What is ICD10 and how will it affect me?

Size: px
Start display at page:

Download "What is ICD10 and how will it affect me?"

Transcription

1 What is ICD10 and how will it affect me?

2 Vikki Lindemuth Blue Cross and Blue Shield of Kansas Statewide Specialty Provider Representative

3 Nancy Ratzlaff Billing Director - LifeTeam Critical Care Ambulance Service

4 Tanya Ratzlaff Coding and Documentation Specialist LifeTeam Critical Care Ambulance Service

5 ICD10-CM Documentation Training For use in ALL healthcare settings. Affects the diagnosis coding of everyone covered by HIPAA. Effective 10/01/2015 ICD-10 allows for more accurate reporting of the patient condition & care received.

6 Transition to ICD10 Coding Began 10/01/2015 Codes increased from 14,000 ICD9 codes to 68,000 with ICD10 Will require much more detailed documentation Will result in more claim denials at the front end if documentation is not specific enough Will NOT ask for anything you don t already know, just requires that you document more than ever before

7 Why Switch? Or Why are you doing this to me?????? The United States is one of the last countries in the world to make the switch to ICD10 ICD9 simply cannot do the job any longer ICD-10 allows for more accurate reporting of the patient condition & care received. This is a very DYNAMIC field. It is constantly changing and we must change with it!

8 Documenting for Success! Or How do I get everyone on board with the new requirements? Motivation Incentives Education Punitive Remember that Billing, Admin & Medical are all on the SAME team with the same ultimate goal in mind.

9 Three good reasons why Billing is everyone s responsibility If we don t collect, we can t provide Documentation has a dramatic impact on revenue Patient care does not stop when we deliver the patient to the hospital

10 Top 4 Excuses 1. I m not paid to do billing/that s Billing s job 2. I was too busy/ran too many calls 3. My partner was supposed to do the run report. 4. I am paid to save lives/i am too busy saving lives to bother with paperwork.

11 Sad Facts Without the appropriate documentation we cannot bill anymore than you could treat a patient without the proper medical equipment If you didn t write it down, it didn t happen and all billing MUST be supported by documentation in the event of an audit A happy customer/patient will tell 2-3 friends while an unhappy customer/patient will tell a minimum of 10 people If you save a patient s life but they are forced to declare bankruptcy due to medical bills, which do you think they will remember?

12 Emergent vs. Non-emergent Dispatch driven EMD protocols may apply Response vs Transport

13 ALS vs. BLS Driven by actual care provided What did you do & why?

14 Scheduled vs. Unscheduled Scheduled Transfers Always considered Non-emergent Requested at least 24 hours in advance Requires a valid, signed PCS prior to transport Unscheduled Transfers Still considered non-emergent 48 hr window to obtain PCS

15 Billing Forms Patient Consent /HIPAA Form Physician s Certification Statement (PCS) Advanced Beneficiary Notice (ABN Form) Attestation Form

16 ABN Forms Non-emergent ONLY! Rarely used for ambulance providers Air vs Ground Level of Service Downgrade Not medically reasonable and necessary

17 Billing Forms Cont d. Do I need an ABN? Is this service a covered ambulance benefit? AND Will payment for all or part of this service be denied as not reasonable and necessary? AND Is the patient stable and the transport non-emergent? (the non-emergent status here is not driven by dispatch but rather by the patient s condition) If the answer to ALL 3 of these questions is YES then you need an ABN form.

18 Charts/Run Reports Narratives should always answer the following questions: What is wrong with the patient? When did this happen? Why does he/she need to be transported by ambulance vs. an other means? For inter-facility transfers: Where is the patient being transferred and what care can they receive there that they can t get where they are now? Why #2 are they not going to the closest facility?

19 Charts/Run Reports Cont d. The Three C s of Billing Consistently Conservatively Correctly

20 Charts/Run Reports Cont d. EPCRs Drop-down boxes vs narratives - Technician signatures - Supporting documentation - Date of Service

21 Signature Requirements Must be legible or have name AND credentials printed beneath signature. Applies to: PCR s PCS ABN Consent forms Illegible or missing signatures will likely require an attestation statement.

22 Signatures Cont d Consent Form Must be signed prior to filing claim with Medicare Must document a legitimate, medical reason patient can t sign Must have an acceptable alternative sign if patient can t NOTE: If the patient simply refuses to sign document (& witness) their refusal and then bill the patient.

23 So Let s Talk About ICD-10 Or What s it really going to mean to me?

24 Requirements specific to ICD10 Laterality Type, quality & location of pain Location Type or distance of fall Activity involved in at time of incident

25 ICD10 Requirements Cont d.. External Causes/Contributing Factors MVA Burns Falls

26 ICD10 Requirements Cont d.. Intent Was this an accident Was it intentional (Overdose may now be considered either intentional OR accidental) Work Status Was patient a civilian, military, volunteer or employed

27 In Other Words The question(s) we may want to ask now: Did the patient fall? Where was he when he fell? What was he doing when he fell? Where did he fall from? What did he hurt when he fell? Was he being paid to do what he was doing when he fell? What was he thinking when he fell (just kidding)

28 ICD10 Requirements Cont d.. Glasgow Coma Scale (GCS) All unconscious or altered patients must include a GCS Must indicate level of response or total score Who recorded it When & where it was recorded If a Hospital to Hospital transfer & you are recording their GCS be sure to indicate origin.

29 Let s put it all together Cardiac Patient Patient was admitted to ABC Hospital yesterday for complaint of palpitations and chest pain. During Cath procedure the echo showed a blockage that the doctor felt needed more specialized care. It was determined the patient should be transported to XYZ Hospital for further specialized cardiac care not available at ABC Hospital.

30 What s Missing? Doesn t state what type of chest pain the patient had been experiencing. Doesn t state if the patient is still having chest pain or if pain meds were given. Doesn t state what kind of advanced care he was being transferred for i.e. CABG, Stent etc. Doesn t state the age or GENDER of the patient! Action Needed: This is a poor narrative & really should be returned to the crew for correction via an addendum. Note: This claim may be denied for medical necessity as it is not documented if the patient was still having chest pain, only that he had it earlier.

