Development of the ICD-10 Procedure Coding System (ICD-10-PCS)
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Incidence of Post Cross Clamp Ventricular Fibrillation in Isolated Coronary Artery Bypass Surgery Using Del Nido Cardioplegia and Conventional Blood Cardioplegia
Jemds.com Original Research Article Incidence of Post Cross Clamp Ventricular Fibrillation in Isolated Coronary Artery Bypass Surgery Using del Nido Cardioplegia and Conventional Blood Cardioplegia Biju Kambil Thyagarajan1, Anandakuttan Sreenivasan2, Ravikrishnan Jayakumar3, Ratish Radhakrishnan4 1, 2, 3, 4 Department of Cardiovascular and Thoracic Surgery, Government T D Medical College, Alappuzha, Kerala, India. ABSTRACT BACKGROUND The cardiac surgical procedures and surgical outcomes witnessed a dramatic Corresponding Author: improvement with the introduction of cardiopulmonary bypass and cardioplegia Dr. Anandakuttan Sreenivasan, techniques. Ventricular fibrillation immediately after removal of aortic cross clamp is Department of Cardiovascular and an energy consuming process leading to myocardial injury in an already energy Thoracic Surgery, Government T D Medical College, Alappuzha, Kerala, India, depleted heart. Electrical cardioversion, which itself causes myocardial injury, is E-mail: [email protected] required to regain normal rhythm. Prevention of ventricular fibrillation is important in preventing myocardial injury. We retrospectively analysed the incidence of post DOI: 10.14260/jemds/2020/797 cross clamp ventricular fibrillation requiring electrical defibrillation in isolated coronary artery bypass surgery using del Nido cardioplegia and conventional blood How to Cite This Article: cardioplegia. Thyagarajan BK, Sreenivasan A, Jayakumar R, et al. Incidence of post cross clamp METHODS ventricular fibrillation in isolated coronary -
Clinical Practice Guideline for Limb Salvage Or Early Amputation
Limb Salvage or Early Amputation Evidence-Based Clinical Practice Guideline Adopted by: The American Academy of Orthopaedic Surgeons Board of Directors December 6, 2019 Endorsed by: Please cite this guideline as: American Academy of Orthopaedic Surgeons. Limb Salvage or Early Amputation Evidence-Based Clinical Practice Guideline. https://www.aaos.org/globalassets/quality-and-practice-resources/dod/ lsa-cpg-final-draft-12-10-19.pdf Published December 6, 2019 View background material via the LSA CPG eAppendix Disclaimer This clinical practice guideline was developed by a physician volunteer clinical practice guideline development group based on a formal systematic review of the available scientific and clinical information and accepted approaches to treatment and/or diagnosis. This clinical practice guideline is not intended to be a fixed protocol, as some patients may require more or less treatment or different means of diagnosis. Clinical patients may not necessarily be the same as those found in a clinical trial. Patient care and treatment should always be based on a clinician’s independent medical judgment, given the individual patient’s specific clinical circumstances. Disclosure Requirement In accordance with AAOS policy, all individuals whose names appear as authors or contributors to this clinical practice guideline filed a disclosure statement as part of the submission process. All panel members provided full disclosure of potential conflicts of interest prior to voting on the recommendations contained within this clinical practice guideline. Funding Source This clinical practice guideline was funded exclusively through a research grant provided by the United States Department of Defense with no funding from outside commercial sources to support the development of this document. -
Alternative Treatment Method for Cervical Ectopic Pregnancy Servikal Ektopik Gebelik İçin Alternatif Tedavi Yöntemi
