Procedure Code Description Medicaid Fee 2013 0001F HEART FAILURE
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2. Screening Techniques
2. SCREENING TECHNIQUES 2.1 X-ray techniques the contrast and the spatial resolution are poor, making detection of small lesions difficult. The The original technique for mammography mammogram in Fig. 2.1b, from the same era, is of was introduced by Salomon in Germany in 1913, much higher quality and illustrates a cancer seen 18 years after the discovery of X-rays by Roentgen on the basis of an irregularly shaped mass (black (Salomon, 1913). A mammogram is formed by arrow). Fig. 2.1c shows a digital mammogram, recording the two-dimensional (2D) pattern of illustrating the enormous improvement that X-rays transmitted through the volume of the has occurred in both technology and technique. breast onto an image receptor. Breast cancer is Breast positioning, penetration of the tissue, and detected radiographically on the basis of four contrast are excellent, allowing visualization of major signs: a mass density with specific shape a small area of ductal carcinoma in situ (DCIS) and border characteristics, microcalcifications, seen on the basis of microcalcifications, and, architectural distortions, and asymmetries more importantly, providing the opportunity to between the radiological appearance of the left detect an immediately adjacent high-grade inva- and right breast (Kopans, 2006). These signs sive cancer 1.7 mm in diameter. are often very subtle, and in order for them to Excellent image quality is an essential compo- be detected accurately and when the cancer is at nent but not, on its own, a sufficient component the smallest detectable size, the technical image to ensure a high level of accuracy in cancer detec- quality of the mammograms must be excellent tion. -
Postoperative Imaging of the Ankle: a Review
Postoperative Imaging of the Ankle: A Review Society of Skeletal Radiology Annual Meeting, 2020 Okezika Kanu MD1, Sameh A. Labib MD2, Adam Singer MD1, Monica Umpierrez MD1, Felix Gonzalez MD1, Philip Wong MD1 1Emory University School of Medicine Department of Radiology and Imaging Sciences Division of Musculoskeletal Imaging 2Emory University School of Medicine Department of Orthopaedics Correspondence: [email protected] Objectives • To review common procedures performed in the ankle • Be come familiar with the expected postoperative appearance of the various procedures • Recognize complications associated with these procedures Posterior Ankle PROCEDURES ❑ Primary end-to-end Achilles tendon repair ❑ Achilles tendon lengthening ❑ Flexor hallucis longus (FHL) transfer ❑ Haglund excision and Achilles tendon reattachment Achilles Tendon Repair A B C 53 year old female with right posterior ankle pain after hearing a pop. (A): Sagittal PD FS of the ankle demonstrating full thickness midsubstance tear of the Achilles tendon with tendon gap of approximately 4.0 cm (bracket). (B and C): Sagittal T1 and PD FS postoperative images 3 years after primary end-to-end repair. There is expected thickening of the repaired tendon, which is intact. Linear intermediate intrasubstance signal (arrows) within the mid substance may represent minimal degeneration or postoperative changes. Additionally, there is loss of the calcaneus declination angle, indicative of possible lengthening of the Achilles. Achilles Lengthening A B C Achilles tendon lengthening procedures are typically done for patients with congenital or acquired equinus contracture. Z-lengthening Technique: (A): Illustration demonstrating the Z-lengthening technique. This is an open procedure with longitudinal incision made 2-6 cm proximal to the insertion. -
Hemi-Castaing Ligamentoplasty for the Treatment of Chronic Lateral Ankle Instability: a Retrospective Assessment of Outcome
