KSC-2012-4927

NASA Image and Video Library

2012-09-11

CAPE CANAVERAL, Fla. – At Fire Station 1 at NASA’s Kennedy Space Center in Florida, Fire and Rescue personnel pause for a moment of silence during the 9/11 memorial dedication ceremony. Kennedy Fire and Rescue Services commemorated the 11th anniversary of 9/11 with a ceremony that included a minute of silence at 10:28 a.m., which was the moment of collapse of the north tower of the World Trade Center. Kennedy center-wide emergency units dispatched by Fire Control engaged in one-minute sirens, the new memorial was dedicated and the Honor Guard performed a flag-folding ceremony. Photo credit: NASA/Dimitri Gerondidakis

KSC-2012-4920

NASA Image and Video Library

2012-09-11

CAPE CANAVERAL, Fla. – NASA Kennedy Space Center’s Fire and Rescue personnel stand at attention during a 9/11 memorial dedication ceremony in front of Fire Station 1 at Kennedy in Florida. Kennedy Fire and Rescue Services commemorated the 11th anniversary of 9/11 with a ceremony that included a minute of silence at 10:28 a.m., which was the moment of collapse of the north tower of the World Trade Center. Kennedy center-wide emergency units dispatched by Fire Control engaged in one-minute sirens, the new memorial was dedicated and the Honor Guard performed a flag-folding ceremony. Photo credit: NASA/Dimitri Gerondidakis

KSC-2012-4937

NASA Image and Video Library

2012-09-11

CAPE CANAVERAL, Fla. – At Fire Station 1 at NASA’s Kennedy Space Center in Florida, Fire and Rescue personnel gathered near the new 9/11 memorial after the dedication ceremony. Kennedy Fire and Rescue Services commemorated the 11th anniversary of 9/11 with a ceremony that included a minute of silence at 10:28 a.m., which was the moment of collapse of the north tower of the World Trade Center. Kennedy center-wide emergency units dispatched by Fire Control engaged in one-minute sirens, the new memorial was dedicated and the Honor Guard performed a flag-folding ceremony. Photo credit: NASA/Dimitri Gerondidakis

KSC-2012-4921

NASA Image and Video Library

2012-09-11

CAPE CANAVERAL, Fla. – NASA Kennedy Space Center’s Fire and Rescue personnel stand at attention during a 9/11 memorial dedication ceremony in front of Fire Station 1 at Kennedy in Florida. Kennedy Fire and Rescue Services commemorated the 11th anniversary of 9/11 with a ceremony that included a minute of silence at 10:28 a.m., which was the moment of collapse of the north tower of the World Trade Center. Kennedy center-wide emergency units dispatched by Fire Control engaged in one-minute sirens, the new memorial was dedicated and the Honor Guard performed a flag-folding ceremony. Photo credit: NASA/Dimitri Gerondidakis

KSC-2012-4931

NASA Image and Video Library

2012-09-11

CAPE CANAVERAL, Fla. – At Fire Station 1 at NASA’s Kennedy Space Center in Florida, Fire and Rescue personnel salute during the 9/11 memorial dedication ceremony. Kennedy Fire and Rescue Services commemorated the 11th anniversary of 9/11 with a ceremony that included a minute of silence at 10:28 a.m., which was the moment of collapse of the north tower of the World Trade Center. Kennedy center-wide emergency units dispatched by Fire Control engaged in one-minute sirens, the new memorial was dedicated and the Honor Guard performed a flag-folding ceremony. Photo credit: NASA/Dimitri Gerondidakis

Comparison of procedure coding systems for level 1 and 2 hospitals in South Africa.

PubMed

Montewa, Lebogang; Hanmer, Lyn; Reagon, Gavin

2013-01-01

The ability of three procedure coding systems to reflect the procedure concepts extracted from patient records from six hospitals was compared, in order to inform decision making about a procedure coding standard for South Africa. A convenience sample of 126 procedure concepts was extracted from patient records at three level 1 hospitals and three level 2 hospitals. Each procedure concept was coded using ICPC-2, ICD-9-CM, and CCSA-2001. The extent to which each code assigned actually reflected the procedure concept was evaluated (between 'no match' and 'complete match'). For the study sample, CCSA-2001 was found to reflect the procedure concepts most completely, followed by ICD-9-CM and then ICPC-2. In practice, decision making about procedure coding standards would depend on multiple factors in addition to coding accuracy.