31 Fall Victim Responded to XYZ Nursing Home for report of elderly fall victim. On arrival found 80 YOF patient in bed confused and agitated. Patient voiced no complaints. Staff states patient fell in hallway landing on her hip. Staff assisted patient back to her bed & called for EMS. Assessed patient and found pain to hip but no obvious deformity. Moved patient to cot & transported to hospital. IV attempted without success. Patient released to ER.

32 What s missing? Laterality Mentions only pain to hip. Doesn t say which hip. Type of fall Doesn t say if she fell from a standing position, out of bed, out of her wheelchair or off the roof! Baseline Doesn t mention patient s normal mental status. We don t know if confusion/agitation is normal i.e. Alzheimer s or could she have struck her head when she fell.

33 Unresponsive Patient EMS dispatched to the corner of Main & South St. for unconscious person. Upon arrival Law Enforcement stated they found patient lying in yard, unconscious with a bloody nose & strong odor of ETOH. Friends of patient told Law Enforcement that he d been in a bar fight earlier that evening and decided to walk home. Friends state it had been approximately 3 hours before they came to check on him, found him in current condition and called Maintained c-spine, secured patient to spine board & moved to unit. Patient remained unresponsive throughout transport. Patient transported to ABC Hospital ED in above condition.

34 What s missing? Location No location is given for where the patient was found. Was it in the yard of a private residence or not. Was it his home or a neighbor s? GCS No documented GCS given

35 MVA (Motorcycle) Patient is a 16 yr old male involved in a motorcycle vs deer at approximately 70 MPH. Patient was ejected from motorcycle and found lying in field. Patient s injuries include C1/C2 fractures, left clavicle fracture, right tension pneumothorax (chest tube inserted), pelvic fracture and small abrasions. Patient was brought to local ED by ABC County EMS and is currently being transported to XYZ Hospital for level 1 trauma services including trauma surgeon, orthopedics, pediatrics, neurology, neuro-surgeon, pulmonary and rehabilitation services.

36 What s missing Location Doesn t say where the MVA occurred (highway, residential street, dirt road etc.) Helmet Doesn t say if patient was wearing a helmet Type of FX Burst, Arch etc. (Since this is a Hospital to Hospital transfer you MIGHT know this information but you would really have to be on your toes & ASK questions of the doctor)

37 In Conclusion. Documentation has always been important but now more than ever. Details are critical! Record everything you see & hear. Do NOT delay patient care! Patients before Paper! BE KIND TO YOUR BILLER(S) AND REMEMBER YOU ARE ALL ON THE SAME TEAM!

Objectives. Emergency Medicine Risk Factors

Objectives. Emergency Medicine Risk Factors The Uniqueness of Emergency Medicine Risk Management W. Peter Vellman, MD, FACEP Serio Physician Management, LLC Littleton, CO Objectives Recognize key areas impacting the provision of emergency medical

More information

MEDICAL TRANSPORT PERSONNEL

MEDICAL TRANSPORT PERSONNEL MEDICAL TRANSPORT PERSONNEL SCOPE: All AMR HoldCo, Inc. and its subsidiaries (the Company ) colleagues. For purposes of this policy, all references to colleague or colleagues include temporary, part-time

More information

EMTALA Talking Points for Patients Who Are Inpatients and Transferring to Another Hospital

EMTALA Talking Points for Patients Who Are Inpatients and Transferring to Another Hospital EMTALA Talking Points for Patients Who Are Inpatients and Transferring to Another Hospital The movement of a patient from one hospital to another is a transfer (ie: NHRMC to Cherry Hospital, NHRMC to Walter

More information

EMS Lawsuits and Documentation Issues

EMS Lawsuits and Documentation Issues EMS DOCUMENTATION Case Studies, Compliance and More! Disclaimer The consultant is not an attorney and does not provide legal advice. The information contained in this presentation is not intended and should

More information

If you do not have a chart already created Click Create blank chart to create a new chart. The Dispatch screen will appear

If you do not have a chart already created Click Create blank chart to create a new chart. The Dispatch screen will appear Let s Get Started!!! Click on incomplete chart to finish a previously started chart. Example of Patient Records Page If you do not have a chart already created Click Create blank chart to create a new

More information

California Ambulance Association September Presented by: Medicare Part B Provider Outreach and Education

California Ambulance Association September Presented by: Medicare Part B Provider Outreach and Education California Ambulance Association September 2017 Presented by: Medicare Part B Provider Outreach and Education Disclaimer This information release is the property of Noridian Healthcare Solutions, LLC.

More information

Emergency Medical Services Program

Emergency Medical Services Program County of Santa Cruz HEALTH SERVICES AGENCY 1080 EMELINE AVENUE, SANTA CRUZ, CA 95060 (831) 454-4120 FAX: (831) 454-4272 TDD: (831) 454-4123 EMERGENCY MEDICAL SERVICES PROGRAM Policy No. 7000 Reviewed

More information

Hospital Transfer Orders

Hospital Transfer Orders Date Hospital Transfer Orders Time 1. Transfer Patient to: [ ] Susquehanna Health [ ] Geisinger Medical Center [ ] Other: 2. Accepted by: Dr 3. Reason for transfer: 4. Mode of Transfer: [ ] BLS [ ] ACLS:

More information

EMTALA Talking Points for Patients Who Are Inpatients and Transferring to Another Hospital

EMTALA Talking Points for Patients Who Are Inpatients and Transferring to Another Hospital EMTALA Talking Points for Patients Who Are Inpatients and Transferring to Another Hospital The movement of a patient from one hospital to another is a transfer (ie: NHRMC to Cherry Hospital, NHRMC to Walter

More information

May Family Chiropractic Health Information and Health History Patient Name: Gender: Male Female