J Kartal TR 2016;27(2):147-149 CASE REPORT doi: 10.5505/jkartaltr.2015.065982 OLGU SUNUMU Alternative Treatment Method for Cervical Ectopic Pregnancy Servikal Ektopik Gebelik İçin Alternatif Tedavi Yöntemi Ali Emre TAHAOĞLU, Mehmet İrfan KÜLAHÇIOĞLU, Ahmet ESER, Cihan TOĞRU Diyarbakır Obstetrics and Child Health Hospital, Diyarbakır, Turkey Summary Özet Cervical ectopic pregnancy is a very rare form of ectopic Servikal ektopik gebelik, tüm ektopik gebelikler arasında çok pregnancy. Cervical ectopic pregnancy can be a cause of se- nadir rastalanan bir ektopik gebelik formudur. Servikal ektopik vere bleeding and it is associated with high morbidity and gebelik ciddi bir hemoraji nedeni olabilir. Ayrıca yüksek morbi- mortality. In recent years, many conservative methods of dite ve mortalite ile ilişkilidir. Son yıllarda fertiliteyi korumak treatment seeking to preserve fertility have been reported. amacı ile farklı birçok konservatif yaklaşım rapor edilmiştir. Presently described is case of pregnant woman at gesta- Kliniğimize yedi hafta dört gün ile uyumlu fetal kardiyak ak- tional age of 7 weeks and 4 days who was admitted to clinic tivitesi olmayan gebe vajinal kanama şikayeti ile başvurdu. with vaginal bleeding. Fetal cardiac activity was negative. Hasta yüksek servikal sütür ve Mcdonald serklaj uygulanarak Patient was successfully treated with high ligation suture başarı ile tedavi edildi. Servikal gebelik tedavisi hala tartışma and McDonald cerclage. There is no consensus yet on best konusudur. Fakat tedavi konusunda henüz kesin bir fikir birliği treatment of cervical ectopic pregnancy, but conservative bulunmamaktadır. Konservatif yaklaşım hastayı histerektomi methods can avoid major surgical procedure such as hyster- gibi büyük bir cerrahiden ve bunun getirdiği kötü sonuçlardan ectomy and its consequences. -
Table 1 Table 2 Table 3 Table 4 Colonoscopy-Related Costs
Digestive Health Network, Inc. List of Tables Top 10 Physician Specialties Performing Colonoscopies, Medicare Fee-for- Table 1 Service, 2015 Colonoscopy-related Costs, Medicare Fee-for-Service Beneficiaries who Table 2 Received a Screening or Diagnostic Colonoscopy, 2015 Colonoscopy-related Costs, Medicare Fee-for-Service Beneficiaries who Table 3 Received a Colonoscopy in an Ambulatory Surgical Center (ASC), Hospital Outpatient Department, or Physician Office, 2015 Proportion of Medicare Fee-for-Service Medicare Beneficiaries who Received Table 4 a Colonoscopy and were Treated in the Emergency Department within 7 Days of the procedure, 2015 Digestive Health Network, Inc. Responses to Questions Among Medicare beneficiaries, how many colonoscopies are performed in the US, by type of Q1 physician? Nearly 2 million screening and diagnostic colonoscopies were performed in 2015. Of these, over 78% were performed by a gastroenterologist. Nearly 10% were performed by a general surgeon and about 6% were performed by an internal medicine specialist. These results are shown in Table 1. Q2 What proportion of spending on colonoscopies is accounted for by physician services? In 2015, Medicare expenditures associated with colonoscopies totaled over $1.3 billion. (This excludes anesthesiology, pathology, radiology, and other costs identified in Table 2.) Approximately 31% of this amount, or $416 million was associated with professional fees. Q3 What share of Part B Medicare spending is accounted for by colonoscopies? Medicare Part B expenditures in 2015 totaled over $131 billion (data not shown). Colonoscopy costs accounted for approximately 1.03% of this total. Q4 What are the costs associated with colonoscopies for the different settings of care? Costs associated with colonoscopies in ambulatory surgical centers (ASC), hospital outpatient departments (HOPD), and physician offices are shown in Table 3. -
Surgical Best Practices: 14-Point Plan William P
Surgical Best Practices: 14-Point Plan William P. Adams, Jr., MD & Anand K. Deva, MBBS (Hons), MS SURGICAL BEST PRACTICES: 14-POINT PLAN William P. Adams, Jr., MD and Anand K. Deva, MBBS (Hons), MS Introduction The 14-Point Plan aims to reduce the number of bacteria present at the time of breast implant placement, thereby reducing the risk of associated infection.1 Each of these steps outlined below is backed by evidence and cumulatively have been shown to reduce the risk of capsular contracture in patients following breast implant surgery. During breast implant placement, if bacteria attach to the surface of an implant and create a biofilm over time, the biofilm becomes almost impossible to remove. If the bacterial biofilm load reaches a certain threshold it can lead to chronic inflammation and known