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2016 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

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Weight Loss Dallas Medical Surgery

If you are looking for more intensive methods for weight loss Dallas medical professionals may be of help. Many morbidly obese and severely overweight individuals who have not lost weight with traditional weight loss methods turn to procedures such as lapband surgery for the improvement of their physical appearance and overall health, after they have qualified for these kinds of surgery.

Qualifying for weight loss surgery requires the patient to satisfy certain conditions. One factor is the degree of obesity the potential surgical candidate has. On average, surgeons must find that you are a minimum of 80 lbs. overweight, for instance; if not, other less invasive methods of weight loss such as a strict dietary and exercise regimen with the supervision of a licensed nutritionist and physical trainer may be recommended.

State of health is another factor you will need to qualify for to be able to receive weight loss surgery. Being overweight is also likely to result in other illnesses or disorders, and your doctor will outline how important it is for you to lose weight if findings support the procedure. If health specialists confirm that fast and drastic weight loss is a matter of the survival of the patient, surgery may be approved.

Lapband and Gastric Bypass Surgery

Lapband surgery and gastric bypass surgery are two of the most popular procedures for surgical weight loss. The type of surgery you will undergo depends on your physical condition and the recommendation of your surgeon, as these two surgeries differ in principle. Gastric bypass surgery, for example, incorporates stapling part of the stomach to diminish the absorption of calories from food, while lapband surgery involves an adjustable band that lowers its capacity to hold food consumed in one sitting.

Most procedures for surgical weight loss are developed around reducing the size of the use-able stomach by artificially building a smaller stomach pouch. This necessitates that the patient follow all instructions as to food consumption, exercise, and other recommendations after the surgery. Otherwise, the continued consumption of food over the allowed amounts or the deviation of the patient from a set exercise regimen may not only result in the failure of the surgical procedure, but also endanger the health of the recipient of the surgery.

These are just a few things you need to know prior to getting lapband or gastric bypass operations. To determine the viability of surgical procedures for weight loss Dallas medical professionals may be of help.

Are you an overweight individual looking for information on weight loss Dallas? Katherine Smith is a medical writer who specializes in writing about surgical procedures that result in weight loss Dallas to help you identify the best medical procedure from qualified medical professionals. http://katherinegsmith.wordpress.com

Attain Effective Weight Loss under Medical Supervision

Medical supervision is very essential for people desirous of effective weight loss. There are lots of people who are suffering from some or the other side effects of being overweight, but they attain effective weight loss under medical supervision. This way, they can have a perfect shape as well.

People first of all, need to understand what is meant by being overweight. There is a medically set range of weight in ratio to the height and age of the individual. This always has to in proportion. Once the weight is to height ratio becomes disproportionate, the person is said to be obese. It is better that people should keep checking their weight: Height ratio, lest they become out of proportion. A medical practitioner knows well as to when be the right time for the person to start the diet to lose weight.

People usually start the diet when they feel that they are becoming out of shape, but by then, already a good health is lost. They feel losing pounds of extra fat will be enough for weight reduction diet, but to slim down is not so important. In fact, what is even more important is losing body fat and maintaining body weight at a constant one. This can be achieved through medical weight loss program easily as being under a supervised weight loss program, people can come to know better about how to keep themselves healthier and lose weight at the same time, but without losing the energy and stamina.

People also have this misconception that if their friend is losing weight under a particular weight loss program, he will equally be benefitted. This is not true. Every individual has a particular body mass index and base metabolic rate. These are the basic factors which decide the type of program to be adopted for every individual. Moreover, the choice of equipments for exercises could also vary greatly from one individual to another. Acute weight loss over a very short period of time is once again a sign of danger, but if are under a supervised weight loss or medical weight loss program, you need not to worry, as the doctors will take care of this fact.

Nicolas Bell is a famous author for health related articles. He has written many articles on weight Loss, san ramon medical weight loss, supervised weight loss, Quickest Way to Lose Weight long term weight loss and so on.

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Weight Loss Surgery Medical Considerations

Considering minimally invasive weight loss surgery to help you lose weight and live a healthier lifestyle? Only a qualified bariatric surgeon can help you decide which procedure is best for you.

Before you schedule your consultation with a bariatric surgeon, determine if you meet the minimum criteria:

At least 100 pounds overweight
At least 18 years old
Obese for more than 5 years

A Body Mass Index (BMI) of 40 or more, or at least 35 with one or more obesity-related health conditions, is also a requirement. If you are pregnant, drink alcohol in excess, or suffer from another disease which may cause obesity, you may not qualify.

Weight Loss Surgery Basics

Laparoscopic surgery became a preferred surgical method in the United States in the early 1990s. Today, thousands of laparoscopic procedures are performed each year. To perform laparoscopic weight loss surgery, your bariatric surgeon creates several small incisions in the abdomen, called ports, through which long, slender instruments can be inserted into the abdomen. A high resolution camera and thin tubular telescope are inserted, allowing your surgeon to ‘see’ inside your abdomen via a TV monitor.