May Family Chiropractic Health Information and Health History Patient Name: Gender: Male Female 1 Health Information and Health History Patient Name: Gender: Male Female Marital Status: (Circle one) M S D W Other: Date of Birth / / Spouse Name: How many children: Patient Social Security Number: -

More information

WESTCHESTER REGIONAL

WESTCHESTER REGIONAL WESTCHESTER REGIONAL EMERGENCY MEDICAL SERVICES COUNCIL POLICY STATEMENT Supersedes/Updates: New Policy No. 11-02 Date: February 8, 2011 Re: EMS System Resource Utilization Pg(s): 5 INTRODUCTION The Westchester

More information

CENTRAL CALIFORNIA EMERGENCY MEDICAL SERVICES

CENTRAL CALIFORNIA EMERGENCY MEDICAL SERVICES CENTRAL CALIFORNIA EMERGENCY MEDICAL SERVICES Manual Subject Emergency Medical Services Administrative Policies and Procedures First Responder Prehospital Care Report - BLS Policy Page 1 of 13 References

More information

HOSPITALS TO ENTER PATIENTS INTO THE

HOSPITALS TO ENTER PATIENTS INTO THE PATIENT CRITERIA FOR HOSPITALS TO ENTER PATIENTS INTO THE TRAUMA SYSTEM 1 THE ALABAMA TRAUMA SYSTEM IS UNIQUE NOT ONLY ARE THE TRAUMA HOSPITALS INSPECTED AND CERTIFIED BUT ALSO THEIR CRITICAL RESOURCES

More information

Medicare Coverage of Ambulance Services. CENTERS for MEDICARE & MEDICAID SERVICES

Medicare Coverage of Ambulance Services. CENTERS for MEDICARE & MEDICAID SERVICES CENTERS for MEDICARE & MEDICAID SERVICES Medicare Coverage of Ambulance Services This official government booklet explains: When Medicare helps cover ambulance services What you pay What Medicare pays

More information

Ambulance Provider Compliance Summary for EMERGENCY RESPONSE Compliance Criteria

Ambulance Provider Compliance Summary for EMERGENCY RESPONSE Compliance Criteria Ambulance Provider Compliance Summary for EMERGENCY RESPONSE Compliance Criteria Date: April 23, 2012 Source Information: Medicare Policy Purpose The United Mine Workers of America Health and Retirement

More information

RECEIVING HOSPITALS. APPROVED: EMS Administrator

RECEIVING HOSPITALS. APPROVED: EMS Administrator Page 1 RECEIVING HOSPITALS APPROVED: EMS Administrator EMS Medical Director Assistant EMS Medical Director 1. Purpose: To provide paramedics and EMT-1's with information and guidance about the capability

More information

Chapter 1. Emergency Medical Care Systems, Research, and Public Health. Copyright 2010 by Pearson Education, Inc. All rights reserved.

Chapter 1. Emergency Medical Care Systems, Research, and Public Health. Copyright 2010 by Pearson Education, Inc. All rights reserved. Chapter 1 Emergency Medical Care Systems, Research, and Public Health Prehospital Emergency Care, Ninth Edition Joseph J. Mistovich Keith J. Karren Copyright 2010 by Pearson Education, Inc. All rights

More information

Oakland County Medical Control Authority System Protocols Transportation Protocol Section Transportation Protocol.

Oakland County Medical Control Authority System Protocols Transportation Protocol Section Transportation Protocol. Purpose: To define the decision-making process to be followed by EMS personnel in order to ensure patients are transported to a facility appropriate for their condition. I. Transportation Procedure A.

More information

Ambulance Services: New Policy and Review Updates (A/B) July 11, 2018

Ambulance Services: New Policy and Review Updates (A/B) July 11, 2018 Ambulance Services: New Policy and Review Updates (A/B) July 11, 2018 Presented By First Coast Service Options, Inc. Provider Outreach & Education Robert Lewis, CPC Provider Relations Representative 1

More information

Title: ED Management of Trauma Patient Protocol

Title: ED Management of Trauma Patient Protocol Title: ED Management of Trauma Patient Protocol Document Category: Clinical Document Type: Protocol Department/Committee Owner: Emergency Department Original Date: August 2009 Approver(s) last review:

More information

ADC ED/TRAUMA POLICY AND PROCEDURE Policy 221. I. Title Trauma team Activation Protocol/Roles & Responsibilities of the Trauma Team

ADC ED/TRAUMA POLICY AND PROCEDURE Policy 221. I. Title Trauma team Activation Protocol/Roles & Responsibilities of the Trauma Team Section: ADC Trauma ADC ED/TRAUMA POLICY AND PROCEDURE Policy 221 Subject: Trauma Team Activation Protocol/Roles & Responsibilities of the Trauma Team Trauma Coordinator UTMB respects the diverse culture

More information

Hesch Institute Jerry Hesch, MHS, PT, DPT(s)

Hesch Institute Jerry Hesch, MHS, PT, DPT(s) Jerry Hesch, MHS, PT, DPT(s) 1609 Silver Slipper Avenue www.heschinstitute.com Las Vegas, Nevada 89002 email: HeschInstitute@yahoo.com Phone: (702) 558-6011 8am-5pm PST (702) 565-6027 fax To future Out-of-Town

More information

Nassau Regional Medical Advisory Committee

Nassau Regional Medical Advisory Committee Nassau Regional Medical Advisory Committee Advisories Advisory# Subject Issued Effective 07-02.1 BLS Assisted Medications 2/7/07 2/7/07 07-06.1 BLS Use of Pulse Oximeters 6/6/07 6/6/07 08-12.1 Incident

More information

Medicare Coverage of Ambulance Services. CENTERS for MEDICARE & MEDICAID SERVICES

Medicare Coverage of Ambulance Services. CENTERS for MEDICARE & MEDICAID SERVICES CENTERS for MEDICARE & MEDICAID SERVICES Medicare Coverage of Ambulance Services This official government booklet explains: When Medicare helps cover ambulance services What you pay What Medicare pays