International Orthopaedics (SICOT) DOI 10.1007/s00264-011-1284-9 ORIGINAL PAPER Hemi-Castaing ligamentoplasty for the treatment of chronic lateral ankle instability: a retrospective assessment of outcome Tim Schepers & Lucas M. M. Vogels & Esther M. M. Van Lieshout Received: 30 April 2011 /Accepted: 17 May 2011 # The Author(s) 2011. This article is published with open access at Springerlink.com Abstract augmentation (i.e. the Broström-Gould technique) and the Purpose In the treatment of chronic ankle instability, most non-anatomical repair should be reserved for unsuccessful non-anatomical reconstructions use the peroneus brevis cases after anatomical repair or in cases where no adequate tendon. This, however, sacrifices the natural ankle stabilising ligament remnants are available for reconstruction. properties of the peroneus brevis muscle. The aim of this study was to evaluate the functional outcome of patients treated with a hemi-Castaing procedure, which uses only half Introduction the peroneus brevis tendon. Methods We performed a retrospective cohort study of It has been estimated that more than 80 techniques exist for patients who underwent hemi-Castaing ligamentoplasty for the treatment of lateral ankle instability [16, 18]. One of the chronic lateral ankle instability between 1993 and 2010, earliest ideas was to prevent chronic instability from with a minimum of one year follow-up. Patients were sent a happening by early suturing of the acutely ruptured postal questionnaire comprising five validated outcome ligaments; currently, this management strategy is no longer measures: Olerud-Molander Ankle Score (OMAS), Karlsson in use [26]. Nowadays, most agree to perform surgery in Ankle Functional Score (KAFS), Tegner Activity Level Score the 15–40% of patients with recurrent instability who are (pre-injury, prior to surgery, at follow-up), visual analog scale hampered in daily or sporting activities [4, 7, 37]. -
Radiation Protection Guidance for Diagnostic X Rays
Disclaimer - For assistance accessing this document or additional information, please contact [email protected]. EPA 520/4-76-019 FEDERAL GUIDANCE REPORT NO. 9 RADIATION PROTECTION GUIDANCE FOR DIAGNOSTIC X RAYS ENVIRONMENTAL PROTECTION AGENCY INTERAGENCY WORKING GROUP ON MEDICAL RADIATION FEDERAL GUIDANCE REPORT NO. 9 RADIATION PROTECTION GUIDANCE FOR DIAGNOSTIC X RAYS Interagency Working Group on Medical Radiation U.S. Environmental Protection Agency Washington, D.C. 20460 October 1976 PREFACE The authority of the Federal Radiation Council to provide radiation protection guidance was transferred to the Environmental Protection Agency on December 2, 1970, by Reorganization Plan No. 3. Prior to this transfer, the Federal Radiation Council developed reports which provided the basis for guidance recommended to the President for use by Federal agencies in developing standards for a wide range of radiation exposure circumstances. This report, which was prepared in cooperation with an Interagency Working Group on Medical Radiation formed on July 5, 1974, constitutes a similar objective to provide the basis for recommendations to reduce unnecessary radiation exposure due to medical uses of diagnostic x rays. The Interagency Working Group developed its recommendations with the help of two subcommittees. The Subcommittee on Prescription of Exposure to X rays examined factors to eliminate clinically unproductive examinations and the Subcommittee on Technic of Exposure Prevention examined factors to assure the use of optimal technic in performing x-ray examinations. Both subcommittees also considered the importance of appropriate and properly functioning equipment in producing radiographs of the required diagnostic quality with minimal exposure. Reports by these subcommittees were made available for public comment. -
Effectiveness of Distal Tibial Osteotomy
Nozaka et al. BMC Musculoskeletal Disorders (2020) 21:31 https://doi.org/10.1186/s12891-020-3061-7 RESEARCH ARTICLE Open Access Effectiveness of distal tibial osteotomy with distraction arthroplasty in varus ankle osteoarthritis Koji Nozaka* , Naohisa Miyakoshi, Takeshi Kashiwagura, Yuji Kasukawa, Hidetomo Saito, Hiroaki Kijima, Shuichi Chida, Hiroyuki Tsuchie and Yoichi Shimada Abstract Background: In highly active older individuals, end-stage ankle osteoarthritis has traditionally been treated using tibiotalar arthrodesis, which provides considerable pain relief. However, there is a loss of ankle joint movement and a risk of future arthrosis in the adjacent joints. Distraction arthroplasty is a simple method that allows joint cartilage repair; however, the results are currently mixed, with some reports showing improved pain scores and others showing no