Medicare Laboratory Payment Policy

Medicare Laboratory Payment Policy
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 261
Release: 2000-12-04
Genre: Medical
ISBN: 0309183618

Clinical laboratory tests play an integral role in helping physicians diagnose and treat patients. New developments in laboratory technology offer the prospect of improvements in diagnosis and care, but will place an increased burden on the payment system. Medicare, the federal program providing coverage of health-care services for the elderly and disabled, is the largest payer of clinical laboratory services. Originally designed in the early 1980s, Medicare's payment policy methodology for outpatient laboratory services has not evolved to take into account technology, market, and regulatory changes, and is now outdated. This report examines the current Medicare payment methodology for outpatient clinical laboratory services in the context of environmental and technological trends, evaluates payment policy alternatives, and makes recommendations to improve the system.

The Promise of Assistive Technology to Enhance Activity and Work Participation

The Promise of Assistive Technology to Enhance Activity and Work Participation
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 503
Release: 2017-09-01
Genre: Medical
ISBN: 030945784X

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.

Understanding Hospital Billing and Coding

Understanding Hospital Billing and Coding
Author: Debra P. Ferenc
Publisher: Elsevier Health Sciences
Total Pages: 626
Release: 2013-02-26
Genre: Medical
ISBN: 0323292267

- Updated Claim Forms chapter covers the UB-04 claim form. - Updated information covers diagnosis and procedural coding, with guidelines and applications. - Updated claim forms and names are used throughout.

Evidence-Based Management of Low Back Pain - E-Book

Evidence-Based Management of Low Back Pain - E-Book
Author: Simon Dagenais
Publisher: Elsevier Health Sciences
Total Pages: 497
Release: 2011-01-31
Genre: Medical
ISBN: 0323079245

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.

Administrative Healthcare Data

Administrative Healthcare Data
Author: Craig Dickstein
Publisher: SAS Institute
Total Pages: 250
Release: 2014-10
Genre: Computers
ISBN: 162959380X

Explains the source and content of administrative healthcare data, which is the product of financial reimbursement for healthcare services. The book integrates the business knowledge of healthcare data with practical and pertinent case studies as shown in SAS Enterprise Guide.

Molybdenum-99 for Medical Imaging

Molybdenum-99 for Medical Imaging
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 264
Release: 2016-11-28
Genre: Medical
ISBN: 0309445310

The decay product of the medical isotope molybdenum-99 (Mo-99), technetium-99m (Tc-99m), and associated medical isotopes iodine-131 (I-131) and xenon-133 (Xe-133) are used worldwide for medical diagnostic imaging or therapy. The United States consumes about half of the world's supply of Mo-99, but there has been no domestic (i.e., U.S.-based) production of this isotope since the late 1980s. The United States imports Mo-99 for domestic use from Australia, Canada, Europe, and South Africa. Mo-99 and Tc-99m cannot be stockpiled for use because of their short half-lives. Consequently, they must be routinely produced and delivered to medical imaging centers. Almost all Mo-99 for medical use is produced by irradiating highly enriched uranium (HEU) targets in research reactors, several of which are over 50 years old and are approaching the end of their operating lives. Unanticipated and extended shutdowns of some of these old reactors have resulted in severe Mo-99 supply shortages in the United States and other countries. Some of these shortages have disrupted the delivery of medical care. Molybdenum-99 for Medical Imaging examines the production and utilization of Mo-99 and associated medical isotopes, and provides recommendations for medical use.

CPT 2015

CPT 2015
Author: American Medical Association
Publisher: Cengage Learning
Total Pages: 0
Release: 2014
Genre: Health insurance claims
ISBN: 9781622020270

This codebook helps professionals remain compliant with annual CPT code set changes and is the AMAs official coding resource for procedural coding rules and guidelines. Designed to help improve CPT code competency and help professionals comply with current CPT code changes, it can help enable them to submit accurate procedural claims.