More information

BCEAA Instructional Guide for EMS Charts Data Entry. Example of Home Page

BCEAA Instructional Guide for EMS Charts Data Entry. Example of Home Page BCEAA Instructional Guide for EMS Charts Data Entry Go to web site: www.emscharts.com Login: first and last name, no caps, no spaces Password: password you selected Click Login Button Example of Home Page

More information

POLICIES AND PROCEDURES

POLICIES AND PROCEDURES POLICIES AND PROCEDURES POLICY: 553.25 TITLE: EFFECTIVE: 4/13/17 REVIEW: 4/2022 SUPERCEDES: APPROVAL SIGNATURES ON FILE IN EMS OFFICE PAGE: 1 of 5 I. AUTHORITY Division 2.5, California Health and Safety

More information

Chapter 1. Learning Objectives. Learning Objectives 9/11/2012. Introduction to EMS Systems

Chapter 1. Learning Objectives. Learning Objectives 9/11/2012. Introduction to EMS Systems Chapter 1 Introduction to EMS Systems Learning Objectives Define the attributes of emergency medical services (EMS) systems List 14 attributes of a functioning EMS system Differentiate the roles and responsibilities

More information

UNIQUE CONSIDERATIONS IN SPECIALTY AND CRITICAL CARE TRANSPORTS Anthony W. Minge, MBA Fitch & Associates, LLC

UNIQUE CONSIDERATIONS IN SPECIALTY AND CRITICAL CARE TRANSPORTS Anthony W. Minge, MBA Fitch & Associates, LLC UNIQUE CONSIDERATIONS IN SPECIALTY AND CRITICAL CARE TRANSPORTS Anthony W. Minge, MBA Fitch & Associates, LLC THERE ARE TEXTBOOKS 1 COURSES CONFERENCES 2 CERTIFICATIONS AND ASSOCIATIONS 3 SPECIALTY CARE

More information

Dynamic Documentation: The Link Between Documentation and Billing

Dynamic Documentation: The Link Between Documentation and Billing North Carolina EMS Administrators Dynamic Documentation: The Link Between Documentation and Billing presented by Steve Wirth, Esq., EMT-P swirth@pwwemslaw.com 5010 East Trindle Road, Suite 202 Mechanicsburg,

More information

News SEPTEMBER. Hospital Outpatient Quality Reporting Program. Support Contractor

News SEPTEMBER. Hospital Outpatient Quality Reporting Program. Support Contractor Volume 1, Issue 4 Hospital Outpatient Quality Reporting Program Support Contractor News SEPTEMBER 2011 In This Issue... Emergency Department Arrival and Departure Times Page 2 Hospital OQR Benchmarks Page

More information

HealthStream Regulatory Script

HealthStream Regulatory Script HealthStream Regulatory Script [EMTALA] Version: [May 2005] Lesson 1: Introduction Lesson 2: History and Enforcement Lesson 3: Medical Screening Lesson 4: Stabilizing Care Lesson 5: Appropriate Transfer

More information

Advanced Directive For Health Care

Advanced Directive For Health Care Advanced Directive For Health Care Your Right to Make Your Own Decisions About Medical Care The best source for more information about Advanced Directive is your attorney. Patients of Helen Keller Hospital

More information

PARAMEDIC STUDENT FIELD INTERNSHIP GUIDE

PARAMEDIC STUDENT FIELD INTERNSHIP GUIDE Through field experience in the emergency ambulance, the paramedic student will develop a more comprehensive understanding of the pathophysiology of disease and trauma, rationale for treatments rendered,

More information

interventional cardiac facility (see Appendix 2). Notify receiving hospital, as soon as possible of impending arrival of the patient and give ETA.

interventional cardiac facility (see Appendix 2). Notify receiving hospital, as soon as possible of impending arrival of the patient and give ETA. Page 1 of 9 Purpose: To define the decision-making process to be followed by EMS personnel in order to ensure patients are transported to a facility appropriate for their condition. I. Transportation Procedure

More information

0031 MESA COUNTY EMS SYSTEM PROTOCOLS: PCRs

0031 MESA COUNTY EMS SYSTEM PROTOCOLS: PCRs PATIENT CARE REPORTS POLICY 1. At least one provider will complete and file a patient care report (PCR), and any required data reports, for each patient contact. 2. If the author of the PCR is not the

More information

Just Another Closed Head Injury Anatomy of a Lawsuit. Rob Canan RN EMTP

Just Another Closed Head Injury Anatomy of a Lawsuit. Rob Canan RN EMTP Just Another Closed Head Injury Anatomy of a Lawsuit Rob Canan RN EMTP Objectives: 1. Scare you 2. Challenge you 3. Help you see the goal Official Objectives: Understand the components of negligence Understand

More information

Legal vs. Ethical. Scope of Practice. Standard of Care 11/18/2010. Can something Illegal be ethical? Do ethics vary?

Legal vs. Ethical. Scope of Practice. Standard of Care 11/18/2010. Can something Illegal be ethical? Do ethics vary? Legal vs. Ethical Can something legal be unethical? Can something Illegal be ethical? Do ethics vary? Legal duties: Provide for the well being of the patient by rendering necessary care interventions outlined

More information

Introduction to the EMS System

Introduction to the EMS System Because of permissions issues, some material (e.g., photographs) has been removed from this chapter, though reference to it may occur in the text. The omitted content was intentionally deleted and is not

More information

Inpatient Rehabilitation Program Information

Inpatient Rehabilitation Program Information Inpatient Rehabilitation Program Information The Inpatient Rehabilitation Program at TIRR Memorial Hermann The Woodlands has a team of physicians, therapists, nurses, a case manager, neuropsychologist,

More information

Medical Directive. Credentialed EMT-Paramedic. Credentialed EMD

Medical Directive. Credentialed EMT-Paramedic. Credentialed EMD Medical Directive Directive Number 11-05 Credentialed System Responder Information Publish Date 22 July 2011 Credentialed EMT Information Effective Date 01 August 2011 Credentialed EMT-Intermediate Information

