The Martlet; a newsletter where Surgery, Culture, Innovation, Finance and Informatics cohabitate
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What a year 2020 was. InterTrauma Clinicians got involved all over the place; from COVID ICU in safety net hospitals in NYC, to Health & Safety Consulting for a broad array of clients.
As we see what a dramatic impact COVID-19 can have on so many aspects of our lives, we've been busy adapting to our new reality. For example, we now have rapid Molecular COVID Analyzers and our own limited lab registered with NYS. Who would have guessed a year ago that we'd be doing this?
Let's hope 2021 brings all of us and our loved ones health and safety.
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Easy Money: How are you billing for your Trauma Ultrasounds? |
Most of us do e-FASTs routinely during trauma resuscitations. But what we don't often do is create a system to capture these charges. CMS requires that you have a system by which the images can be stored and retrieved for the purposes of auditing. I see hospitals assume that means PACS integration, but that isn't necessarily the case. If you don't have that level of IT sophistication, just save images as you go and manually download them if needed.
Create a "normal e-FAST" procedure note and integrate these codes:
76705-26: Ultrasound abdomen limited
76775-26: Ultrasound retroperitoneum
76604-26: Limited thoracic ultrasound
93308-26: Limited cardiac ultrasound
If you're not doing this, then your trauma center isn't billing for services you are performing.
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Penrose drains are great for abscess drainage and peeling garlic |
When Charles Bingham Penrose, a Gynecologist in the late 19th century, developed a rubber drain to prevent surgical wound infections, he probably didn’t realize that his drain was an ideal adjunct in the kitchen.
Next time you need to peel a garlic clove, try this. Take a (brand new) 1-inch Penrose drain, push the clove in one end, and you’ll find a peeled clove pop out the other. Every few cloves, rinse the drain with some water.
Next time you’re making Linguine alle Vongole, and you almost cut your finger trying to peel garlic, think about Dr. Charles Penrose, and how his simple drain is good for more than just abscess drainage.
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IVC Injuries: Do you use a Bridge Catheter? |
You know the feeling; you're doing a trauma ex-lap at 2am, and the right colon has an expanding retroperitoneal hematoma. You know as soon as you do your Cattell-Braasch you're going to unleash a Pandora's box of bleeding. Next time, before you do that, place a Bridge Catheter. This little balloon was developed for SVC pacemaker wire injuries, but works great in the IVC. You can either use it for proximal control, or span the injury. Either way, put it in place, and inflate it if you get into bleeding. It's as easy as placing a femoral line. It is colloquially referred to as "REBOC". Resuscitative Endovascular Balloon Occlusion of the Cava.
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News from our various bureaus around the world |
This crazy year, which was full of surprises, will have implications for all our lives for years to come. Our company is a tiny microcosm of that radical reshuffling of life and work as we know it.
The entertainment division, based in Manhattan has blossomed in to a practically standalone entity with its own COVID diagnostic lab, whereas the staffing division, based in Pennsylvania, now has an entire nursing service line, with our very own Chief Nursing Officer. InterTrauma West is expanding into the last homestead regions of the US while continuing its Clinical Informatics and Charge Capture Consulting. Our Tanzania projects did not slow down for COVID in the least bit.
Throughout all this, our man in London Bureau has plenty to say about the future of Trauma Surgery.
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