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Improving critical care documentation and coding using an online teaching module [Meeting Abstract]

Hartstein, G; Habboushe, J; Muckey, E; Wu, T; Goldberg, W; Femia, R
Background: Emergency medicine professional reimbursement-in particular, the Evaluation and Management levels-is based on Medicare's rules defining the complexity of care. Services are only reimbursable if they are properly recorded. Therefore detailed documentation is essential for optimal compensation. Critical care follows a different set of rules than other Evaluation and Management levels and a lack of clinician awareness of these rules leads to incomplete documentation and under billing. Objectives: The goal of this study is to: 1. Identify gaps in critical care documentation knowledge among emergency physicians. 2. Determine if these gaps can be filled via a selfadministered online training module. 3. Determine whether improvement in knowledge can improve documentation and enhance reimbursement. Methods: Critical care charts were examined in an urban tertiary care center with approximately 68,000 ED visits per year. Pre-intervention, 1.2% of charts were coded as "critical care"; less than the national average of 2.5%. Physicians completed a pre-module assessment, followed by a 15-minute online educational module, followed by a post-module assessment. Critical care rates were measured during the months preceding and following module completion. Results: 1. Gaps in knowledge were defined when average correct pre-assessment response was < 75%, revealing deficiencies in specific aspects of critical care documentation, which may be reflected in the critical care rate. 2. Post-module assessments had an overall higher correct response rate (65.9% to 84.8%, p<0.001). Specifically for knowledge gap questions, the correct response rate increased from 53% to 86.5% (p<0.001). 3. After all clinicians completed the teaching module, ED critical care rates increased from 1.4% (Nov-Dec, 2015) to 3.22% (Mar-Apr, 2016), an increase of 129% that trended towards statistical significance (p=0.058). This extrapolates to an annual increase in reimbursement of $103,900, based on the ED's specific average collection rates. Conclusions: The training module was able to identify and correct gaps in critical care knowledge, likely leading to an increase in proper charting and coding and a subsequent increase in revenue. Additionally, the effectiveness of a short, easily distributed teaching module carries broad implications for future physician education initiatives
EMBASE:623466091
ISSN: 1936-9018
CID: 3261662

Why is Keith Richards still alive? [General Interest Article]

Leyner, Mark; Goldberg, Billy
ORIGINAL:0006201
ISSN: 1548-212x
CID: 74119

Por que los hombres se duermen despues de darse un revolcon? : mas preguntas que solo harias a tu medico despues del tercer whisky = Why do men fall asleep after sex? : more questions you'd only ask a doctor after your third whisky sour

Leyner, Mark; Goldberg, Billy
Barcelona : Ediciones Peninsula, 2007
Extent: 250 p. ; 23cm
ISBN: 8483077701
CID: 1353

Why do men fall asleep after sex? : more questions you'd only ask a doctor after your third whisky sour

Leyner, Mark; Goldberg, Billy
New York : Three Rivers Press, 2006
Extent: xxii, 263 p. ; 20cm
ISBN: 0307345971
CID: 1350

Proc i muzi maji bradavky? = Why do men have nipples? : hundreds of questions you'd only ask a doctor after your third martini

Leyner, Mark; Goldberg, Billy
Brod : Fragment, 2006
Extent: 192 s. ; 20 cm
ISBN: 8025302725
CID: 1349

Why do men fall asleep after sex?

Leyner, Mark; Goldberg, Billy
[New York] : Harper Aduio, 2006
Extent: 1 Compact Disc
ISBN: 0061173436
CID: 1351

Po co facetom sutki? : setki pytan ktore zadalibyscie lekarzowi dopiero po kilku glebszych = Why do men have nipples? : hundreds of questions you'd only ask a doctor after your third martini

Leyner, Mark; Goldberg, Billy
Warsszawa : Wydawnictwo Natalis, 2006
Extent: 159 s. ; 20 cm
ISBN: 836032610x
CID: 1347

Wei shen me nan ren you ru tou? 163 jian ni xiang zhi dao, yi xue yuan que mei jiao guo de shi! = Why do men have nipples? : hundreds of questions you'd only ask a doctor after your third martini

Leyner, Mark; Goldberg, Billy
Taibei Shi : Ping an wen hua you xian gong si, 2006
Extent: 235 p. ; 21 cm
ISBN: 9578035845
CID: 1346

Honderden vragen die je niet aan de dokter durft te stellen = Why do men have nipples? : hundreds of questions you'd only ask a doctor after your third martini

Leyner, Mark; Goldberg, Billy
Amsterdam : Promotheus, 2006
Extent: 175 p. ; 20 cm
ISBN: 9044608746
CID: 1345

Why do men have nipples? : hundreds of questions you'd only ask a doctor after your third martini

Leyner, Mark; Goldberg, Billy
London : Orion, 2006
Extent: xxvi, 194 p. ; 20 cm
ISBN: 0752879693
CID: 1344