard coding manuals with pediatric-specific documentation and billing solutions for pediatricians, nurse practitioners, administration staff, and pediatric coders. This year's edition has been fully updated and revised to include all changes to the 2016 Current Procedural Terminology (CPT®), complete with accompanying guidelines for their application. The numerous clinical vignettes and examples featured in the book, as well as the many coding pearls included throughout, have also been fully revised and revisited. Coding for Pediatrics, 2016 continues to provide guidance on ICD-10-CM transition including coding tips highlighting key conventions and documentation elements to support specific and accurate ICD-10-CM code selection. Other updates for this edition include Detailed information on new and revised CPT® codes for 2016 including Prolonged clinical staff time Removal of impacted cerumen with irrigation or lavage Revision of photo-screening services New chapter on enhanced quality and pay for performance Expanded coding resources including articles for the AAP Pediatric Coding Newsletter, coding fact sheets, sample appeal letter, denial tracking tool, and more All clinical vignettes presented with corresponding ICD-10-CM codes. Some included with valuable quality measure. Online access to many additional practice resources Table of Contents New and Revised CPT® Codes for 2016 Diagnosis Coding: ICD-10-CM Modifiers and Coding Edits Evaluation and Management Documentation (E/M) and Coding Guidelines: Incident-To, PATH Guidelines, and Scope of Practice Laws Preventive Services Evaluation and Management Services in the Office, Outpatient, Home, or Nursing Facility Setting Perinatal Counseling and Care of the Neonate Noncritical Hospital Evaluation and Management Services Emergency Department Services Critical Care and Intensive Care Evolving Evaluation and Management for Nonphysician Services Common Procedures and Non-E/M Medical Services Coding for Quality and Performance Measures\ Preventing Fraud and Abuse: Compliance, Audits, and Paybacks The Business of Medicine: From Clean Claims to Correct Payment and Emerging Payment Methodologies

Coding for Pediatrics 2015

2014 ◽  
Author(s):  
Keyword(s):  
American Academy ◽  
Nurse Practitioners ◽  
Current Procedural Terminology ◽  
Clinical Vignettes ◽  
American Academy Of Pediatrics ◽  
Icd 10 ◽  
The Many

Published annually and currently in its 20th edition, Coding for Pediatrics is the signature publication in a comprehensive suite of coding products offered by the American Academy of Pediatrics (AAP). This AAP exclusive complements standard coding manuals with pediatric-specific documentation and billing solutions for pediatricians, nurse practitioners, administration staff, and pediatric coders. This year’s edition has been fully updated and revised to include all changes to the 2015 Current Procedural Terminology (CPT®) codes, complete with accompanying guidelines for their application. The numerous clinical vignettes and examples featured in the book, as well as the many coding pearls included throughout, have also been fully revised and revisited. On October 1, 2015 all HIPAA covered entities will transition to the ICD-10-CM. Coding for Pediatrics provides guidance on this future transition including important documentation elements to support code selection in ICD-10-CM. Numerous helpful tips are included throughout the book and highlight the ICD-10-CM code set with “Transitioning to 10” boxes. Other updates to this edition include

Coding for Pediatrics 2017, 22nd Ed

2016 ◽  
Author(s):  
Keyword(s):  
Physician Practice ◽  
Allied Health Professionals ◽  
Moderate Sedation ◽  
Caregiver Health ◽  
Clinical Vignettes ◽  
Icd 10 ◽  
Bright Futures ◽  
New Codes ◽  
The Many ◽  
First Time

Code it right the first time - and minimize claim denials and payment delays with today's most trusted pediatric coding and documentation guide. For beginners and advanced coders alike, this is the first place to look for pediatric-specific coding solutions! A widely used AAP exclusive, Coding for Pediatrics complements standard coding manuals with proven pediatric-specific documentation and billing solutions. This year's completely updated 22nd edition features updates from both CPT and ICD-10-CM most relevant to pediatrics to provide specific examples and guidance on how to implement the new codes. Some new and revised services under CPT include parent/caregiver health risk assessment and moderate sedation. The book's many clinical vignettes, as well as the many coding pearls included throughout, provide added guidance needed to ensure accuracy and maximize payment. In addition to revised CPT codes, new and updated features in this edition include New chapter providing information on coding for services by allied health professionals in the physician practice New chapter focused on coding for management of chronic and complex medical conditions More examples of coding for preventive services recommended by Bright Futures Coding quiz (approved for American Academy of Professional Coders (AAPC) for 4 continuing education units)