More information

The Most Common Billing Mistakes for PA Services

The Most Common Billing Mistakes for PA Services Transcript Details This is a transcript of an educational program accessible on the ReachMD network. Details about the program and additional media formats for the program are accessible by visiting: https://reachmd.com/programs/clinicians-roundtable/the-most-common-billing-mistakes-for-paservices/3518/

More information

POLST Discussions Doing it Better. Clinical Update in Geriatric Medicine. Judith S. Black, MD, MHA. POLST Overview. Faculty Disclosure PART I

POLST Discussions Doing it Better. Clinical Update in Geriatric Medicine. Judith S. Black, MD, MHA. POLST Overview. Faculty Disclosure PART I Faculty Disclosure POLST Discussions Doing it Better Clinical Update in Geriatric Medicine Dr. Black discloses that she is employed by Allegheny Health Network and is an executive committee member of the

More information

Presented for the AAPC National Conference April 4, 2011

Presented for the AAPC National Conference April 4, 2011 Presented for the AAPC National Conference April 4, 2011 Penny Osmon, BA, CPC, CPC-I, CHC, PCS Director of Educational Strategies - Wisconsin Medical Society penny.osmon@wismed.org CPT codes, descriptions

More information

Documenting & Coding for Compliance

Documenting & Coding for Compliance Documenting & Coding for Compliance Department of Family and Community Medicine October 17, 2012 UNMMG Compliance Documentation Documentation Why is it important? Enables the physician and other health

More information

Ethics in EMS. Presented by: Dwayne Cottel ACP Jeff Conway ACP, LLB

Ethics in EMS. Presented by: Dwayne Cottel ACP Jeff Conway ACP, LLB Ethics in EMS Presented by: Dwayne Cottel ACP Jeff Conway ACP, LLB Objectives Define Ethics, Morals and Ethical Dilemmas Review of Legal and Ethical Accountability in EMS Describe common Ethical Dilemmas

More information

DIRECTIONS FOR COMPLETING THE E.M.S. RUN REPORT

DIRECTIONS FOR COMPLETING THE E.M.S. RUN REPORT PAGE ONE HIPPA FORM LEFT WITH PATIENT Circle YES or NO PAGE OF. (UTILIZING MORE THAN ONE CHART) If using one form to document care this box should read Page 1 of 1. If using more than one form for the

More information

9.1.1 Medicaid Managed Care Enrollment Prior Authorization Emergency Ambulance Services

9.1.1 Medicaid Managed Care Enrollment Prior Authorization Emergency Ambulance Services Section 9Ambulance 9 9.1 Enrollment........................................................ 9-2 9.1.1 Medicaid Managed Care Enrollment................................. 9-2 9.2 Reimbursement....................................................

More information

Residential Assisted Living Procedure Development

Residential Assisted Living Procedure Development Revised: 04-10-17 Residential Assisted Living Procedure Development WHEN TO CALL 911 POCATELLO FIRE DEPARTMENT 408 E. Whitman, Pocatello, Idaho, 83201 Revised: 04-10-17 Table of Contents Purpose of this

More information

Refusal Protocol. Christopher J. Bosche, MD FACEP Medical Director Mehlville Fire Protection District

Refusal Protocol. Christopher J. Bosche, MD FACEP Medical Director Mehlville Fire Protection District Refusal Protocol Christopher J. Bosche, MD FACEP Medical Director Mehlville Fire Protection District I am not a lawyer Advice to Me The law is vague for a reason. ex: Appropriate medical screening exam

More information

CITY OF VIRGINIA BEACH DEPARTMENT OF EMERGENCY MEDICAL SERVICES

CITY OF VIRGINIA BEACH DEPARTMENT OF EMERGENCY MEDICAL SERVICES DEPARTMENT OF EMERGENCY MEDICAL SERVICES (757)-385-1999 FAX (757) 431-3019 477 VIKING DRIVE, SUITE 130 VIRGINIA BEACH, VA 23452 CITY OF VIRGINIA BEACH DEPARTMENT OF EMERGENCY MEDICAL SERVICES OPERATIONAL

More information

SAN FRANCISCO EMERGENCY MEDICAL SERVICES AGENCY DOCUMENTATION, EVALUATION AND NON-TRANSPORTS

SAN FRANCISCO EMERGENCY MEDICAL SERVICES AGENCY DOCUMENTATION, EVALUATION AND NON-TRANSPORTS SAN FRANCISCO EMERGENCY MEDICAL SERVICES AGENCY DOCUMENTATION, EVALUATION AND NON-TRANSPORTS Policy Reference No.: 4040 Review Date: February 1, 2011 Supersedes: August 1, 2008 TABLE OF CONTENTS I. PURPOSE

More information

Modifier -25 Significant, Separately Identifiable E/M Service

Modifier -25 Significant, Separately Identifiable E/M Service Manual: Policy Title: Reimbursement Policy Modifier -25 Significant, Separately Identifiable E/M Service Section: Modifiers Subsection: None Date of Origin: 1/1/2000 Policy Number: RPM028 Last Updated:

More information

MOUNTAIN-VALLEY EMS AGENCY POLICY: POLICIES AND PROCEDURES TITLE: ALS or LALS EMERGENCY MEDICAL RESPONDER AUTHORIZATION

MOUNTAIN-VALLEY EMS AGENCY POLICY: POLICIES AND PROCEDURES TITLE: ALS or LALS EMERGENCY MEDICAL RESPONDER AUTHORIZATION POLICY: 412.00 POLICIES AND PROCEDURES TITLE: ALS or LALS EMERGENCY MEDICAL APPROVED: Signature On File In EMS Office EFFECTIVE DATE: 1/1/2016 Executive Director REVISED: Signature On File In EMS Office

More information

LIVING WILL AND ADVANCE DIRECTIVES. Exercise Your Right: Put Your Healthcare Decisions in Writing

LIVING WILL AND ADVANCE DIRECTIVES. Exercise Your Right: Put Your Healthcare Decisions in Writing LIVING WILL AND ADVANCE DIRECTIVES Exercise Your Right: Put Your Healthcare Decisions in Writing Maryland Advance Directive A Message from the Maryland Attorney General Adults can decide for themselves

More information

LIVING WILL AND ADVANCE DIRECTIVES. Exercise Your Right: Put Your Healthcare Decisions in Writing.

