Tina Smith COC, CPC
Laureen shows you her proprietary “Bubbling and Highlighting Technique”
Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page 2018 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 Click here for more sample CPC practice exam questions and answers with full rationaleTag Archives: some
Can some one please help with this coding
Procedure performed: Excision of lymphedema pocket of right upper inner thigh with multiple layer reconstruction and wound VAC application.
Indication: This pt is a female who has developed lymphedema on bilateral lower extremities and on the medical aspect of her right inner thigh had developed a pocket which had significant entrapment of lymphatic fluid with irreversible changes and hypertrophy. The pt developed the pocket of tissue approximately the size of a bowling ball which hung from the upper inner distal medial right thigh and did hang on the ground. It severely impacted her lifestyle and limited her ability to exercise and ambulate and after seeking consultation from multiple doctors finally agreed to allow for excision of this area. Details,risks, and benefits of the operation were gone over with her. All of her questions were answered. All pertinent informed consents were gone over and signed. Medial clearance was obtained preoperatively.
Procedure: the patient was brought into the operative suite and placed in the supine position with all dependent portions carefully padded. After successful induction of general endotracheal anesthesia, was prepped and draped in usual fashion. Incision was made on the anterior and posterior surface of this massive lymphatic contained extravasation from the distal inner right thigh. Dissection was carried down through the skin and subcutaneous tissue with Bovie electro cautery. Once the lymphatic channels were encountered, harmonic scalpel was then used in order to coagulate and cuaterize the lymphatic channels, Meticulous treatment of the lymphatic channels with the Harmonic scalpel was able to accomplished full thickness from anterior to posterior. The superficial and deep venous system of the leg was kept intact, and a significant amount of skin and lymphatics was able to be removed and debulked from this area. The required free ties were placed, and after perfect hemostasis was obtained, chromic suture was used in the depths of the wound to close off the deep layer. Chromic suture were also used in the deep and subdermal layer in interrupted fashion in hopes of causing some inflammatory changes and provide for closure of this area. Metallic staples were placed to re approximate the skin loosely with multiple areas of separation to allow for lymphatic egress. All soft tissue appeared to be pink, healthy and viable at the termination of procedure. A wound VAC was then applied to account for this lymphatic egress. This served as the only dressing required, but a circumferential Ace wrap was applied for gentle compression of the lower extremity. The pt tolerated the procedure well with an estimated intraoperative blood
loss of 100 mL. she was taken from the operating room, extubated in stable condition to the recovery room. She will be admitted for pain control and wound care.
Thanks in advance
i have some question about HCC coder
Hoping for some input on a procedure
I do have a question on the procedure noted below.
Ultrasound guidance was used to gain access to the right common femoral artery using needle puncture and seldinger technique. A 5-french sheath was placed. A diagnostic catheter was advanced to the aortic bifurcation and oblique images of the left iliofemoral system were then obtained. The catheter was then advanced into teh left common femoral artery and left lower extremity angiography was performed. There seemed to be obvious thrombus within the superficial femoral artery as well as some distal tibial disease that may also represent a small level of embolization. The sheath was then placed over the aortic bifurcation such that the distal tip way in the proximal superficial femoral artery. An infusion thrombolytic wire was then advanced such that the infusion ports lay encompassing the area of thrombosis/embolism. Thrombolytic agent will be infused through the infusion wire overnight while a small amount of heparinized saline will be infused through the sheath. Sterile dressings were applied and the patient taken to the recovery room in stable condition.
Any suggestions on the codes for this procedure is greatly appreciated. Also, any suggestions for study helps to get more familiar with vascular would be greatly appreciated.
Thank you
Anesthesia preop eval some days before the procedure
Medical malpractice New York – Some facts and trends
Medical malpractice is an act which is attempted by a doctor in which he diagnosed the patient improperly that ultimately leads to the wrong treatment of the patient. So to avoid such harmful acts you must be familiar with some facts and trends of present scenario which are being discussed below as-
Fact related to the medical malpractice act in New York-
Patients generally sue the doctors and hospitals in the court of New York as they have to sacrifice a lot due to the improper treatment given by the professional and just because of committing this act of medical malpractice; victim has to suffer from a permanent injury. That is a fact but the trend going on these days appears to be completely different from the fact.
Another fact which would be quite strange to know that various victims of medical malpractice New York are not even aware of this as they have not been told about this type of practice.
In spite of the fact, trend provides a unique picture-
As there are ample of people in New York who are suffering because of the negligent act committed by a doctor but only few of them are able to identify that they are the victim of medical malpractice act and hence they are not compensated for the act due to their unawareness about the fact that it is the result of doctor’s ignorance in treating the patient.
Fact about the result of a lawsuit-
Even when the victims realize that they should file a lawsuit against the negligent party i.e. the doctors, most of the cases filed for medical malpractice New York are being settled out of court before the turn of its trial in the court.
Trend of these cases are quite different from the described facts-
As the victims of medical malpractice case have the authority of suing the concerned doctors and hospitals in court to get the justice in terms of compensation. Among all the cases which go for trial in New York, majority of the cases filed results in to the defeat of victims of around 66% to 80%. As the doctors manipulate the juries by proving that the case occurred due to the normal complications faced by the patient. There are some more reasons which compels the judges to give final decision in favor of doctors as-
· Doctors have a reputed image in the mind of juries as compared to the victims.
· As the jury trust the doctors and nurses for their treatment so they cannot suspect on their profession easily until the misdeed is correctly proved in the court by the lawyer.
· Insurance companies have manipulated the opinion of juries by saying that all the cases are being filed on false information to grab the compensation from the doctors.
