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Proper documentation and coding are about more than just financial benefits. There has been a lot of talk about the financial benefit in addressing hierarchical condition categories (HCCs) on an annual basis. I think it’s time we bring the conversation back to the epicenter. After all, proper HCC documentation and reimbursement does directly impact our […]
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When billing for neonatal weight based services (99478-99480) what is the appropriate weight to go by? Dosing or actual weight? Sometimes it differs and could be either depending on what you go by. I was taught to go by dosing weight but now am being told to use actual weight. Is there anywhere that has that in writing? I don’t want to get audited and have it come back on me.
Thanks!
assessment plan: patient is gaining weight appropriately. Come back in 2 weeks for weight check newborn.
Z00.111 is the code used.
Does this meet the guidelines for incident to reporting? Weight check is not a diagnosis with a designated plan of care? Is this a billable service?
Thanks!
I have a provider who wants to bill for group visits for helping people with weight loss.
1. How would a provider bill a group visit?
2. Can a physician provide a group service for obesity counseling and bill a level of care for each patient that is present?
3. If you can bill the encounter based on time, can you use the same block of time towards each patient?
Any help is appreciated! Thank you!
There are major consequences to being heavy. For example, Diabetes Gall Bladder and Gallstones problems, Stroke, Hypertension or high blood pressure, Knee and back pain, Sleep Apnea, Heart Disease, and even Depression could be caused or made worse by being overweight or obesity . Most people who will begin on a diet might not get the long term success they want. That is why having a physician and their staff at the center can be a good thing if you are honestly commit to dropping the pounds.
When you phone the weight loss place , you will set up a appointment with a medical doctor and their people. The doctor will start taking different tests
like body fat index, weight , blood pressure, EKG, and a comprehensive blood work panel. You will make a choice for a diet that is correct for you from the medical choices. These might include bariatric surgery, r a program that is low calorie with shots or drugs, low calorie program or just plain injections.
You will get personal attention from them right away when you start or chose to use them A lot of the other choices of diet programs will have non medical people whose duties are not as important as their sales. Your doctor can be able chart your progress to ensure you have effective weight loss and are safe. They will can say how much is from loss is from muscle loss, water loss, and fat loss and make corrections accordingly.
Your health professionals and doctors at the weight loss place can also help to set accurate and realistic goals using your measurements and body compositions and the program you have. You will get personal attention from your team including the doctor at the weight loss center. A lot of the centers say they get almost 100 percent success with the people who stay with their choice program.
Once you get your goal reached, your relationship for support does not go away. You will have a smaller different kind of contact with the center -like coming in one time per week so they can help you keep your new weight. ninety percent of typical people who can lose weight on a diet plan can add it back on in 6 months, there can also a long running healthy phase at most weight loss clinics.
A lot of clinics have a special plans for particular groups of people such as teens or new moms. As soon you get serious about dropping the pounds off and not about doing the latest and newest fad diet, get in touch with the closest medical weight loss clinic.
Mark Hall reveals ways to lose weight fast and easy to help you reach your goals. You can read his special report disclosing things they don’t tell you about QuickTrim Cleanse.
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
I’m billing for our private dr who did this as an outpatient procedure at a big hospital here, the hospital did the path. I don’t know if we can request going forward that the uterus be weighed independently for coding purposes???
Thanks in advance!! I’m sure I’ll be seeing you guys around quite frequently now that I’ve found this forum! Excited to learn as much as I can!
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.
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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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.