Physician Payment Reform Essay Example for Free

Physician Payment Reform Essay 1. The three goals of the Physician Payment Reform is to decrease medicare expenditures by promoting preventative care and preventing unnecessary hospital stays. The next goal is to Re-distribute physicians payments more equitably by ensuring that physicians receive a fair payment for services rendered. The last goal is to ensure quality health care at a reasonable rate. 2. Modifier -25 would be the appropriate choice, it is a separately indentifiable service that was provided by the same physician on the same day. 3. Medicare pays physicians for services based on three basic compnents called relative value units. The first is Physician work which is the time, skill, and training it takes to provide a particular service. The next is practice expense which is everything that goes into running a practice, like equipment, rent, supplies, etc. The last of these is malpractice, which covers the cost of professional liability expenses. 4. The three types of persons eligible for medicare are the elderly who are age 65 and older. The second are people who are disabled and drawing by social security disability The third are people who are in the stage of renal failure (ESRD). 5. The six basic location methods to find main terms in the index of CPT are; procedure/service, synonym, eponymous, anatomic site, condition of disease, and abbreviations. 6. 99253 is the appropriate E/M code of the initial impatient consultation. The consultation was with a detailed history, a detailed exam, and MDM of low complexity 7. The four elements of history are the chief complaint, the second is the history of present illness. The third is the review of systems, and the final is past, family, and/or social history. 8. The complexity of medical decision making is based off of the number of diagnoses, risk or morbidity (complication or death), and the amount of data (complexity). 9. The appropriate CPT code for this scenario is 99214. The re is a detailed history, a detailed exam, and a MDM of moderate complexity. 10. The three key components that are present in every patient case, (except counseling encounters or time-based codes) are  history, examination and medical decision making. 11. The correct CPT code for this clinic note is 99396. It is a 42-year-old female who is going for a routine physical exam, which is a preventative measure to ensure her health. 12. The appropriate CPT code would be 99341. This case is for a home visit with a problem focused history, a problem focused exam, as well as a straight forward MDM. 13. The four levels of history type are problem focused, expanded problem focused, detailed and comprehensive. 14. The appropriate CPT code is 99281, and the ICD-9 code is 918.1. 15. This scenario has a problem focused history, a problem focused exam and a straight forward MDM (or of low complexity.) Therefore the correct CPT code is 99231. 16. If a patient were discharged from the hospital with a diagnosis of probable myocardial infarction without a history of MI in the past, the coder would use the ICD-9 diagnosis code 410 for this stay. 17. The correct CPT code is 13160, and the correct ICD-9 code is 998.32. 18. The difference between outpatient and inpatient measures of time is that outpatient care is when a patient comes in and receives a medical procedure or treatment and goes home immediately. As where with inpatient care they will receive a medical procedure and stay at the hospital. 19. In this scenario the patient has a fracture of the distal radius, the appropriate CPT code for this is 25600. 20. Four of the five graft types in the musculoskeletal system are bone graft, tissue, fascia, and cartilage. 21. The procedure that was performed in this scenario is on the placement of a halo. The correct CPT code for this scenario is 20661. 22. Since the procedure in this scenario is a left heath catherterization with coronary angiography and left ventriculogra, the correct CPT code for this is 93452. 23. The correct CPT code for the placement only of a dual-chamber pacemaker is 33208. 24. In this scenario the proced ure is for the replacement of a pulse generator in an old pacemaker, the correct CPT code is 33228. 25. The correct CPT diagnosis code is 58558, and the correct ICD-9 code is 621.0. 26. This outpatient clinic scenario is for a bilateral screening mammogram, the correct CPT code is 77057. 27. The correct CPT code for this scenario, an MRI of the brain, is 70552. 28. This scenario is for a dialysis progress note, the correct CPT code is 90947. 29. The correct CPT code for a pulmonary walking stress test is 94620. 30. Physical status modifier P3 indicates a patient with severe systemic disease. 31. The correct CPT code  for a patient who receives anesthesia for revision of total hip arthroplasty is 01215. The physical status modifier would be P2, because the patient has mild systemic disease. 32. The main term in the diagnosis of fractured clavicle is fractured. 33. The main term in the diagnosis of globe adhesions is adhesions. 34. The main term in the diagnosis of urinary retention is retention. 35. The main term in the diagnosis of acute pneumonia is pneumonia. 36. The correct code for personal history of peptic ulcer is V12.71. 37. The correct code for family history of breast cancer (for a), female is V16.3. 38. The correct code for the preoperative evaluation is V72.83, the code for COPD is 496. 39. In this scenario it is for a simple repair of a superficial wound of the nose measuring 5.2cm, the correct CPT code for this is 12014. 40. To correctly code a lesion excision you must first know the size, location, and number of lesions. You must also know if it is malignant or benign to properly code. 41. The appropriate CPT code for an unlisted procedure of the neck or thorax is 21899.

