7 minute read
PHYSICIAN’S CONNECTION
Medical Documentatio on Tip o ’ the Month ~or~ How to Survive the Government Documentation Rules
Acute or Chronic?
The Federal Government has enough regulations to handcuff any coder and significantly impair his or her ability to properly demonstrate how sick our patients are.
H Here ’ s what you already know:
Many of our patients with CHF, bronchitis and pneumonia have underlying pulmonary disease, such as COPD. These underlying conditions make managing the case more challenging, requiring more therapies.
Here ’ s what you may not know:
An exacerbation of a chronic condition - such as COPD - will complicate a case, but only if you specify in your notes that there is an acute exacerbation of the chronic condition!
Let’s say you admit an elderly patient suffering from COPD, and presenting with pneumonia. O2 saturations were 89%. She has decreased breath sounds and diffuse wheezing. You treat with not only antibiotics for treatment of the pneumonia, but also oxygen and frequent bronchodilator nebulizer treatments due to a component of COPD exacerbation. With your effective treatment, you discharge her in good condition. How can this play out in our report cards?
MS DRG Description
Average Medicare Compensation
Average Length of Stay 195 Simple Pneumonia & Pleurisy w/o CC/MCC $4,011.13 2.3 days 194 Simple Pneumonia & Pleurisy with CC $5,251.10 2.9 days
In the first case, you listed both “pneumonia” and “chronic obstructive pulmonary disease.” But if you had noted “acute exacerbation of chronic obstructive pulmonary disease” in your admission note, in addition to the pneumonia, you would have gotten the severity of illness described in the coding.
The moral:
What is self-evident to clinicians will often be ignored by the government unless we spell it out. I If the patient is experiencing an acute exacerbation of a chronic condition, always clearly document its acuity!
The Michigan Department of Licensing and Regulatory Affairs (LARA) now requires Implicit Bias Training for physicians (and other health care professionals), effective as of June 1, 2022. The requirements apply to both new applicants as well as those renewing their existing licenses or registrations.
An applicant for license renewal shall have completed a minimum of 1 hour of implicit bias training for each year of the applicant’s license or registration cycle. An applicant for new licensure, both limited and medical, shall have completed a minimum of 2 hours of implicit bias training within the 5 years immediately preceding issuance of the license or registration.
Please note, the implicit bias training for licensure must “provide opportunities for interaction among participants and with the instructor” to meet LARA requirements
For more information on the Implicit Bias requirement and any other issues regarding physician licensing, please visit: michigan.gov/lara
PHYSICIAN SUPPORT LINE: (888) 409-0141
• Free & Confidential • No appointment necessary • Available 7 days a week 8:00AM - 1:00AM ET Learn More: www.physiciansupportline.com
What is Physician Support Line?
Physician Support Line is a national, free, and confidential support line service made up of 600+ volunteer psychiatrists, joined together in the determined hope to provide peer support for our physician colleagues and medical students. Physician Support Line was created with the mission of physicians supporting physicians as we navigate the many professional and personal intersections of our lives.
Physician Support Line promises to provide emotional support and a safe holding space for physicians and medical students.
continuing medical education (cmE)
REGISTER NOW~
(This activity fulfills the CE requirements for medical ethics.)
MARCH 8, 2023 – Wednesday
Hyatt Place Flint/Grand Blanc 5481 Hill-23 Drive, Flint, MI 48507 5:30pm – 7:30pm Approved for AMA PRA Category 1 Credit ™
Register online: education.hurleymc.com/cme/calendar or snap the QR code below:
SAVE the DATE*
MARCH 22, 2023 – Wednesday
Practices to Foster Physician Presence and Connection with Patients in the Clinical Setting
APRIL 12, 2023 – Wednesday
Advances in OB Pain Management
APRIL 26, 2023 – Wednesday
Pediatric Update
*Activity dates and/or speakers are tentative and subject to change until final advertising.