Preparing for Weight Loss Surgery

 

After your surgeon qualifies you for weight loss surgery, you may be asked to make certain preparations to transition to a healthier lifestyle.

 

Lose weight

For two weeks before surgery, follow a high-protein, low calorie liquid diet to begin the weight loss process and shrink a fatty liver, a common occurrence in the obese. Dr. Carson Liu, a respected Los Angeles bariatric surgeon, explains, “When the patient is lying down during surgery, the liver naturally covers the upper stomach and esophagus. To implant the LAP-BAND device, the liver must be lifted up to expose the stomach. A fatty liver is fragile, making this step in the procedure more difficult.”

 

Exercise

Your bariatric surgeon may ask you to ‘kickstart’ your weight loss with a reasonable walking program. When exercise becomes a habit before surgery, you are more likely to continue exercising after surgery.

 

Quit Smoking

Smokers heal more slowly after surgery. They also are at greater risk for gastrointestinal ulcers, which can interfere with the LAP-BAND device.

 

Develop Emotional Readiness

For overweight individuals, food is emotionally important. Gaining a deeper understanding of why you overeat is crucial to your success with weight loss surgery. Seek professional help or join a weight loss support group.

Does weight loss surgery sounds like the right choice for you? Please visit the website of Dr. Carson Liu in Los Angeles, California to learn more.

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Medical Conditions and Hair Loss!

Certain medical conditions such as non-androgenetic causes including pregnancy, gynecologic problems, birth control pills, and thyroid disease causes hair loss commonly in women. They create diffused pattern in women. This diffuse pattern is a term used when a woman has thin hair all over. It is often seen, that people talk more about men’s baldness as if baldness in women is just not prevalent. But, there is immediate attention that needs to be paid, as this is rare but worse.

Other conditions being menopause and obstetric conditions, Polycystic ovaries, Hormonal imbalances, severe emotional disorder such as stress and tension, cancerious cells, post pregnancy state, drop in estrogen, etc.

Medication such as chemotherapy, tablets such as birth pills and others. This will stop when you stop consuming those tablets. In addition to this, colouring your hair with chemicals or ironing, exposure to heat, improper diet and tension may lead to the same. Before you take any treatment, a prior screening of your hair follicle is essential.

Soon after your hair testing, you need to change your diet if it is not adequate for your hair growth. Eat lot of green leafy vegetables and iron rich food. Proper diet and exercise will also boost the results of your hair fall treatment.

DHT, commonly known as Dihydrotestosterone a male hormone prevalent in woman damages the hair follicles and further causes hair loss. This can be prevented by estrogen induced into your body. Estrogen is said to boost hair growth, hence a sudden drop in estrogen will also lead to loss of hair; Not to ignore the fact that some medications which affect the hair growth are birth control pills, chemotherapy used to treat cancer and other post surgeries or postpartum surgery and excessive consumption of medicines.

Exposure to chemical hair treatment may not always be helpful in some women. It may further worsen the hormonal conditions in women unlike men. A sample test is always recommended in case of women. Once, your hair problem is resolved, your hair returns back to its normal state.

Kirthy Shetty, Platinum author,

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Real Medical Research on the HCG Weight Loss Diet

The Original Research by Dr. A.T.W. Simeons
The research by Dr. Simeons was published in 1954 in his book, ‘Pounds and Inches’, which is widely available at no cost on many websites. He designed his protocol to be very precise regarding the amount of HCG required for injection, for the number of calories and the types foods allowed, and for the optimal duration of the program. He also published a brief synopsis of his program in the British medical journal Lancet (vol. 2, pp. 946-947, 1954).

This weight loss program has attracted considerable attention from the medical community and from people who have undergone treatment. Its popularity is one reason why so many people, including medical doctors, have decided to offer opinions on whether it works. The success of HCG for weight loss has been so great that it has attracted negative attention from the FDA.

Before I go further, I want to note that the FDA is not an agency that serves human health. It is an agency that serves the financial interests of pharmaceutical companies. Negative attention from the FDA almost always means that the health benefits of the treatment in question might undermine drug profits. Indeed, seeing the statement that HCG is not approved by the FDA for weight loss is, in my opinion, support for the effectiveness of this protocol.

Medical Studies
The government’s PubMed database lists more than 18,000 journal articles on HCG, with less than a few dozen of these having anything to do with weight loss. Most of the research on this hormone involves fertility, pregnancy, and the detection of cancerous tumors. What I want to do is call your attention to just three studies as examples of the confusion that is rampant in the medical literature on HCG and weight loss.

1963 Study
This study was published in the American Journal of Clinical Nutrition (vol. 12, pp. 230-234, 1963), at the height of popularity of the HCG diet plan in the U.S. In my reading of this article, it looks to me as though the researchers behind this study, from the University of California, San Francisco, School of Medicine, followed the Simeons protocol to the letter. There was one exception: the consumption of a baked potato each day, which is not on Simeons’ list of allowed vegetables. The main result of the study was an average loss of 6.5 pounds in the HCG-treated group, compared with an average loss of 8.8 pounds in the untreated (control) group. The authors concluded that the hormone did not cause weight loss.