Coding for urologic office procedures.

PubMed

Dowling, Robert A; Painter, Mark

2013-11-01

This article summarizes current best practices for documenting, coding, and billing common office-based urologic procedures. Topics covered include general principles, basic and advanced urologic coding, creation of medical records that support compliant coding practices, bundled codes and unbundling, global periods, modifiers for procedure codes, when to bill for evaluation and management services during the same visit, coding for supplies, and laboratory and radiology procedures pertinent to urology practice. Detailed information is included for the most common urology office procedures, and suggested resources and references are provided. This information is of value to physicians, office managers, and their coding staff. Copyright © 2013 Elsevier Inc. All rights reserved.

Are procedures codes in claims data a reliable indicator of intraoperative splenic injury compared with clinical registry data?

PubMed

Stey, Anne M; Ko, Clifford Y; Hall, Bruce Lee; Louie, Rachel; Lawson, Elise H; Gibbons, Melinda M; Zingmond, David S; Russell, Marcia M

2014-08-01

Identifying iatrogenic injuries using existing data sources is important for improved transparency in the occurrence of intraoperative events. There is evidence that procedure codes are reliably recorded in claims data. The objective of this study was to assess whether concurrent splenic procedure codes in patients undergoing colectomy procedures are reliably coded in claims data as compared with clinical registry data. Patients who underwent colectomy procedures in the absence of neoplastic diagnosis codes were identified from American College of Surgeons (ACS) NSQIP data linked with Medicare inpatient claims data file (2005 to 2008). A κ statistic was used to assess coding concordance between ACS NSQIP and Medicare inpatient claims, with ACS NSQIP serving as the reference standard. A total of 11,367 colectomy patients were identified from 212 hospitals. There were 114 patients (1%) who had a concurrent splenic procedure code recorded in either ACS NSQIP or Medicare inpatient claims. There were 7 patients who had a splenic injury diagnosis code recorded in either data source. Agreement of splenic procedure codes between the data sources was substantial (κ statistic 0.72; 95% CI, 0.64-0.79). Medicare inpatient claims identified 81% of the splenic procedure codes recorded in ACS NSQIP, and 99% of the patients without a splenic procedure code. It is feasible to use Medicare claims data to identify splenic injuries occurring during colectomy procedures, as claims data have moderate sensitivity and excellent specificity for capturing concurrent splenic procedure codes compared with ACS NSQIP. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Cracking the code: the accuracy of coding shoulder procedures and the repercussions.

PubMed

Clement, N D; Murray, I R; Nie, Y X; McBirnie, J M

2013-05-01

Coding of patients' diagnosis and surgical procedures is subject to error levels of up to 40% with consequences on distribution of resources and financial recompense. Our aim was to explore and address reasons behind coding errors of shoulder diagnosis and surgical procedures and to evaluate a potential solution. A retrospective review of 100 patients who had undergone surgery was carried out. Coding errors were identified and the reasons explored. A coding proforma was designed to address these errors and was prospectively evaluated for 100 patients. The financial implications were also considered. Retrospective analysis revealed the correct primary diagnosis was assigned in 54 patients (54%) had an entirely correct diagnosis, and only 7 (7%) patients had a correct procedure code assigned. Coders identified indistinct clinical notes and poor clarity of procedure codes as reasons for errors. The proforma was significantly more likely to assign the correct diagnosis (odds ratio 18.2, p < 0.0001) and the correct procedure code (odds ratio 310.0, p < 0.0001). Using the proforma resulted in a £28,562 increase in revenue for the 100 patients evaluated relative to the income generated from the coding department. High error levels for coding are due to misinterpretation of notes and ambiguity of procedure codes. This can be addressed by allowing surgeons to assign the diagnosis and procedure using a simplified list that is passed directly to coding.

42 CFR 405.512 - Carriers' procedural terminology and coding systems.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Carriers' procedural terminology and coding systems... Determining Reasonable Charges § 405.512 Carriers' procedural terminology and coding systems. (a) General. Procedural terminology and coding systems are designed to provide physicians and third party payers with a...