Comparing Relationships in Josephine Miles Housewife and Cathy Songs Picture Bride :: Comparison Compare Contrast Essays

Relationships in Josephine Miles' Housewife and Cathy Song's Picture Bride Having a relationship is a very exciting and sense of belonging thing. A relationship between a man and a woman can have extremely great times and also can bring out the worst times. There are just certain things that you have to do and believe to have a relationship work out right. Times are changing rapidly, and so are relationships. Both people in the relationship need to have the same feelings, or else things just do not work out. Before, women in the relationship were expected to do all of the housework and take care of the children. These days, women just do not normally do this by themselves. Our modern women believe in the 50-50 type of lifestyle. In Josephine Miles' "Housewife," the narrator is talking about a woman who basically is very unhappy. "Occasional mornings when an early fog/ not yet dispersed stands in every yard/ And drips and undiscloses, she is severely/ Put to the task of herself," explains how this woman gets up, before it is completely light out, and is already working on her daily work. (Pg. 285 lines 1-4) She does not get to sit and relax first thing in the morning, she goes straight for her chores, which she probably continues nonstop the whole day. "But when the fog at the glass pauses and closes/ She is put to ponder/ A life-line, how it chooses to run obscurely/ In her hand, before her," is basically showing how she wants to do something else with her life. (lines 9-12) She is wonde ring if she will ever be able to do something besides take care of the house and family. Many people, not as much today, are set up with their future husbands/wives. In royal families and certain cultures, the parents pick who their child's spouse will be. This obviously in most cases will lead to a very unhappy married life. How could you spend your life with someone that you do not even love? Why should someone get to choose your mate for you? There are also what they call "mail order brides." These women usually come from poor communities, who just want to get away and come to the United States or elsewhere and make a better life for them. Cathy Song's poem, "Picture Bride" is about this type of marriage. "Did she simply close/ the door of her father's house/ and walk away," shows that the husband is questioning the type of life that his bride had.