LIVING WILL AND ADVANCE DIRECTIVES. Exercise Your Right: Put Your Healthcare Decisions in Writing. LIVING WILL AND ADVANCE DIRECTIVES Exercise Your Right: Put Your Healthcare Decisions in Writing. Maryland Advance Directive A Message from the Maryland Attorney General Adults can decide for themselves

More information

CASEY COUNTY HOSPITAL EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT ( EMTALA )

CASEY COUNTY HOSPITAL EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT ( EMTALA ) CASEY COUNTY HOSPITAL EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT ( EMTALA ) SCOPE: This Policy and Procedure applies to the hospital and rural health clinics including Casey County Primary Care and

More information

Trauma Type of Service: 911 Response (Scene) Dest. Reason: Closest Facility (none. Odometer End: Patients Txed from Amb: Protocols Used:

Trauma Type of Service: 911 Response (Scene) Dest. Reason: Closest Facility (none. Odometer End: Patients Txed from Amb: Protocols Used: Vehicle: PCM10 Call Sign 224 CREW INFO Med/Trauma: Call Type: RESPONSE INFO Run Number: Date of Service: Patient Name: 23605 DISPOSITION 04/19/2016 william raun TIMES Trauma Type of Service: 911 Response

More information

Declining Emergency Medical Care or Transport

Declining Emergency Medical Care or Transport I. PURPOSE This policy defines the requirements for patients with decision making capacity to decline medical care/ This policy is applicable to all EMS providers. Providers should recognize these situations

More information

SNF Determinations of Non-Coverage Denial Letters, ABNs & Expedited Determinations

SNF Determinations of Non-Coverage Denial Letters, ABNs & Expedited Determinations SNF Determinations of Non-Coverage Denial Letters, ABNs & Expedited Determinations for clients of: www.teamtsi.com 800.765.8998 Content developed and presented by: 3030 N. Rocky Point Drive, Suite 240

More information

Presented by: Arlene Maxim, RN-Founder A.D. Maxim Consulting, LLC.

Presented by: Arlene Maxim, RN-Founder A.D. Maxim Consulting, LLC. Presented by: Arlene Maxim, RN-Founder A.D. Maxim Consulting, LLC. On January 24, 2013, the U. S. District Court for the District of Vermont approved a settlement agreement in the case of Jimmo v. Sebelius,

More information

Reimbursement Policy Subject: Present on Admission Indicator for Health Care-Acquired Conditions 01/01/14 Administration 05/02/16

Reimbursement Policy Subject: Present on Admission Indicator for Health Care-Acquired Conditions 01/01/14 Administration 05/02/16 Anthem BlueCross BlueShield Medicaid Reimbursement Policy Subject: Committee Approval Obtained: Effective Date: 01/01/14 Section: Administration 05/02/16 ***** The most current version of our reimbursement

More information

Getting Started with OIG Compliance

Getting Started with OIG Compliance Getting Started with OIG Compliance Kathy Mills Chang, MCS-P CCPC Do You Feel Like This? Or This? Does Your Business Deserve the Same Focus Your Patients Do? How This Training Will Protect You! Stay within

More information

BCBSTX Admission Type Definitions Grouper Version 33

BCBSTX Admission Type Definitions Grouper Version 33 Shared NPI between Acute Care and Specialty Provider numbers NPI is not shared between Acute Care and Specialty Provider numbers Residential Treatment Center, Eating Disorder Inpatient DRG 876, 880-887

More information

SAN FRANCISCO EMERGENCY MEDICAL SERVICES AGENCY DESTINATION POLICY

SAN FRANCISCO EMERGENCY MEDICAL SERVICES AGENCY DESTINATION POLICY SAN FRANCISCO EMERGENCY MEDICAL SERVICES AGENCY I. PURPOSE DESTINATION POLICY Policy Reference No.: 5000 Supersedes: February 1, 2015 A. To identify the approved ambulance-transport destinations for the

More information

How to Survive Audits By Accurately Documenting Medical Necessity. Presented by Jennifer Warfield, BSN, HCS-D, COS-C Education Director, PPS Plus

How to Survive Audits By Accurately Documenting Medical Necessity. Presented by Jennifer Warfield, BSN, HCS-D, COS-C Education Director, PPS Plus How to Survive Audits By Accurately Documenting Medical Necessity Presented by Jennifer Warfield, BSN, HCS-D, COS-C Education Director, PPS Plus How to Survive Audits By Accurately Documenting Medical

More information

Field Triage Decision Scheme: The National Trauma Triage Protocol

Field Triage Decision Scheme: The National Trauma Triage Protocol Field Triage Decision Scheme: The National Trauma Triage Protocol U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Injury Prevention and Control

More information

EMERGENCY MEDICINE CLINICAL ROTATION COMPETENCY BASED CURRICULUM

EMERGENCY MEDICINE CLINICAL ROTATION COMPETENCY BASED CURRICULUM CLINICAL ROTATION COMPETENCY BASED CURRICULUM EMERGENCY MEDICINE During the third year of the curriculum, students expand their knowledge of emergent conditions and gain the ability to apply the knowledge

More information

Reimbursement Policy Subject: Present on Admission Indicator for Health Care-Acquired Conditions 04/01/14 Administration 05/02/16

Reimbursement Policy Subject: Present on Admission Indicator for Health Care-Acquired Conditions 04/01/14 Administration 05/02/16 Reimbursement Policy Subject: Present on Admission Indicator for Health Care-Acquired Conditions Committee Approval Obtained: Effective Date: 04/01/14 Section: Administration 05/02/16 ***** The most current

More information

CITY OF VIRGINIA BEACH DEPARTMENT OF EMERGENCY MEDICAL SERVICES

CITY OF VIRGINIA BEACH DEPARTMENT OF EMERGENCY MEDICAL SERVICES DEPART MENT OF EMERGENCY MEDICAL SERVICES (757)-426-5005 FAX (757) 425-7864 1917 ARCTIC AVENUE VIRGINIA BEACH, VA 23451 CITY OF VIRGINIA BEACH DEPARTMENT OF EMERGENCY MEDICAL SERVICES OPERATIONAL RESPONSE

More information

The following policy was adopted by the San Luis Obispo County EMS Agency and will become effective March 1, 2012 at 0800 hours.