Coding for Pediatrics, 2014

2013 ◽  
Author(s):  
Keyword(s):  
American Academy ◽  
Transitional Care ◽  
Pay For Performance ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Clinical Vignettes ◽  
Prior Approval ◽  
Classification Of Diseases ◽  
Icd 10

“Published annually and currently in its 19th edition, Coding for Pediatrics is the signature publication in a comprehensive suite of coding products offered by the American Academy of Pediatrics (AAP). Written by coding experts for coders and physicians, this manual is a product of the AAP Committee on Coding and Nomenclature and is extensively reviewed each year by the AAP Coding Publications Editorial Advisory Board. This edition has been fully updated and revised to include all changes to the 2014 Current Procedural Terminology (CPT®) and International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes, complete with accompanying guidelines for their application. The numerous clinical vignettes and examples featured in the book, as well as the many “Coding Pearls” included throughout, have also been fully revised and revisited. New to this edition, is an emphasis through the entirety of the manual on the upcoming transition to International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) with newly added “Transitioning to 10” boxes. These boxes accompany the text and highlight for the reader the various codes and situations most affected by the forthcoming change. New 2014 features and updates make Coding for Pediatrics more indispensable that ever! ICD-10-CM guidance and examples with dynamic call-out boxes New chapter on preventive medicine services New information on changes to transitional care management Updated guidance for reporting new codes for interprofessional consultations New explanation of changes to the code for cerumen removal Web access to Coding for Pediatrics updates and alerts Updated clinical vignettes to bring complex coding issues to life. Updated coding fact sheets, sample letters, denial tracking tool, and more The basics and beyond-with chapter after chapter of important information, updates and advice, including * New and Revised CPT® and ICD-9-CM Codes for 2014 * Diagnosis Coding: ICD-9-CM and ICD-10-CM * Evaluation and Management Documentation and Coding Guidelines: Incident-To, PATH Guidelines, and Scope of Practice Laws * Preventive Evaluation and Management Services in the Office, Outpatient, Home, or Nursing Facility Setting * Noncritical Hospital Care * Perinatal Counseling and Care of the Neonate and Critically Ill Infant/Child * Emergency Department Services * Common Procedures and Non-E/M Medical Services * Modifiers and Coding Edits * Category II CPT® Codes-Pay for Performance Measures and Category III CPT® Codes-Emerging Technologies * Fraud and Abuse: Compliance for the Pediatric Practice * The Business of Medicine: From Clean Claims to Correct Payment and Emerging Payment Methodologies Coding for Pediatrics, has the prior approval of American Academy of Professional Coders (AAPC) for 4.0 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.”

Efficiency of pay for performance program on the brazilian judiciary

2014 ◽  
Author(s):  
Luis Cláudio de Jesus-Silva ◽  
Antônio Luiz Marques ◽  
André Luiz Nunes Zogahib
Keyword(s):  
Performance Improvement ◽  
Pay For Performance ◽  
Field Research ◽  
The State ◽  
Quantitative Approach ◽  
The Internet ◽  
Court Of Justice ◽  
And Performance ◽  
Compensation Program ◽  
Structured Questionnaire

This article aims to examine the variable compensation program for performance implanted in the Brazilian Judiciary. For this purpose, a survey was conducted with the servers of the Court of Justice of the State of Roraima - Amazon - Brazil. The strategy consisted of field research with quantitative approach, with descriptive and explanatory research and conducting survey using a structured questionnaire, available through the INTERNET. The population surveyed, 37.79% is the sample. The results indicate the effectiveness of the program as a tool of motivation and performance improvement and also the need for some adjustments and improvements, especially on the perception of equity of the program and the distribution of rewards.

ARTISTIC AND AESTHETIC EDUCATION AND MUSICAL PSYCHOTHERAPY OF A SPECIALIST’S TRAINING

2020 ◽  
Vol 384 (2) ◽  
pp. 222-232
Author(s):  
P. V. Menshikov ◽  
G. K. Kassymova ◽  
R. R. Gasanova ◽  
Y. V. Zaichikov ◽  
V. A. Berezovskaya ◽  
...  
Keyword(s):  
Performance Practice ◽  
Piano Music ◽  
Traumatic Experiences ◽  
Special Role ◽  
Native Culture ◽  
History Of ◽  
The Subject ◽  
And Performance ◽  
The Many ◽  
Special Meaning