sequelae, including infection, capsular contracture, double capsule, and breast implant-associated ALCL (BIA-ALCL).1, 2 We have performed extensive bench and clinical studies on this topic and are committed to educating plastic surgeons on proven steps that have been shown to reduce the bacterial biofilm load.1 These simple steps have been shown to decrease the risk of developing capsular contracture ten-fold.3-5 Additionally, a wealth of evidence has demonstrated a link between chronic inflammation from bacterial biofilm in the pathogenesis of BIA-ALCL, especially in textured devices where the increased surface area can result in an increased amount of bacterial biofilm.2 A meticulous procedure will help minimize the known and likely sequelae of bacterial attachment including infection and chronic biofilm, which is implicated in the pathogenesis of both capsular contracture and BIA-ALCL. -
Utility of the Digital Rectal Examination in the Emergency Department: a Review
The Journal of Emergency Medicine, Vol. 43, No. 6, pp. 1196–1204, 2012 Published by Elsevier Inc. Printed in the USA 0736-4679/$ - see front matter http://dx.doi.org/10.1016/j.jemermed.2012.06.015 Clinical Reviews UTILITY OF THE DIGITAL RECTAL EXAMINATION IN THE EMERGENCY DEPARTMENT: A REVIEW Chad Kessler, MD, MHPE*† and Stephen J. Bauer, MD† *Department of Emergency Medicine, Jesse Brown VA Medical Center and †University of Illinois-Chicago College of Medicine, Chicago, Illinois Reprint Address: Chad Kessler, MD, MHPE, Department of Emergency Medicine, Jesse Brown Veterans Hospital, 820 S Damen Ave., M/C 111, Chicago, IL 60612 , Abstract—Background: The digital rectal examination abdominal pain and acute appendicitis. Stool obtained by (DRE) has been reflexively performed to evaluate common DRE doesn’t seem to increase the false-positive rate of chief complaints in the Emergency Department without FOBTs, and the DRE correlated moderately well with anal knowing its true utility in diagnosis. Objective: Medical lit- manometric measurements in determining anal sphincter erature databases were searched for the most relevant arti- tone. Published by Elsevier Inc. cles pertaining to: the utility of the DRE in evaluating abdominal pain and acute appendicitis, the false-positive , Keywords—digital rectal; utility; review; Emergency rate of fecal occult blood tests (FOBT) from stool obtained Department; evidence-based medicine by DRE or spontaneous passage, and the correlation be- tween DRE and anal manometry in determining anal tone. Discussion: Sixteen articles met our inclusion criteria; there INTRODUCTION were two for abdominal pain, five for appendicitis, six for anal tone, and three for fecal occult blood. -
Unicompartmental Knee Replacement
This is a repository copy of Unicompartmental Knee Replacement. White Rose Research Online URL for this paper: http://eprints.whiterose.ac.uk/120113/ Version: Accepted Version Article: Takahashi, T, Pandit, HG orcid.org/0000-0001-7392-8561 and Phil, D (2017) Unicompartmental Knee Replacement. Journal of Arthroscopy and Joint Surgery, 4 (2). pp. 55-60. ISSN 0021-8790 https://doi.org/10.1016/j.jajs.2017.08.009 © 2017 International Society for Knowledge for Surgeons on Arthroscopy and Arthroplasty. Published by Elsevier, a division of RELX India, Pvt. Ltd. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ Reuse This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs (CC BY-NC-ND) licence. This licence only allows you to download this work and share it with others as long as you credit the authors, but you can’t change the article in any way or use it commercially. More information and the full terms of the licence here: https://creativecommons.org/licenses/ Takedown If you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing [email protected] including the URL of the record and the reason for the withdrawal request. [email protected] https://eprints.whiterose.ac.uk/ Accepted Manuscript Title: Unicompartmental Knee Replacement Author: Tsuneari Takahashi PII: S2214-9635(17)30041-X DOI: http://dx.doi.org/doi:10.1016/j.jajs.2017.08.009 Reference: JAJS 97 To appear in: Authors: Hemant G. -
The Differences Between ICD-9 and ICD-10
