by Caroline Fife, M.D. | Aug 20, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Health Information Technology and Wound Care, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
Here’s a note from a hospital EHR. The nurse has typed into the record so it’s legible, but you can’t use the data for anything because there’s no place to put or retrieve measurements or wound products and no place to put photos. This is what is happening in most...
by Caroline Fife, M.D. | Aug 19, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Last week I showed you the abnormally low transcutaneous oximetry of a woman after radiation to the axillae with single digit TCOM values. With oxygen breathing, the two really low values improve but not up to normal like the one that is over 200 mmHg. I did an oxygen...
by Caroline Fife, M.D. | Aug 18, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Last week I mentioned ICD-10 so I thought it might be interesting to discuss why using the right “words” in the chart, to get a coder to code correctly for HBOT, is going to be very tricky. I’m going to try to explain this for “late effects of radiation” but it IS...
by Caroline Fife, M.D. | Aug 14, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Good morning and Happy Friday! Friday’s on the blog are reserved for “Ask the Physician Friday.” If you have any questions for me please feel free to leave them in the comments below, ask on Twitter (@carolinefifemd), or on Facebook (@Woodlands Wound Physicians). I...
by Caroline Fife, M.D. | Aug 13, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
Here is a note from a doctor I worked with for years who is one of the best clinicians I ever had the privilege to practice with. I hope they won’t read this blog and ever find out that I used one of their notes as an example of a fabulous doctor with illegible...
by Caroline Fife, M.D. | Aug 12, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Yesterday I discussed the challenges of ICD-10 coding late effects of radiation. Last week I showed you the axillae of a lady after breast cancer who had radiation changes and a non-healing wound. Her transcutaneous oximetry values on leads 1 and 3 were 8mmHg and...
by Caroline Fife, M.D. | Aug 11, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
ICD-10 has completely consumed my time in the past few weeks. Let’s talk straight about how this is going to work for wound care and hyperbaric medicine. There are 2 fundamental ways coding has ALWAYS worked, even with ICD-9. Option #1: The doctor knows the codes...
by Caroline Fife, M.D. | Aug 10, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Pressure Cooker: Rethinking Pressure Ulcers, Quality Payment Program, US Wound Registry
I have big news. The Undersea and Hyperbaric Medical Society (UHMS) has partnered with the US Wound Registry (USWR) to sponsor The Hyperbaric Oxygen Therapy Registry (HBOTR). Submitting data to this registry will satisfy the requirement of a specialty registry...
by Caroline Fife, M.D. | Aug 6, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
I have been thinking a lot about whether we have or haven’t improved how we keep patient health records. Here’s a record from the 1800’s when the primary purpose of the record was to remind the doctor what the patient had complained about and what he had done about...
by Caroline Fife, M.D. | Aug 5, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
This is the axillae of a woman who had breast cancer a year ago and underwent radiation to the axillae after a lymph node biopsy. She developed a seroma which was drained and then became infected. She has a large wound about the size of an orange that you can’t see...