welcome
new providers
MEDICINE Riad Al Natour, MD
Internal Medicine Michigan Health Specialists 2700 Robert T. Longway Suite B Flint, Michigan 48503 Office Phone: 810-235-2004 Office Fax: 810-235-2841 Office Manager: Khadra Kahin
SURGERY Sidney Martin, MD
Orthopaedic Surgery Ortho Michigan 4466 West Bristol Road Flint, Michigan 48507 Office Phone: 810-733-1200 Office Fax: 810-733-0688 Office Manager: Lisa Mora
Steven Reschak, DO
Otolaryngology Ear, Nose, Throat & Plastic Surgery Associates 3455 Regency Park Drive Grand Blanc, Michigan 48439 Office Phone: 810-694-0600 Office Fax: 810-603-3152 Office Manager: Lindsay Moore
Jason Warczinsky, NP
Nurse Practitioner Urological Services, P.C. G-1121 West Hill Road Flint, Michigan 48507 Office Phone: 810- 232-8888 Office Fax: 810- 232-9190 Office Manager: Stacy Wilson
Antonio Williams, MD
Pediatric Surgery Hurley Comprehensive Surgical Group 2 Hurley Plaza Suite 109 Flint, Michigan 48503 Office Phone: 810-262-73600 Office Fax: 810-262-7243 Office Manager: Laura Bentley
continuing medical education (cmE)
To get FREE continuing medical education online, please visit: education.hurleymc.com/cme/calendar for the following topics that have been approved for AMA PRA Category 1 Credit ™:
• Drug Endangered Children • Pediatric & Adolescent Obesity • Thyroid Cancer Management • Impact of Racism on Children and Adolescents
CONTINUING EDUCATION REQUIREMENTS FOR MICHIGAN MEDICAL DOCTORS
Authority: Public Act 368 of 1978, as amended
REQUIREMENTS FOR RENEWAL
The continuing education requirements apply to every physician renewing a Michigan medical license who has been licensed in the 3-year period immediately preceding the application for renewal. The requirements apply whether or not the physician is actively engaged in the practice of medicine. No one, including medical school faculty and resident physicians, is exempt from this requirement.
Each medical doctor is required to complete 150 hours of continuing education in courses or programs approved by the Board of Medicine, of which a minimum 75 hours of the required 150 hours must be earned in courses or programs designated as Category 1 programs.
A minimum of 1 hour of continuing education must be earned in the area of medical ethics. A minimum of 3 hours of continuing education must be earned in the area of pain and symptom management.
NOTE: LARA trainings are separate from Continuing Education requirements. • LARA requires a one-time mandatory training in Opioids and Controlled Substances Awareness and
Human Trafficking.
• LARA requires Implicit Bias Training for new applicants, as well as those renewing their existing licenses or registrations.
An applicant for license renewal shall have completed a minimum of 1 hour of implicit bias training for each year of the applicant’s license or registration cycle, and every renewal cycle thereafter.
An applicant for new licensure, both limited and medical, shall have completed a minimum of 2 hours of implicit bias training within the 5 years immediately preceding issuance of the license or registration.
For more information or questions, please visit: michigan.gov/lara
Hurley offers the following free CME on Demand courses that fulfill requirements, training, and are approved for AMA PRA Category 1 Credit ™
• Ethical Principles – Choosing Wisely (This activity fulfills the CE requirements for medical ethics.) Please visit: education.hurleymc.com/cme/calendar • Managing the Chronic Opioid User (This activity fulfills the CE requirements for pain and symptom management.) • Human Trafficking: the Role of the Healthcare Provider Coronavirus Educational Resources (This activity fulfills the LARA training standards for identifying victims of human trafficking requirements.) There is a Novel Coronavirus Education Resources webpage on the
Please visit: education.hurleymc.com/cme/calendar ACCME website at www.accme.org/coronavirus-resources that includes a list of accredited continuing education (CE) activities and additional resources that can help the clinician community respond to the novel Coronavirus coronavirus public health emergency. The majority of the CE activities are Educational Resources There is a Novel Coronavirus Education Resources webpage on the ACCME website at www.accme.org/ Free. coronavirus-resources that includes a list of accredited continuing education (CE) activities and additional resources that can help the clinician community respond to the novel coronavirus public health emergency. The majority of the CE activities are free.
HURLEY REGULARLY SCHEDULED SERIES (RSS)
CREDIT CONTACT NAME RSS TITLE HOURS DEPT LOCATION DAY & TIME & NUMBER
Multidisciplinary Tumor Board
1.00 Oncology Virtual Wednesdays, 7:00-8:00 AM
WEEKLY
Robyn Hatch 810-262-9585
Pediatric Grand Rounds 1.00 Pediatric Virtual and Ed Center Rm 123 Wednesdays, 8:00-9:00 AM
WEEKLY
Audrina Roberts 810-262-7045
Pediatric Oncology Tumor Board
1.00 Oncology For Location, Day, and Time, please call the Pediatric Dept at 810-262-7045 Audrina Roberts 810-262-7045
Surgical Conference 1.00 Surgery Virtual and 7B Conference Rm
Surgical Critical Care Journal Club
1.00 Surgery Virtual and 7B Conference Rm 3rd Friday, 7:00-8:00 AM
MONTHLY
4th Friday, 7:00-8:00 AM
MONTHLY
Pauline Tippett 810.262.6823
Pauline Tippett 810.262.6823
Trauma Conference 1.00 Trauma Virtual and 7B Conference Rm 1st Friday, 7:00-8:00 AM
MONTHLY
Pauline Tippett 810.262.6823