Preparing for the ICD-10 Code Set: Fact Sheet 2 October 1, 2015 Compliance Date Get the Facts to be Compliant Alert: The new ICD-10 compliance date is October 1, 2015. The Differences Between ICD-9 and ICD-10 This is the second fact sheet in a series and is focused on the differences between the ICD-9 and ICD-10 code sets. Collectively, the fact sheets will provide information, guidance, and checklists to assist you with understanding what you need to do to implement the ICD-10 code set. The ICD-10 code sets are not a simple update of the ICD-9 code set. The ICD-10 code sets have fundamental changes in structure and concepts that make them very different from ICD-9. Because of these differences, it is important to develop a preliminary understanding of the changes from ICD-9 to ICD-10. This basic understanding of the differences will then identify more detailed training that will be needed to appropriately use the ICD-10 code sets. In addition, seeing the differences between the code sets will raise awareness of the complexities of converting to the ICD-10 codes. Overall Comparisons of ICD-9 to ICD-10 Issues today with the ICD-9 diagnosis and procedure code sets are addressed in ICD-10. One concern today with ICD-9 is the lack of specificity of the information conveyed in the codes. For example, if a patient is seen for treatment of a burn on the right arm, the ICD-9 diagnosis code does not distinguish that the burn is on the right arm. -
Arthroscopy - Orthoinfo - AAOS 6/10/12 3:40 PM
Arthroscopy - OrthoInfo - AAOS 6/10/12 3:40 PM Copyright 2010 American Academy of Orthopaedic Surgeons Arthroscopy Arthroscopy is a surgical procedure orthopaedic surgeons use to visualize, diagnose, and treat problems inside a joint. The word arthroscopy comes from two Greek words, "arthro" (joint) and "skopein" (to look). The term literally means "to look within the joint." In an arthroscopic examination, an orthopaedic surgeon makes a small incision in the patient's skin and then inserts pencil-sized instruments that contain a small lens and lighting system to magnify and illuminate the structures inside the joint. Light is transmitted through fiber optics to the end of the arthroscope that is inserted into the joint. By attaching the arthroscope to a miniature television camera, the surgeon is able to see the interior of the joint through this very small incision rather than a large incision needed for surgery. The television camera attached to the arthroscope displays the image of the joint on a television screen, allowing the surgeon to look, for example, throughout the knee. This lets the surgeon see the cartilage, ligaments, and under the kneecap. The surgeon can determine the amount or type of injury and then repair Here are parts of the shoulder joint as or correct the problem, if it is necessary. seen trhough an arthroscope: the rotator cuff (RC), the head fo the humerus Why is arthroscopy necessary? (HH), and the biceps tendon (B). Diagnosing joint injuries and disease begins with a thorough medical history, physical examination, and usually X-rays. Additional tests such as magnetic resonance imaging (MRI) or computed tomography (CT) also scan may be needed. -
Scarless Breast Augmentation by Dr
Scarless Breast Augmentation By Dr. Babak Farzaneh Trans-Umbilical Breast Augmenta- naval, allowing for a virtually undetect- volume adjustment for better symmetry. tion (TUBA), more commonly known able scar - even in patients with darker The path for placement shortly as the “Belly Button Procedure”, is the skin tone. This alleviates the need for heals without visible tracts, providing a most innovative and novel approach any incision on the breast. The incision quick return to normal activity. There is in the long history of breast implant is so minimal that some have nicknamed also no need for sharp cutting or burn- surgery. It has been a long time since a the procedure “Band-Aid Breast Aug- ing of the breast tissue, which mini- new approach has allowed a multitude mentation”. (Naval piercing, if present, mizes bleeding and the need for drains; of desirable additions without signifi- is left undisturbed, and the naval ring is post- procedure numbness; and, more cant drawbacks. Endoscopic surgery has sterilized and replaced at the conclusion tangibly, reduces bruising