Hyphenated American

Chinese Americans tend to keep their separate identity In the United States, there are multiple hyphenated Americans groups, such as African- American, Asian- American, Irish- American, and Indian- American. People hold American nationality, but have a foreign birth or origins tend to identify themselves in some term of Hyphenated Americans. It means that they are not only Americans, but also involve in different ethnicity, religion, language, and culture. Chinese- Americans comprises the largest ethnic group of Asian Americans.Most of the early Chinese workers immigrated from Guangdong province in China for the Gold Rush (â€Å"Chinese Immigrants and the Gold Rush†, n. d. ). Since 1865, lots of Chinese worker come to the United States and worked on the famous Transcontinental Railroad project. The Chinese also worked as small merchants, gardener, laundry workers, farmers, and so on. More and more Chinese Americans immigrated with their children from mainland China, Hong Kong, Macau, and Taiwan(â€Å"Chinese Historycal Society of Southern California†, 2010).The Chinese Americans try to keep their Chinese culture, language, and community, and they tend to retain the separate identity. Chinese Americans tend to live together in their own culture community. According to the 2010 census, the Chinese American population was around 3. 8 million, and half of them lived either in  California  or  New York (â€Å"Race Reporting for the Asian Population by Selected Categories: 2010†, 2010 ). The Chinatown in San Francisco was the oldest and largest Chinese community in the United States.People can find Chinese culture elements everywhere in the Chinatown, for example, herbal shops, temples, dragon parades, Chinese book store, Chinese restaurant, Chinese language school, and even Chinese hospital. People living in the Chinatown communicate in Chinese language, and live exactly the same life style as people in China. Chinese Americans in New York also have such community in the Flushing area, know as Chinatown. There are Chinese transportation companies; travel agencies, and Chinese language school also. Almost every child in Chinese American family has attended Chinese language school after their regular school time.Their parents want them to keep ancestor’s culture, so they will always remember that they are rooted in China. There is a Columbus Chinese Christian Church in Columbus Ohio. Every Sunday, thousands of Chinese American Christians living in Columbus get together and model in the bible through teaching, music, and worship. After the teaching, people share a big dinner of Chinese food. Most of them speak Chinese, and only the new generations who were born in America prefer to speak English. Many of the old immigrated Chinese American even cannot speak English at all.Even though the kids speak English with each other, they can still speak frequently in Chinese with their parents. Chinese Americans stay in th eir own community to retain their culture, language, and customs. Chinese Americans are pride of their ethnic and culture. Music and dance are the common language among all human being. Chinese Americans hold Shen Yun performances all around the United States to spread Chinese art and music. Every year, students can see posts about Shen Yun performance on the wall around the OSU campus. The video Shen Yun 2013 Trailer on the Shen Yun website also shows some significant parts of the performance.Dancers wearing different styles of Chinese traditional ancient clothes performed the Chinese cultures of different dynasty and different ethics. The music play by Chinese traditional instruments was as good as the dancing. As it said in the video, the aim of the performance is to revive 5000 years of divine civilization. It shows Chinese Americans’ strong sense of pride of Chinese culture. Many of the new generation of Chinese American, which is also known as American born Chinese (ABC ), had a hard time to define themselves identity.A short story named â€Å"The Paper Menagerie† written by Ken Liu won the 2012 Hugo Awards. This short, bittersweet story describe Ken suffered a pain of having a Chinese born mom who was different with every else’s mom, also, whose accent and broken sentences embarrassed him (Ken, 2012). His mom taught him Chinese, cooked Chinese food, and made him Chinese tradition paper animals as toys. She liked to see the Chinese parts in her son. However, he hated his chink face and all the other Chinese parts from his mother. He refused to talk to her in Chinese even though she can barely speak English.After reading her lasting letter inside the paper animals after his mother’s death, Ken finally understand his mother’s life and know how much she loved him (Ken, 2012). There is an America born Chinese girl Amy Tan who define herself a completely American, and she wants nothing to do with China. However, she actually struggled a lot about which country she truly belongs to. Then she had a trip back to China with her mother. Tan said that once she touched Chinese soil, she better understood her connection to the land and to the country.She finally understood how she belongs to two cultures at the same, which make her accept her hyphenated identity, and view herself as a Chinese American. She said â€Å"I discovered how American I was. I also discover how Chinese I was. I discovered a sense of finally belonging to a period of history, which I never felt with American history†. She realized that â€Å"Once you were born Chinese, you cannot help but feel and think Chinese† (Lemontree, n. d. ). Ken and Amy all tried to refuse everything about China, and they want nothing to do with Chinese.Finally, somehow, they find the way to connect their Chinese heritage and American nationality, and they accept themselves as who they are. American born Chinese new generation all suffered from an un expected pain of trying to belong. They have Chinese faces; they were mostly raised up in Chinese community and eat Chinese food; they have Chinese friends and their family members speak Chinese at home. They don’t know which nation and culture they truly belong to. Sometime they feel embarrassed about having such a different family, and try to integrate into the American society.Their parents hope they can hold the hyphenated identity, because they are pride of Chinese ethnic and culture. Young generations always refuse to do so, but the Chinese heritages do exist in their body, and will have influences on their life. They need to honor their ancestor’s culture and accept combination of being Chinese and American. Reference Chinese Historycal Society of Southern California. (2010). Retrieved on Nov. 21, 2012, from http://www. chssc. org/history/histtimeline. html Chinese Immigrants and the Gold Rush (n. d. ). Retrieved on Nov. 21. 2012, from http://www. pbs. rg/wgbh/a mex/goldrush/peopleevents/p_chinese. html Ken,L. (2011). The Paper Menagerie. Fantasy & Science Fiction. Retrieved on Nov. 21, 2012, from http://a1018. g. akamai. net/f/1018/19022/1d/randomhouse1. download. akamai. com/19022/pdf/Paper_Menagerie. pdf Lemontree. (n. d. ). Hyphenated Identity: A Long Research Journey, Retrieved on Nov, 21, 2012, from http://ayjw. org/articles. php? id=696640 Race Reporting for the Asian Population by Selected Categories: 2010. (2010). U. S. Census Bureau, Retrieved on Nov. 21, 2012, from http://factfinder2. census. gov/faces/tableservices/jsf/pages/productview. xhtml