The following policy was adopted by the San Luis Obispo County EMS Agency and will become effective March 1, 2012 at 0800 hours. SLO County Emergency Medical Services Agency Bulletin 2012-02 PLEASE POST New Trauma System Policies and Procedures February 9, 2012 To All SLO County EMS Providers and Training Institutions: The following

More information

(A Guide to Consumer Rights under HIPAA)

(A Guide to Consumer Rights under HIPAA) Your Medical Record Rights in Delaware (A Guide to Consumer Rights under HIPAA) JOY PRITTS, JD MARISA GUEVARA HEALTH POLICY INSTITUTE GEORGETOWN UNIVERSITY Your Medical Record Rights in Delaware (A Guide

More information

Inpatient Rehabilitation Program Information

Inpatient Rehabilitation Program Information Inpatient Rehabilitation Program Information The Inpatient Rehabilitation Program at TIRR Memorial Hermann-Greater Heights has a team of physicians, therapists, nurses, a case manager, neuropsychologist,

More information

ICD-10 STARTS WITH PROVIDERS

ICD-10 STARTS WITH PROVIDERS ICD-10 STARTS WITH PROVIDERS Steve Arter, CPC Managing Member Hawaii, LLC 765 Amana Street, Suite 302, Honolulu, HI 96814 hcchhawaii.com 808.947.2633 THANK YOU FOR JOINING US WHO IS HERE TODAY HEALTHCARE

More information

Quality of Care in Long-Term Care Facilities

Quality of Care in Long-Term Care Facilities CHAPTER EIGHT Quality of Care in Long-Term Care Facilities Comprehensive information about the laws and practices of California s long-term care facilities is available in the Nursing Home Companion and

More information

Long Term Care Hospital Clinical Coverage Policy No: 2A-2 Services (LTCH) Amended Date: October 1, Table of Contents

Long Term Care Hospital Clinical Coverage Policy No: 2A-2 Services (LTCH) Amended Date: October 1, Table of Contents Long Term Care Hospital Clinical Coverage Policy No: 2A-2 Services (LTCH) Table of Contents 1.0 Description of the Procedure, Product, or Service... 1 1.1 Definitions... 1 2.0 Eligibility Requirements...

More information

EMTALA. Federal Law and the Medical Staff. Shaheed Koury, MD, MBA, FACEP SVP & Chief Medical Officer Quorum Health

EMTALA. Federal Law and the Medical Staff. Shaheed Koury, MD, MBA, FACEP SVP & Chief Medical Officer Quorum Health EMTALA Federal Law and the Medical Staff Shaheed Koury, MD, MBA, FACEP SVP & Chief Medical Officer Quorum Health Objectives Review EMTALA Law Clarify Key Terms Define Hospital and Physician Responsibilities

More information

Preventive and Sick Visits Same Day. Objectives

Preventive and Sick Visits Same Day. Objectives Preventive and Sick Visits Same Day Brenda Chidester-Palmer CPC, CPC-I, CEMC, CCS-P AAPC National Conference June 8, 2010 Nashville, Tennessee Objectives Preventive visit definition Services included in

More information

Increase Your Bottom Line by Eliminating Physician Driven Denials. Olakunle Olaniyan MD President Case Management Covenants

Increase Your Bottom Line by Eliminating Physician Driven Denials. Olakunle Olaniyan MD President Case Management Covenants Increase Your Bottom Line by Eliminating Physician Driven Denials Olakunle Olaniyan MD President Case Management Covenants Escalating cost of care Physician Driven Denials Denial drivers Working with physicians

More information

WELCOME TO THE PEDIATRIC SURGERY SERVICE

WELCOME TO THE PEDIATRIC SURGERY SERVICE We re happy to welcome you to the Pediatric Surgery team. If you haven t done much pediatrics, sick children can be a bit intimidating but you will quickly discover a few things: it s easy to recognize

More information

My Voice - My Choice

My Voice - My Choice My Voice - My Choice My Advance Directive Table of Contents Introduction... 2 Words You Need to Know... 3 Legal Document... 4 Helpful Information about your Advance Directive... 10 What makes your life

More information

The Future of Emergency Care in the United States Health System. Regional Dissemination Workshop New Orleans, LA November 2, 2006

The Future of Emergency Care in the United States Health System. Regional Dissemination Workshop New Orleans, LA November 2, 2006 The Future of Emergency Care in the United States Health System Regional Dissemination Workshop New Orleans, LA November 2, 2006 Sponsors Josiah Macy, Jr. Foundation Agency for Healthcare Research and

More information

Member Handbook. HealthChoices Allegheny County

Member Handbook. HealthChoices Allegheny County Member Handbook HealthChoices Allegheny County Contents Welcome to Community Care! 3 About Community Care 6 Behavioral Health Services for HealthChoices Members 9 Getting Help 11 Your Rights and Responsibilities

More information

Running head: JOURNAL THREE 1

Running head: JOURNAL THREE 1 Running head: JOURNAL THREE 1 Journal Three Chelsea Youngman Kent State University - Stark JOURNAL THREE 2 120 Hour Journal Part I: Integration of Leadership and Management Magnet Status The Magnet Recognition