improvement. Distal tibial osteotomy (DTO) without fibular osteotomy is a type of joint preservation surgery that has garnered attention in recent years. However, to our knowledge, there are no reports on DTO with joint distraction using a circular external fixator. Therefore, the purpose of this study was to examine the effect of DTO with joint distraction using a circular external fixator for treating ankle osteoarthritis. Methods: A total of 21 patients with medial ankle arthritis were examined. Arthroscopic synovectomy and a microfracture procedure were performed, followed by angled osteotomy and correction of the distal tibia; the ankle joint was then stabilized after its condition improved. An external fixator was used in all patients, and joint distraction of approximately 5.8 mm was performed. All patients were allowed full weight-bearing walking immediately after surgery. Results: The anteroposterior and lateral mortise angle during weight-bearing, talar tilt angle, and anterior translation of the talus on ankle stress radiography were improved significantly (P < 0.05). -
Li Abundances in F Stars: Planets, Rotation, and Galactic Evolution ,
A&A 576, A69 (2015) Astronomy DOI: 10.1051/0004-6361/201425433 & c ESO 2015 Astrophysics Li abundances in F stars: planets, rotation, and Galactic evolution, E. Delgado Mena1,2, S. Bertrán de Lis3,4, V. Zh. Adibekyan1,2,S.G.Sousa1,2,P.Figueira1,2, A. Mortier6, J. I. González Hernández3,4,M.Tsantaki1,2,3, G. Israelian3,4, and N. C. Santos1,2,5 1 Centro de Astrofisica, Universidade do Porto, Rua das Estrelas, 4150-762 Porto, Portugal e-mail: [email protected] 2 Instituto de Astrofísica e Ciências do Espaço, Universidade do Porto, CAUP, Rua das Estrelas, 4150-762 Porto, Portugal 3 Instituto de Astrofísica de Canarias, C/via Lactea, s/n, 38200 La Laguna, Tenerife, Spain 4 Departamento de Astrofísica, Universidad de La Laguna, 38205 La Laguna, Tenerife, Spain 5 Departamento de Física e Astronomía, Faculdade de Ciências, Universidade do Porto, Portugal 6 SUPA, School of Physics and Astronomy, University of St. Andrews, St. Andrews KY16 9SS, UK Received 28 November 2014 / Accepted 14 December 2014 ABSTRACT Aims. We aim, on the one hand, to study the possible differences of Li abundances between planet hosts and stars without detected planets at effective temperatures hotter than the Sun, and on the other hand, to explore the Li dip and the evolution of Li at high metallicities. Methods. We present lithium abundances for 353 main sequence stars with and without planets in the Teff range 5900–7200 K. We observed 265 stars of our sample with HARPS spectrograph during different planets search programs. We observed the remaining targets with a variety of high-resolution spectrographs. -
Naming the Extrasolar Planets
Naming the extrasolar planets W. Lyra Max Planck Institute for Astronomy, K¨onigstuhl 17, 69177, Heidelberg, Germany [email protected] Abstract and OGLE-TR-182 b, which does not help educators convey the message that these planets are quite similar to Jupiter. Extrasolar planets are not named and are referred to only In stark contrast, the sentence“planet Apollo is a gas giant by their assigned scientific designation. The reason given like Jupiter” is heavily - yet invisibly - coated with Coper- by the IAU to not name the planets is that it is consid- nicanism. ered impractical as planets are expected to be common. I One reason given by the IAU for not considering naming advance some reasons as to why this logic is flawed, and sug- the extrasolar planets is that it is a task deemed impractical. gest names for the 403 extrasolar planet candidates known One source is quoted as having said “if planets are found to as of Oct 2009. The names follow a scheme of association occur very frequently in the Universe, a system of individual with the constellation that the host star pertains to, and names for planets might well rapidly be found equally im- therefore are mostly drawn from Roman-Greek mythology. practicable as it is for stars, as planet discoveries progress.” Other mythologies may also be used given that a suitable 1. This leads to a second argument. It is indeed impractical association is established. to name all stars. But some stars are named nonetheless. In fact, all other classes of astronomical bodies are named. -