The Reality Of Planned Parenthood And Abortion - 935 Words

The Reality of Planned Parenthood and Abortion The truth is simple: We need Planned Parenthood in order to provide affordable and safe healthcare for people in the United States. Planned Parenthood had estimated that in 2013 and 2014 alone, its associates provided 865,721 Pap tests and breast exams, conducted 704,079 tests for HIV, and provided 1,440,495 emergency contraception kits. Yes, Planned Parenthood provides access to safe and legal abortion procedures, but they only account for three percent of the services the organization offers out of over five million Americans it serves. The effort of defunding Planned Parenthood due to their abortion services is absurd because those services are paid for out-of-pocket by the individual, and it takes away the many other essential services the organization has to offer. There is an inescapable myth that Planned Parenthood just does abortions. Planned Parenthood provides numerous services besides abortion, including and related to: adopt ion, birth control, body image, general healthcare, men’s sexual health, morning after pill, pregnancy, relationships, sex and sexuality, sexual orientation and gender, STD’s, women’s health, and more. Why defund an organization that gives such valuable, essential services, especially if the government does not fund abortions? They play a huge part in identifying and providing treatment for sexually transmitted diseases, help women who are pregnant and want to carry their babies to term andShow MoreRelatedA Social Problem That Is Currently Occurring Is Rather1748 Words   |  7 Pagesrather federal funding should continue to keep Planned Parenthood open. Donald Trump has recently joined other Republicans in their vow to end federal funding for Planned Parenthood, solely based on the idea that Planned Parenthood health care services provide for patients to receive an abortion. 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Their missionRead MoreAnalysis Of Marilyn Fryes Theory Of Oppression1689 Words   |  7 Pagessimilar services provided are services which really are needed by people who are for one reason or another incapacitated – unwell, burdened with parcels, etc. So the message is that women are incapable. The detachment of the acts from the concrete realities of what women need and do not need is a vehicle for the message that women’s actual needs and interests are unimportant or irrelevant† (13). What Frye seems to be claiming is that when a man goes out of his way to perform such a simple task, he takesRead More Teens, Sex, and Virginity - Teenagers and the Importance of Abstinence1213 Words   |  5 Pageslikely to contract sexually transmitted diseases, and they will be safe from unwanted pregnancies that could lead to abortions. Three million people under the age of 20 in the United States become infected with a sexually transmitted disease each year. 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