Payment was denied because the documentation did not support the medical necessity for the injection procedure. The documentation did not support the trigger points as reasonable and necessary. There was no indication of symptoms or physical findings that would support the medical necessity of the service at the level billed, in accordance with Medicare Guidelines. For the procedure code 20553 to be considered medically necessary and reasonable, an appropriate payable diagnosis needs to be billed as outlined in the Local Coverage Determination (LCD) (L30155).…
The surgeon collects a new tendon from the body. Usually after harvesting the…
DOI: 10/28/2015. Patient is a 46-year-old male field technician who sustained a work-related injury to his right index finger while he was working with cables and doing a twisting motion with both hands. As per OMNI entry, he was initially diagnosed with right index finger sagittal band sprain. Based on the medical report dated 11/02/16 by Dr. Tabibian, the patient complains of right index finger pain of the hand. Patient is taking pain medications as prescribed, which has been helping the patient's functional mobility.…
DOI: 5/9/2011. The patient is a 63 -year-old female contract buyer who sustained a work-related injury due to computer/typing duties. The patient is status post left wrist endoscopic carpal tunnel release, first dorsal compartment release, second dorsal compartment release and tenosynovectomy and arthroscopy and excision of central triangular fibrocartilage complex tear on 08/25/14 and right wrist arthroscopy and excision of central triangular fibrocartilage complex tear, carpal tunnel syndrome, first and second dorsal compartment tenosynovitis and lunotriquetral ligament partial tear on 01/25/16. Based on the progress report dated 05/26/16, the patient presents for follow-up of her bilateral upper extremity complaints.…
Purpose: To evaluate the use and efficacy of Stroke Thrombolysis as a treatment in a blocked artery that has caused ischemic stroke. Description of Pathology: Ischemic strokes account for 87% of all stroke incidents, making this type of stroke the most common. Ischemic strokes occur as a result of a blood clot plugging or obstructing an artery carrying blood to the brain. This keeps oxygen and nutrient rich blood from flowing into the brain.…
STAGE 2: SUB-ACUTE MANAGEMENT As agony dies down and turns out to be to a lesser extent an issue, the point of treatment is to urge the useless ligament to mend, and to reestablish quality to the influenced lower arm. Manual Therapy will be the methodology utilized by the Physiotherapist at this stage. Further, to finish the repair procedure, an activity system will be presented that will take a gander at reinforcing the lower arm in a way that you might not have seen before - named flighty fortifying. STAGE 3: RETURN TO NORMAL FUNCTION…
She included the story of the very first Canadian stroke patient who underwent the procedure even though the procedure was still relatively new. She also included the after story of the said patient which was that the patient was able to move her left hand just moments are the procedure was done. Another example that the author added was when a 72-year-old grandfather could not move his body just moments after experiencing a dull headache. He was quickly taken into the operating room and the very next day he could take a shower unaided. This clearly shows the significance of this procedure in modern medicine as it can save lives not only from death but also from permanent…
On 3/26/18 I met Ms. Black at the office of Dr. Sardelli. She reports that her shoulder is still painful; she cannot fully extend her elbow or rotate from side to side. She reports pain to the inner aspect of the elbow. Her 4th and 5th fingers cannot open fully or close fully. There continues to be a pain in the inner elbow.…
Influencing the Outcome for Effective Treatment of Cubital Tunnel Syndrome Cubital tunnel syndrome is the second most common compression neuropathy of the upper extremity after carpal tunnel syndrome (Trehan et al, 2012). It represents a source of considerable discomfort and disability for the patient and in extreme cases may progress to loss of function of the hand (Cutts, S., 2007). Some specialists refer to this condition as ulnar nerve compression as it takes place within the cubital tunnel and most commonly occurs at the elbow (Trehan et al, 2012). Pressure is put on the ulnar nerve each time the elbow is bent which reduces the supply of blood to the nerves and causing damage over time (Trehan et al, 2012).…
Overview Venous thromboembolism (VTE) is the collective term used to describe deep vein thrombosis (DVT) and pulmonary embolism (PE). What is DVT? DVT is a clot formation within the deep vasculature in the legs. What is PE?…
Introduction Perfusion is a very important aspect to the human body. Perfusion is defined as the flow of blood through arteries and capillaries that deliver oxygen and nutrients to the cells and removing cellular waste from the body (Giddens, 2013, p. 148). For us to maintain optimal perfusion, we need are heart to generate sufficient cardiac output. This means transporting the blood through patent blood vessels to supply the tissues throughout the body. Impaired perfusion may occur when the blood supply is reduced or completely interrupted (Giddens, 2013, p. 148).…
The Phantom Limb Phenomenon The phantom limb phenomenon is a known response that occurs following surgery in amputee patients. This response provides a vivid sensation that the amputated limb is still present and phantom limb pain is most commonly seen following the amputation of the arm or leg. The pain felt, may be related to physical or psychological factors, including the weather, or emotional stress, (Flor, 2002). Phantom limb is frequently apparent with physical pain, and this occurs in 50% – 80% of amputees, (Flor, 2002). The pain felt by these amputees can be described as stabbing, burning, tingling, or throbbing.…
There is significant weakness on muscle testing (i.e., the patient is unable to exert a normal force with muscle contraction). On tapping the knee tendon there is a contraction of the quadriceps muscle in the leg, and on tapping the biceps tendon there is a contraction of the biceps muscle in the arm. No fasciculations are noted. There is normal muscle tone detected by passive movement…
Hypertension is a steadily rapid disease. About one in every three adults in the United States have been diagnosed with the rapidly increasing disease. Hypertension is a very dangerous condition of having excessively high blood pressure. Another name for hypertension is high blood pressure (HBP). High blood pressure is the force of the blood against the artery wall.…
Main Question Post: Week 4: Cardiovascular Disorders Myocardial Ischemia and Acute Coronary Syndrome Cardiovascular disease (CVD) persists as the principle source of death amongst the men and women globally, and has claimed further breathes yearly in the United States (U.S) than “cancer, chronic lung disease, and accidents” collectively (Dunlay, & Roger, 2012). Myocardial ischemia and acute coronary syndrome originate with the coronary artery disease. According to Huether and McCance (2012), coronary artery disease (CAD) can reduce the myocardial bloodstocks until scarcity ruins myocardial metabolism sufficiently enough to instigate ischemia, an indigenous state whereby the cells are provisional denied of blood supply. A persistent ischemia or an absolute blockage of the coronary artery triggers the acute coronary syndrome. This continual obstruction advances into an infarction generally branded as a heart attack; the hallmark of averting a heart attack is contingent on avoiding the inception of coronary artery disease (Huether & McCance, 2012; Dunlay, & Roger, 2012).…