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The U.S. Census Bureau has reported that 56.7 million Americans had some type of disability in 2010, which represents 18.7 percent of the civilian noninstitutionalized population included in the 2010 Survey of Income and Program Participation. The U.S. Social Security Administration (SSA) provides disability benefits through the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. As of December 2015, approximately 11 million individuals were SSDI beneficiaries, and about 8 million were SSI beneficiaries. SSA currently considers assistive devices in the nonmedical and medical areas of its program guidelines. During determinations of substantial gainful activity and income eligibility for SSI benefits, the reasonable cost of items, devices, or services applicants need to enable them to work with their impairment is subtracted from eligible earnings, even if those items or services are used for activities of daily living in addition to work. In addition, SSA considers assistive devices in its medical disability determination process and assessment of work capacity. The Promise of Assistive Technology to Enhance Activity and Work Participation provides an analysis of selected assistive products and technologies, including wheeled and seated mobility devices, upper-extremity prostheses, and products and technologies selected by the committee that pertain to hearing and to communication and speech in adults.
These guidelines have been approved by the four organizations that make up the Cooperating Parties for the ICD-10-CM: the American Hospital Association (AHA), the American Health Information Management Association (AHIMA), CMS, and NCHS. These guidelines are a set of rules that have been developed to accompany and complement the official conventions and instructions provided within the ICD-10-CM itself. The instructions and conventions of the classification take precedence over guidelines. These guidelines are based on the coding and sequencing instructions in the Tabular List and Alphabetic Index of ICD-10-CM, but provide additional instruction. Adherence to these guidelines when assigning ICD-10-CM diagnosis codes is required under the Health Insurance Portability and Accountability Act (HIPAA). The diagnosis codes (Tabular List and Alphabetic Index) have been adopted under HIPAA for all healthcare settings. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses and procedures. These guidelines have been developed to assist both the healthcare provider and the coder in identifying those diagnoses that are to be reported. The importance of consistent, complete documentation in the medical record cannot be overemphasized. Without such documentation accurate coding cannot be achieved. The entire record should be reviewed to determine the specific reason for the encounter and the conditions treated.
Recoup lost time and revenue with denials management and appeals know-how. Claim denials can sink a profit margin. And given the cost of appeals, roughly $118 per claim, not all denials can be reworked. A practice submitting 50 claims a day at an average reimbursement rate of $200 per claim should bring in $10,000 in daily revenue. But if 10% of those claims are denied, and the practice can only appeal one, they lose $800 per day—upwards of $200K annually. Your medical claims are the lifeblood of operations. Don’t compromise your financial health. Learn how to preempt denials with the Denials Management & Appeals Reference Guide. This vital resource will equip you to get ahead of payers by simplifying the leading causes of denials and showing you how to address insufficient documentation, failing to establish medical necessity, coding and billing errors, coverage stipulations, and untimely filing. Rely on AAPC to walk you through the appeal process. We’ll help you establish protocols to avoid an appeals backlog and teach you how to identify and prioritize denials likely to win an appeal. What’s more, you’ll learn when a claim can be “reopened” to fix a problem. Collect the revenue your practice deserves with effective denials and appeals solutions: Know how to analyze your denials Defeat documentation and compliance issues for successful claims success Utilize payer policy for coverage clues Lock in revenue with face-to-face reimbursement guidance Refine efforts to avoid E/M claim denials Ace ICD-10 coding for optimum reimbursement Put an end to modifier confusion Stave off denials with CCI edits advice Navigate the appeals process like a pro And much more!
Cibas (pathology, Harvard Medical School) and Ducatman (pathology, West Virginia University) provide practicing and trainee pathologists with a guide to diagnostic interpretation of cytological specimens, with chapters devoted to various and organ systems. Coverage includes the use of special techniques such as immunohistochemistry, flow cytometry, and molecular biology, as well as indications, methods, and diagnostic pitfalls for various conditions. Color medical images are included. This second edition features new chapters on soft tissue methods and laboratory management. Annotation (c)2003 Book News, Inc., Portland, OR (booknews.com).
Covering all commonly used interventions for acute and chronic low back pain conditions, Evidence-Based Management of Low Back Pain consolidates current scientific studies and research evidence into a single, practical resource. Its multidisciplinary approach covers a wide scope of treatments from manual therapies to medical interventions to surgery, organizing interventions from least to most invasive. Editors Simon Dagenais and Scott Haldeman, along with expert contributors from a variety of clinical and academic institutions throughout the world, focus on the best available scientific evidence, summarizing the results from the strongest to the weakest types of studies. No other book makes it so easy to compare the different interventions and treatment approaches, giving you the tools to make better, more informed clinical decisions. - A multidisciplinary approach covers treatments from manual therapies to medical interventions to surgery, and many others in between. - An interdisciplinary approach enables health care providers to work together. - A logical, easy-to-follow organization covers information by intervention type, from least invasive to most invasive. - Integration of interventions provides information in a clinically useful way, so it's easier to consider more than one type of treatment or intervention for low back pain, and easier to see which methods should be tried first. - 155 illustrations include x-rays, photos, and drawings. - Tables and boxes summarize key information. - Evidence-based content allows you to make clinical decisions based on the ranking the best available scientific studies from strongest to weakest. - Patient history and examination chapters help in assessing the patient's condition and in ruling out serious pathology before making decisions about specific interventions. - Experienced editors and contributors are proven authors, researchers, and teachers, and practitioners, well known in the areas of orthopedics, pain management, chiropractic, physical therapy, and behavioral medicine as well as complementary and alternative medicine; the book's contributors include some of the leading clinical and research experts in the field of low back pain. - Coverage based on The Spine Journal special issue on low back pain ensures that topics are relevant and up to date. - A systematic review of interventions for low back pain includes these categories: patient education, exercise and rehabilitation, medications, manual therapy, physical modalities, complementary and alternative medicine, behavioral modification, injections, minimally invasive procedures, and surgery. - Surgical interventions include decompression, fusion, disc arthroplasty, and dynamic stabilization. - Additional coverage includes patient education and multidisciplinary rehabilitation.
CPT(R) 2022 Professional Edition is the definitive AMA-authored resource to help healthcare professionals correctly report and bill medical procedures and services.