More information

Colorado CPR Directives. Colorado Department of Public Health and Environment Emergency Medical and Trauma Services Section

Colorado CPR Directives. Colorado Department of Public Health and Environment Emergency Medical and Trauma Services Section Colorado CPR Directives Colorado Department of Public Health and Environment Emergency Medical and Trauma Services Section Course Objectives Upon completion of this class, you should be able to: Identify

More information

6/14/2017. Evaluation and Management Coding. Jeffrey D. Lehrman, DPM, FASPS, MAPWCA

6/14/2017. Evaluation and Management Coding. Jeffrey D. Lehrman, DPM, FASPS, MAPWCA Evaluation and Management Coding Jeffrey D. Lehrman, DPM, FASPS, MAPWCA APMA Coding Committee APMA MACRA Task Force Expert Panelist, Codingline Fellow, American Academy of Podiatric Practice Management

More information

ICD-10 Awareness Training International Classification of Diseases Tenth Revision

ICD-10 Awareness Training International Classification of Diseases Tenth Revision ICD-10 Awareness Training International Classification of Diseases Tenth Revision Course Objective This course will provide basic awareness training on ICD-10, BMS planning and implementation phases, and

More information

Emergency Medical Services for Children

Emergency Medical Services for Children Emergency Medical Services for Children EMSC Program Background Mission of the Emergency Medical Services for Children Program: to ensure state-of-the-art emergency medical care for ill or injured children

More information

Wadsworth-Rittman Hospital EMS Protocol

Wadsworth-Rittman Hospital EMS Protocol Wadsworth-Rittman Hospital EMS Protocol Prehospital Advanced Life Support Protocol Revised: May 2004 Version 04.1 DISCLAIMER Every attempt has been made to reflect sound medical guidelines and protocols

More information

ESL Health Unit Unit Two The Hospital. Lesson Three Taking Charge While You Are in the Hospital

ESL Health Unit Unit Two The Hospital. Lesson Three Taking Charge While You Are in the Hospital ESL Health Unit Unit Two The Hospital Lesson Three Taking Charge While You Are in the Hospital Reading and Writing Practice Advanced Beginning Goals for this lesson: Below are some of the goals of this

More information

Advanced Imaging and Cardiac Procedures Prior Authorization Update

Advanced Imaging and Cardiac Procedures Prior Authorization Update Advanced Imaging and Cardiac Procedures Prior Authorization Update Presented by: Laurie Kim Director, Provider Relations and Account Management Hawai`i HMSA Provider/Staff Training Webinar August 11, 2016

More information

TENNESSEE Advance Directive Planning for Important Healthcare Decisions

TENNESSEE Advance Directive Planning for Important Healthcare Decisions TENNESSEE Advance Directive Planning for Important Healthcare Decisions Caring Connections 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 Caring Connections, a program of

More information

HIPAA Happenings. Presented by Douglas M. Wolfberg.

HIPAA Happenings. Presented by Douglas M. Wolfberg. HIPAA Happenings Presented by Douglas M. Wolfberg www.pwwemslaw.com 5010 E. Trindle Road, Suite 202 Mechanicsburg, PA 17050 717-691-0100 717-691-1226 (fax) dwolfberg@pwwemslaw.com Disclaimer: These seminar

More information

Community Alternatives Program 1915(c) HCBS Waiver April 26, Department of Health and Human Services Biannual Listening Session

Community Alternatives Program 1915(c) HCBS Waiver April 26, Department of Health and Human Services Biannual Listening Session Community Alternatives Program 1915(c) HCBS Waiver April 26, 2017 Department of Health and Human Services Biannual Listening Session Semiannual Listening Session 2 Statement from CAP/C beneficiary My experience

More information

Chapter 1 - Introduction to Emergency Medical Care

Chapter 1 - Introduction to Emergency Medical Care Introduction to Emergency 1 OBJECTIVES 1.1 Define key terms introduced in this chapter. Slides 16-18, 26 27, 42 44 1.2 Give an overview of the historical events leading to the development of modern emergency

More information

CENTRAL CALIFORNIA EMERGENCY MEDICAL SERVICES

CENTRAL CALIFORNIA EMERGENCY MEDICAL SERVICES CENTRAL CALIFORNIA EMERGENCY MEDICAL SERVICES Manual Subject Emergency Medical Services Administrative Policies and Procedures Patient Care Report Policy Page 1 of 20 References Title 22, Division 9, Chapter

More information

Kansas Board of Emergency Medical Services

Kansas Board of Emergency Medical Services Checklist - Ambulance Service Inspection Number: Inspector: Date: Kansas Board of Emergency Medical Services 900 S.W Jackson, LSOB, Room 1031 Topeka, KS 66612 785-296-7296 Ambulance Service Inspection

More information

Data 101. EMS Information Systems

Data 101. EMS Information Systems EMS Information Systems Data 101 William Fales, MD, FACEP Western Michigan University Homer Stryker MD School of Medicine and Kalamazoo County Medical Control Authority William.fales@med.wmich.edu Disclosures

More information

The Emergency Medical Treatment and Labor Act (EMTALA)

The Emergency Medical Treatment and Labor Act (EMTALA) The Emergency Medical Treatment and Labor Act (EMTALA) Presentation to the 2016 Nurse Leaders in Native Care Conference Mary Ellen Palowitch MHA,RN Division of Acute Services Survey & Certification Group

More information

Preventing Falls in the Home

Preventing Falls in the Home ~ VOLUME I ISSUE V LESSON PLAN ~ OBJECTIVES Upon completion of this program, the home health aide will be able to:» Identify four variables that increase the likelihood of falls» List three common hazards

More information

Primer: Overview of the Emergency Medical Treatment and Active Labor Act (EMTALA) Overview:

Primer: Overview of the Emergency Medical Treatment and Active Labor Act (EMTALA) Overview: Primer: Overview of the Emergency Medical Treatment and Active Labor Act (EMTALA) Overview: In 1986, Congress enacted EMTALA as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA). Often

More information