Screening for Postmenopausal Osteoporosis
This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied. AHRQ is the lead Federal agency charged with supporting research designed to improve the quality of health care, reduce its cost, address patient safety and medical errors, and broaden access to essential services. AHRQ sponsors and conducts research that provides evidence-based information on health care outcomes; quality; and cost, use, and access. The information helps health care decisionmakers— patients and clinicians, health system leaders, and policymakers—make more informed decisions and improve the quality of health care services. Systematic Evidence Review Number 17 Screening for Postmenopausal Osteoporosis Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 2101 East Jefferson Street Rockville, MD 20852 http://www.ahrq.gov Contract No. 290-97-0018 Task Order No. 2 Technical Support of the U.S. Preventive Services Task Force Prepared by: Oregon Health Sciences University Evidence-based Practice Center, Portland, Oregon Heidi D. Nelson, MD, MPH Mark Helfand, MD, MS September 2002 Preface The Agency for Healthcare Research and Quality (AHRQ) sponsors the development of Systematic Evidence Reviews (SERs) through its Evidence-based Practice Program. With ∗ guidance from the third U.S. Preventive Services Task Force (USPSTF) and input from Federal partners and primary care specialty societies, two Evidence-based Practice Centers—one at the Oregon Health Sciences University and the other at Research Triangle Institute-University of North Carolina—systematically review the evidence of the effectiveness of a wide range of clinical preventive services, including screening, counseling, immunizations, and chemoprevention, in the primary care setting. -
Amorphous Lead Oxide (A-Pbo): Suppression of Signal Lag Via Engineering of the Layer Structure Received: 12 June 2017 O
www.nature.com/scientificreports OPEN Amorphous lead oxide (a-PbO): suppression of signal lag via engineering of the layer structure Received: 12 June 2017 O. Semeniuk1,2, O. Grynko1,2, G. Juska3 & A. Reznik2,4 Accepted: 25 September 2017 Presence of a signal lag is a bottle neck of performance for many non-crystalline materials, considered Published: xx xx xxxx for dynamic radiation sensing. Due to inadequate lag-related temporal performance, polycrystalline layers of CdZnTe, PbI2, HgI2 and PbO are not practically utilized, despite their superior X-ray sensitivity and low production cost (even for large area detectors). In the current manuscript, we show that a technological step to replace nonhomogeneous disorder in polycrystalline PbO with homogeneous amorphous PbO structure suppresses signal lag and improves time response to X-ray irradiation. In addition, the newly developed amorphous lead oxide (a-PbO) possesses superior X-ray sensitivity in terms of electron-hole pair creation energy W± in comparison with amorphous selenium – currently the only photoconductor used as an X-ray-to-charge transducer in the state-of-the-art direct conversion X-ray medical imaging systems. The proposed advances of the deposition process are low cost, easy to implement and with certain customization might potentially be applied to other materials, thus paving the way to their wide-range commercial use. Amorphous and polycrystalline modifcations of wide band gap semiconductors are of paramount importance in modern electronics, since they allow large device area production at low cost. However, the transition from crystalline to non-crystalline materials is technologically challenging since structural disorder may lead to degra- dation of the material performance. -
Study Guide Medical Terminology by Thea Liza Batan About the Author