This study is remarkable for a couple reasons. One is that, in spite of following the Simeons protocol for 40 days, neither the treatment group nor the control group came close to the amount of weight loss that is expected. A starvation diet alone (i.e., 550 calories per day) should have caused more weight loss than reported. In fact, one subject on HCG even gained weight. The other reason that this study is remarkable is that the number of study subjects (i.e., 10 in the treatment group, 9 in the control group) and the variability of the results within each group provided insufficient statistical power to explain anything at all! Indeed, this study offered no comparative statistical analysis of weight loss. In other words, the results did not support any conclusions whatsoever.

Nevertheless, one or more factors are not obvious in this study. Generally when a study has such insignificant results, the subjects were not compliant – i.e., they did not follow the protocol very well. The researchers offered no comment on this possibility, so we will never know why both the treatment group and the control group underperformed.

1973 Study
This study was published 10 years later, also in the American Journal of Clinical Nutrition (vol. 26, pp. 211-218, 1963). The researchers who conducted it, at the American Society of Bariatric Physicians Research Council, studied about twice as many subjects as the 1963 study above. The final result was an average loss of 19.96 pounds in the HCG group and 11.05 pounds in the control group. More importantly, the statistical analysis supported this difference as being significant. The conclusion of this study was that HCG did cause weight loss.

1995 Meta Analysis
Meta analysis refers to a comparison of multiple studies on the same topic. This meta analysis was published in the British Journal of Clinical Pharmacology (vol. 40, pp. 237-243, 1995) by researchers at Vrije University, Netherlands. They evaluated 16 studies and observed that most of them were of ‘poor methodological quality’ (meaning, bad science). Only one of the 12 articles of acceptable quality showed an effect on weight loss by HCG. The researchers concluded that ‘there is no scientific evidence that HCG is effective in the treatment of obesity’.

Meta analysis studies have become very popular in medicine because of the notion that a trend over multiple studies shows the truth. Unfortunately, the basic rules of statistics invalidate any such comparisons. Moreover, when even one study stands out against the majority, it is wrong to ignore it completely as these researchers have done. It would be much more valuable to figure out why some studies give contradictory results to one another.

This meta analysis also reveals what I call the dirty laundry of medical science – i.e., most research is so flawed that it is almost useless for saying anything at all with certainty. In fact, this is kind of a scary thought, isn’t it?

Take Home Lesson
Human subject research is the most difficult kind of study because of so many variables that are out of the control of the experimental design. Determining cause and effect is almost impossible. Nevertheless, we can see from some research that HCG can and does drive weight loss. My view is that studies that show this result are better in terms of sticking more closely to the Simeons protocol in the experimental design, then having the study subjects adhere closely to it.

What I conclude regarding HCG and weight loss is based on what I have seen for myself. This includes many, many people who have had the same results that Simeons documented based on his clinical experience with thousands of patients. I have also had the same results for myself. There is nothing like personal experience! The key to my experience, however, was monitoring my body fat composition. Weight loss is almost irrelevant by itself. My result was a reduction of 20 pounds AND of 6% body fat in less than 30 days. Reduction in body fat is supposed to be the main effect of HCG.

Medical researchers are apparently going to argue the merits of HCG and weight loss until the end of time, citing whichever research results support their arguments. As a scientist myself, I have no doubt whatsoever that Simeons was right and that my body changes occurred because of HCG.

One More Thing
Early studies on lab animals are now beginning to show that HCG interacts with the hormone leptin. Leptin is the new master fat hormone that has been known only since 1994. Like HCG, leptin also carries a signal to the hypothalamus. I predict that the more we find out about the interaction between these two hormones, the more we will understand how ingenious the Simeons protocol really is.

Dr. Dennis Clark is a retired university research scientist with more than 30 years of experience in natural products medicine. Before you embark on any HCG program, you must arm yourself with Dr. Clark’s objective scientific analysis of the HCG weight loss phenomenon. This program is not new, and it is not revolutionary. Get his latest report, “Myths and Truths About HCG Weight Loss,” at http://besthcgweightloss.com.

43255 Good Bet For Coding For Excessive Blood Loss

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.

Newborn weight check for weight loss after birth

We are looking for advice on how to diagnose newborn weight checks in the clinic when the patient has weight loss after birth but the reason is not known. The following is the response from the provider when queried – "Baby was breastfeeding and lost over 10% of birth weight after birth. It is often assumed that it is a feeding/calorie issue, but cannot be confirmed until calories are increased and weight gain results. Patient continues to require follow up exams and weight checks."
We believe these should be problem visits and not Health Maintenance visits but are having issues with the diagnosis. Patient did not have a low birth weight so P07.10 would not be accurate. It is not confirmed at this time that it is a feeding/calorie issue so P92._ would not work.

Any suggestions would be greatly appreciated.
Thank you!

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Hearing Loss in ICD-10

Hearing loss is a common problem caused by noise, aging, disease, and heredity. According to the National Institutes of Health, an estimated one-third of people in the U.S. between the ages of 65 and 75 have some degree of hearing loss, while close to one-half of people over 75 years of age are affected. According […]
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