and swelling, revolutionized medicine and surgery, of the surgery.) allowing for shorter and easier recovery. allowing operations to be performed The highly unique instruments In skilled hands, this approach through smaller incisions. Following this specially manufactured for the TUBA allows for natural and predictable results trend, breast augmentation is comple- technique allow me to implement my through a very small, hidden incision. mented immensely by the introduction artistic vision to produce a natural breast As with most unique and highly special- of the TUBA technique. shape with acceptable symmetry, and ized surgical techniques, most surgeons Using a very small incision create the desirable cleavage. -
Acr–Nasci–Sir–Spr Practice Parameter for the Performance and Interpretation of Body Computed Tomography Angiography (Cta)
The American College of Radiology, with more than 30,000 members, is the principal organization of radiologists, radiation oncologists, and clinical medical physicists in the United States. The College is a nonprofit professional society whose primary purposes are to advance the science of radiology, improve radiologic services to the patient, study the socioeconomic aspects of the practice of radiology, and encourage continuing education for radiologists, radiation oncologists, medical physicists, and persons practicing in allied professional fields. The American College of Radiology will periodically define new practice parameters and technical standards for radiologic practice to help advance the science of radiology and to improve the quality of service to patients throughout the United States. Existing practice parameters and technical standards will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner, if indicated. Each practice parameter and technical standard, representing a policy statement by the College, has undergone a thorough consensus process in which it has been subjected to extensive review and approval. The practice parameters and technical standards recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice parameter and technical standard by those entities not providing these services is not authorized. Revised 2021 (Resolution 47)* ACR–NASCI–SIR–SPR PRACTICE PARAMETER FOR THE PERFORMANCE AND INTERPRETATION OF BODY COMPUTED TOMOGRAPHY ANGIOGRAPHY (CTA) PREAMBLE This document is an educational tool designed to assist practitioners in providing appropriate radiologic care for patients. Practice Parameters and Technical Standards are not inflexible rules or requirements of practice and are not intended, nor should they be used, to establish a legal standard of care1. -
Subtalar Joint Version 1.0 Effective June 15, 2021
CLINICAL GUIDELINES CMM-407: Arthroscopy: Subtalar Joint Version 1.0 Effective June 15, 2021 Clinical guidelines for medical necessity review of Comprehensive Musculoskeletal Management Services. © 2021 eviCore healthcare. All rights reserved. Comprehensive Musculoskeletal Management Guidelines V1.0 CMM-407: Arthroscopy: Subtalar Joint Definitions 3 General Guidelines 3 Indications 4 Non-Indications 5 Procedure (CPT®) Codes 5 References 6 ______________________________________________________________________________________________________ ©2021 eviCore healthcare. All Rights Reserved. Page 2 of 6 400 Buckwalter Place Boulevard, Bluffton, SC 29910 (800) 918-8924 www.eviCore.com Comprehensive Musculoskeletal Management Guidelines V1.0 Definitions Red flags indicate comorbidities that require urgent/emergent diagnostic imaging and/or referral for definitive therapy. Clinically meaningful improvement is defined as at least 50% improvement noted on global assessment. General Guidelines Either of the following are considered red flag conditions for subtalar joint arthroscopy: Post-reduction evaluation and management of the subtalar dislocation Septic arthritis in the subtalar joint Although imaging may be normal, prior to subtalar joint arthroscopy, radiographic imaging should be performed and include both of the following: Plain X-rays with one or more views (anteroposterior, lateral, axial, and/or Broden’s) to confirm and differentiate any of the following: Degenerative joint changes Loose bodies Osteochondral lesions Impingement