A special role in the development of a pianist as a musician, composer and performer, as shown by the examples of the well-known, included in the history of art, and the most ordinary pianists, their listeners and admirers, lovers of piano music and music in general, are played by moments associated with psychotherapeutic abilities and music features. The purpose of the study is to comprehend the psychotherapeutic aspects of performing activities (using pianists as an example). The research method is a theoretical analysis of the psychotherapeutic aspects of performing activities: the study of the possibilities and functions of musical psychotherapy in the life of a musician as a “(self) psychotherapist” and “patient”. For almost any person, music acts as a way of self-understanding and understanding of the world, a way of self-realization, rethinking and overcoming life's difficulties - internal and external "blockages" of development, a way of saturating life with universal meanings, including a person in the richness of his native culture and universal culture as a whole. Art and, above all, its metaphorical nature help to bring out and realize internal experiences, provide an opportunity to look at one’s own experiences, problems and injuries from another perspective, to see a different meaning in them. In essence, we are talking about art therapy, including the art of writing and performing music - musical psychotherapy. However, for a musician, music has a special meaning, special significance. Musician - produces music, and, therefore, is not only an “object”, but also the subject of musical psychotherapy. The musician’s training includes preparing him as an individual and as a professional to perform functions that can be called psychotherapeutic: in the works of the most famous performers, as well as in the work of ordinary teachers, psychotherapeutic moments sometimes become key. Piano music and performance practice sets a certain “viewing angle” of life, and, in the case of traumatic experiences, a new way of understanding a difficult, traumatic and continuing to excite a person event, changing his attitude towards him. It helps to see something that was hidden in the hustle and bustle of everyday life or in the patterns of relationships familiar to a given culture. At the same time, while playing music or learning to play music, a person teaches to see the hidden and understand the many secrets of the human soul, the relationships of people.

Otolaryngologist Performance in the Merit-Based Incentive Payment System in 2018

2021 ◽  
pp. 019459982110328
Author(s):  
Lauren E. Miller ◽  
Neil S. Kondamuri ◽  
Roy Xiao ◽  
Vinay K. Rathi
Keyword(s):  
Pay For Performance ◽  
Payment System ◽  
Incentive Payment ◽  
Cross Sectional ◽  
Medicare Data ◽  
And Performance ◽  
Value Based Care ◽  
Sectional Analysis ◽  
Median Change ◽  
Payment Models

In 2017, the Centers for Medicare and Medicaid Services transitioned clinicians to the Merit-Based Incentive Payment System (MIPS), the largest mandatory pay-for-performance program in health care history. The first full MIPS program year was 2018, during which the Centers for Medicare and Medicaid Services raised participation requirements and performance thresholds. Using publicly available Medicare data, we conducted a retrospective cross-sectional analysis of otolaryngologist participation and performance in the MIPS in 2017 and 2018. In 2018, otolaryngologists reporting as individuals were less likely ( P < .001) to earn positive payment adjustments (n = 1076/1584, 67.9%) than those participating as groups (n = 2802/2804, 99.9%) or in alternative payment models (n = 1705/1705, 100.0%). Approximately one-third (n = 1286/4472, 28.8%) of otolaryngologists changed reporting affiliations between 2017 and 2018. Otolaryngologists who transitioned from reporting as individuals to participating in alternative payment models (n = 137, 3.1%) achieved the greatest performance score improvements (median change, +23.4 points; interquartile range, 12.0-65.5). These findings have important implications for solo and independent otolaryngology practices in the era of value-based care.

Interventions Aimed at Reducing Use of Low-Value Health Services: A Systematic Review

2016 ◽  
Vol 74 (5) ◽  
pp. 507-550 ◽  
Author(s):  
Carrie H. Colla ◽  
Alexander J. Mainor ◽  
Courtney Hargreaves ◽  
Thomas Sequist ◽  
Nancy Morden
Keyword(s):  
Performance Feedback ◽  
Risk Sharing ◽  
Pay For Performance ◽  
Clinical Decision ◽  
Evidence Base ◽  
Provider Education ◽  
Rigorous Evaluation ◽  
And Performance ◽  
Multicomponent Interventions

The effectiveness of different types of interventions to reduce low-value care has been insufficiently summarized to allow for translation to practice. This article systematically reviews the literature on the effectiveness of interventions to reduce low-value care and the quality of those studies. We found that multicomponent interventions addressing both patient and clinician roles in overuse have the greatest potential to reduce low-value care. Clinical decision support and performance feedback are promising strategies with a solid evidence base, and provider education yields changes by itself and when paired with other strategies. Further research is needed on the effectiveness of pay-for-performance, insurer restrictions, and risk-sharing contracts to reduce use of low-value care. While the literature reveals important evidence on strategies used to reduce low-value care, meaningful gaps persist. More experimentation, paired with rigorous evaluation and publication, is needed.