Study Guide Medical Terminology By Thea Liza Batan About the Author Thea Liza Batan earned a Master of Science in Nursing Administration in 2007 from Xavier University in Cincinnati, Ohio. She has worked as a staff nurse, nurse instructor, and level department head. She currently works as a simulation coordinator and a free- lance writer specializing in nursing and healthcare. All terms mentioned in this text that are known to be trademarks or service marks have been appropriately capitalized. Use of a term in this text shouldn’t be regarded as affecting the validity of any trademark or service mark. Copyright © 2017 by Penn Foster, Inc. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner. Requests for permission to make copies of any part of the work should be mailed to Copyright Permissions, Penn Foster, 925 Oak Street, Scranton, Pennsylvania 18515. Printed in the United States of America CONTENTS INSTRUCTIONS 1 READING ASSIGNMENTS 3 LESSON 1: THE FUNDAMENTALS OF MEDICAL TERMINOLOGY 5 LESSON 2: DIAGNOSIS, INTERVENTION, AND HUMAN BODY TERMS 28 LESSON 3: MUSCULOSKELETAL, CIRCULATORY, AND RESPIRATORY SYSTEM TERMS 44 LESSON 4: DIGESTIVE, URINARY, AND REPRODUCTIVE SYSTEM TERMS 69 LESSON 5: INTEGUMENTARY, NERVOUS, AND ENDOCRINE S YSTEM TERMS 96 SELF-CHECK ANSWERS 134 © PENN FOSTER, INC. 2017 MEDICAL TERMINOLOGY PAGE III Contents INSTRUCTIONS INTRODUCTION Welcome to your course on medical terminology. You’re taking this course because you’re most likely interested in pursuing a health and science career, which entails proficiencyincommunicatingwithhealthcareprofessionalssuchasphysicians,nurses, or dentists. -
114.3 Cmr: Division of Health Care Finance and Policy Ambulatory Care
114.3 CMR: DIVISION OF HEALTH CARE FINANCE AND POLICY AMBULATORY CARE 114.3 CMR 40.00: RATES FOR SERVICES UNDER M.G.L. c. 152, WORKERS’ COMPENSATION ACT Section 40.01: General Provisions 40.02: General Definitions 40.03: Service and Rate Coverage Provisions 40.04: Provisions Affecting Eligible Providers 40.05: Policies for Individual Service Types 40.06: Fees 40.07: Appendices 40.08: Severability 40.01: General Provisions (1) Scope, Purpose and Effective Date. 114.3 CMR 40.00 governs the payment rates effective April 1, 2009 for purchasers of health care services under M.G.L. c. 152, the Workers’ Compensation Act. Payment rates for services provided by hospitals are set forth in 114.1 CMR 41.00. Program policies relating to medical necessity and clinical appropriateness are determined pursuant to M.G.L. c. 152 and 452 CMR 6.00. (2) Coverage. The payment rates set forth in 114.3 CMR 40.06 are full payment for services provided under M.G.L. c. 152, § 13, including any related administrative or overhead costs. The insurer, employer and health care service provider may agree upon a different payment rate for any service set forth in the fee schedule in 114.3 CMR 40.00. No employee may be held liable for the payment for health care services determined compensable under M.G.L. c. 152, § 13. (3) Administrative Bulletins. The Division may issue administrative bulletins to clarify substantive provisions of 114.3 CMR 40.00, or to publish procedure code updates and corrections. For coding updates and correction, the bulletin will list: (a) new code numbers for existing codes, with the corresponding cross references between existing and new codes numbers; (b) deleted codes for which there are no corresponding new codes; and (c) codes for entirely new services that require pricing. -
Musculoskeletal Program CPT Codes and Descriptions
Musculoskeletal Program CPT Codes and Descriptions Spine Surgery Procedure Codes CPT CODES DESCRIPTION Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition 20930 to code for primary procedure) 20931 Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure) Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar 20936 fragments) obtained from same incision (List separately in addition to code for primary procedure) Autograft for spine surgery only (includes harvesting the graft); morselized (through separate skin or fascial 20937 incision) (List separately in addition to code for primary procedure) Autograft for spine surgery only (includes harvesting the graft); structural, bicortical or tricortical (through separate 20938 skin or fascial incision) (List separately in addition to code for primary procedure) 20974 Electrical stimulation to aid bone healing; noninvasive (nonoperative) Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral 22206 body subtraction); thoracic Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral 22207 body subtraction); lumbar Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral 22208 body subtraction); each additional vertebral segment (List separately in addition to code for