· The last but not the least reason is that sometimes jury is not in favor of providing compensation amount to the victim as they believe that by giving this amount their insurance rates would be raised.
George Turner gives advice to clients who are looking for attorneys to handle injury related cases. To know more about the services of medical malpractice, medical malpractice lawyer new york, medical malpractice lawyers new york, medical malpractice law firm, visit www.nbrlawfirm.com
Find More Medical Coding Articles
Some Ways to Keep Your Electronic Medical Records Plan Moving Ahead
The most common question I get writing this column is: ‘Why is it taking so long to implement electronic medical records?’ Our initial 18-mo project turned out in about three years, instead. Though this seems a bit cautious to some colleagues, people in IT and project management industries commended our careful approach to the situation. It’s well-known that Internet Technology system implementations (such as EMR) fail up to 50 percent of the time. A solid plan must be in place, taking into account any unforeseeable circumstances which could change the time frame. For example, our journey included two new associates, two hurricanes, and a departure of an associate.
Your electronic medical records vendor should be able to refer someone to guide you through implementation. However, this person can be either a person with EMR experience or someone who knows about the system itself, though not so much about roll-out at a medical office. I strongly recommend taking on the services of a certified PM (Project Manager). One important thing a PM can do is turn your project into a dynamic process which can take a series of setbacks or delays. The standard calendar can’t really do much to ensure this sort of follow-through.
We first implemented a Project Manager to plan the location for our new office. Our employees could use what was learned from the process, which includes how to use mind-mapping software. We have used these techniques for all major projects at our practice since then, including implementation of the electronic medical records (EMR).
For meetings and other minor projects I recommend Getting Things Done by David Allen.
The primary advantage of using a work breakdown structure is that any glitches that pop up don’t completely ruin your goal to successfully implement the EMR system. Of course, at a small practice there is more schedule flexibility. A hard deadline should most certainly be set, as part of the plan for EMR roll-out. However, with a proper plan structure your plan can roll on with the punches instead of simply rolling over.
When we finally arrived a a place when staff had training, we posted the hard deadline to go live. There was a simulation date on a Saturday which occurred two days before launch; both dates were mandatory to attend.
Although theoretically we could have pushed the launch date back, these dates helped to keep us working together and exposed risks that were faced. Now we’re about 5 months into our roll-out. The stress levels have begun to settle a bit, and we’re now tweaking our templates and getting ready for the next wave of patients to introduce to electronic medical records.
Peter J. Polack, M.D., F.A.C.S., is founder of emedikon, a medical practice management consulting firm and president of Protodrone, a software development company specializing in medical practice applications. He is managing partner of Ocala Eye, a large multi-specialty ophthalmology practice. Find more useful articles and podcasts at http://www.medicalpracticetrends.com
Related Medical Coding Articles
Remote Job for a CPC-A, I need some help
Is there any companies that will hire a remote coder with little experience? I worked so hard to get my CPC now I can’t find a job that doesn’t require a ton of experience.
Staying Positive – Some Thoughts For Job Seekers (And Also, Employers)
Some Medical Alerts For Kidney Stones
Many people are not aware of it but there are actually different types of kidney stones that some individuals suffer from. Among those types, the most common that most people develop is called “calcium oxalate stone.” While others are called ‘struvite stones,” “uric acid stones,” and “cystine stones.” These types vary depending on what cause them and their characteristics.
People who are prone to kidney stones must familiarize themselves with the different types as early as possible so they would know what to adjust. Aside from setting lifestyles changes, knowing what type of kidney stones develop in the body is also important because it will help you do the things that will prevent their existence in your body system.
The symptoms of kidney stones
To be able to address the condition properly, it a must for people who are prone to having kidney stones to familiarize themselves with the condition. In order to determine if one is suffering from kidney stones, here are some medical alerts or symptoms to be noted:
1. Pain in all levels. As vague as it is, pain in varying levels is one of the major medical alerts of kidney stones. Considered as a common symptom for kidney stones, pain may vary depending on the size of the kidney stone and the length of time that it remains undiagnosed. Experts say that pain-which can be mild or extreme-is normal for people who suffer from kidney stones. This is because as the stone increases in size and weight, the more discomfort it brings especially during urination. Another form of pain that can be experienced due to kidney stones is from renal colic, which brings waves of severe pain that lasts for more than 10 minutes and can even last for an hour depending on the location of the kidney stone.
2. Blood in the urine or “hematuria.” The presence of blood in the urine is quite disturbing but this is one of the most common medical alerts of kidney stones.
Other symptoms of kidney stones include nausea or vomiting, pain with urination, and at times, the urgent need to urinate which are usually characterized among children and adults.
The importance of diagnosis
Did you know that almost 50 percent of the people who suffer from kidney stones would likely have them again in the next 10 years or so? This is because many of the sufferers do not continue medication and they cease from maintaining healthy diet and lifestyle.
People who are likely to suffer from kidney stones can go to any hospital’s Emergency Room or “ER”. Here, you can ask the attending physician or the hospital clerk on duty to undergo testing. It is advantageous for you to go straight in the ER because hospital people will attend to you directly. In most cases, it would take a long time before one can actually set at check up with a specialist. So it would be best if you go directly to the ER and get the prompt attention that you need.
Diagnosis can be done through an assessment of the person’s clinical history, a physical examination, laboratory evaluation, and x-ray for follow up. Having early diagnosis can definitely help you determine which type of kidney stone is present and would lead to faster and reliable treatments.
Visit our website to discover three grocery items that Painlessly Dissolve Kidney Stones. We are also giving away 20 FREE ebooks, so stop by today.