Risikoberechnung mit Routinedaten? Entwicklung und Validierung multivariabler Modelle zur Prädiktion der 30- und 90-Tage-Mortalität nach chirurgischer Behandlung kolorektaler Karzinome

2018 ◽  
Vol 80 (11) ◽  
pp. 963-973
Author(s):  
Alexander Crispin ◽  
Brigitte Strahwald ◽  
Catherine Cheney ◽  
Ulrich Mansmann
Keyword(s):  
Receiver Operating Characteristic ◽  
Ridge Regression ◽  
Operating Characteristic ◽  
Pay For Performance ◽  
Characteristic Curves ◽  
Receiver Operating Characteristic Curves ◽  
Statistische Analyse ◽  
Icd 10 ◽  
Receiver Operating

Zusammenfassung Ziele Qualitätssicherung, Benchmarking und Pay for Performance (P4P) erfordern aussagekräftige Indikatoren sowie die adäquate Berücksichtigung der Risikostruktur der Patientenpopulation der jeweiligen Institution anhand geeigneter statistischer Modelle. Der Ansatz, Abrechnungsdaten zur Qualitätsmessung und Risikomodellierung zu verwenden, wird häufig kritisch gesehen. Ziel unserer Analysen war die exemplarische Entwicklung von Prädiktionsmodellen für die 30- und 90-Tage-Mortalität nach chirurgischer Therapie kolorektaler Karzinome mit Routinedaten. Studiendesign Vollerhebung der Patienten einer großen gesetzlichen Krankenkasse. Setting Chirurgische Kliniken im gesamten Bundesgebiet. Patienten 4283 bzw. 4124 Patienten mit Operationen kolorektaler Karzinome in den Jahren 2013 bzw. 2014. Prädiktoren Alter, Geschlecht, Haupt- und Nebendiagnosen sowie Tumorlokalisation aus den von den Kliniken an die Krankenkasse übermittelten Abrechnungsdaten gemäß §301 Sozialgesetzbuch V. Outcomes 30- und 90-Tage-Mortalität. Statistische Analyse Ableitung von Elixhauser Comorbidities, Charlson Conditions sowie Charlson Scores aus den ICD-10-Diagnosen. Entwicklung von Prädiktionsmodellen anhand eines penalisierten Regressionverfahrens (logistische Ridge Regression) in einer Lernstichprobe (Patienten des Jahres 2013). Beurteilung von Kalibrierung und Diskriminationsfähigkeit der Modelle in einer internen Validierungsstichprobe (Patienten des Jahres 2014) mithilfe von Kalibrierungskurven, Brier Scores und Analysen von Receiver Operating Characteristic Curves (ROC-Kurven) und der Flächen unter denselben (Areas Under the Curves, AUC). Ergebnisse Die 30- bzw. 90-Tage-Mortalität in der Lernstichprobe betrugen 5,7 bzw. 8,4%. Die entsprechenden Werte im Validierungssample waren 5,9% und gleichfalls 8,4%. Modelle auf der Basis der Elixhauser Comorbidities zeigten die beste Diskrimination mit AUC-Werten von 0,804 (95%-KI: 0,776–0,832) bzw. 0,805 (95%-KI: 0,782–0,828) für die 30- bzw. 90-Tage-Mortalität. Die zugehörigen Brier-Scores für die Elixhauser-Modelle betrugen 0,050 (95%-KI: 0,044–0,056) bzw. 0,067 (95%-KI: 0,060–0,074) und stimmten weitgehend mit denjenigen der konkurrierenden Modelle überein. Alle Modelle zeigten im Bereich niedriger prädizierter Wahrscheinlichkeiten eine gute Kalibrierung, bei höheren prädizierten Werten tendierten sie zur Überschätzung der Ereigniswahrscheinlichkeiten. Schlussfolgerung Trotz der augenscheinlich befriedigenden Ergebnisse zur Diskriminierung und Kalibrierung der vorgestellten Prädiktionsmodelle auf der Basis von Abrechnungsdaten ist deren Anwendung im Kontext von P4P kritisch zu sehen. Als Alternative bietet sich die Modellierung auf der Basis klinischer Register an, die ein umfassenderes, valideres Bild vermitteln dürften.

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