42 CFR 405.512 - Carriers' procedural terminology and coding systems.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Carriers' procedural terminology and coding systems... Determining Reasonable Charges § 405.512 Carriers' procedural terminology and coding systems. (a) General. Procedural terminology and coding systems are designed to provide physicians and third party payers with a...

42 CFR 405.512 - Carriers' procedural terminology and coding systems.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Carriers' procedural terminology and coding systems... Determining Reasonable Charges § 405.512 Carriers' procedural terminology and coding systems. (a) General. Procedural terminology and coding systems are designed to provide physicians and third party payers with a...

42 CFR 405.512 - Carriers' procedural terminology and coding systems.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Carriers' procedural terminology and coding systems... Determining Reasonable Charges § 405.512 Carriers' procedural terminology and coding systems. (a) General. Procedural terminology and coding systems are designed to provide physicians and third party payers with a...

42 CFR 405.512 - Carriers' procedural terminology and coding systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Carriers' procedural terminology and coding systems... Determining Reasonable Charges § 405.512 Carriers' procedural terminology and coding systems. (a) General. Procedural terminology and coding systems are designed to provide physicians and third party payers with a...

KSC-2012-4933

NASA Image and Video Library

2012-09-11

CAPE CANAVERAL, Fla. – At Fire Station 1 at NASA’s Kennedy Space Center in Florida, Fire and Rescue personnel salute as the American flag is raised during the 9/11 memorial dedication ceremony. Kennedy Fire and Rescue Services commemorated the 11th anniversary of 9/11 with a ceremony that included a minute of silence at 10:28 a.m., which was the moment of collapse of the north tower of the World Trade Center. Kennedy center-wide emergency units dispatched by Fire Control engaged in one-minute sirens, the new memorial was dedicated and the Honor Guard performed a flag-folding ceremony. Photo credit: NASA/Dimitri Gerondidakis

KSC-2012-4922

NASA Image and Video Library

2012-09-11

CAPE CANAVERAL, Fla. – At Fire Station 1 at NASA’s Kennedy Space Center in Florida, Fire and Rescue personnel stand at attention as Kennedy Director Robert Cabana, at right, participates in a 9/11 memorial dedication at Fire Station 1. Kennedy Fire and Rescue Services commemorated the 11th anniversary of 9/11 with a ceremony that included a minute of silence at 10:28 a.m., which was the moment of collapse of the north tower of the World Trade Center. Kennedy center-wide emergency units dispatched by Fire Control engaged in one-minute sirens, the new memorial was dedicated and the Honor Guard performed a flag-folding ceremony. Photo credit: NASA/Dimitri Gerondidakis

KSC-2012-4928

NASA Image and Video Library

2012-09-11

CAPE CANAVERAL, Fla. – At Fire Station 1 at NASA’s Kennedy Space Center in Florida, Fire and Rescue personnel salute or stand at attention during a flag folding ceremony at the 9/11 memorial dedication ceremony. Kennedy Fire and Rescue Services commemorated the 11th anniversary of 9/11 with a ceremony that included a minute of silence at 10:28 a.m., which was the moment of collapse of the north tower of the World Trade Center. Kennedy center-wide emergency units dispatched by Fire Control engaged in one-minute sirens, the new memorial was dedicated and the Honor Guard performed a flag-folding ceremony. Photo credit: NASA/Dimitri Gerondidakis

KSC-2012-4923

NASA Image and Video Library

2012-09-11

CAPE CANAVERAL, Fla. – At Fire Station 1 at NASA’s Kennedy Space Center in Florida, Fire and Rescue personnel stand at attention as Kennedy Director Robert Cabana, at right, participates in a 9/11 memorial dedication at Fire Station 1. Kennedy Fire and Rescue Services commemorated the 11th anniversary of 9/11 with a ceremony that included a minute of silence at 10:28 a.m., which was the moment of collapse of the north tower of the World Trade Center. Kennedy center-wide emergency units dispatched by Fire Control engaged in one-minute sirens, the new memorial was dedicated and the Honor Guard performed a flag-folding ceremony. Photo credit: NASA/Dimitri Gerondidakis

KSC-2012-4936

NASA Image and Video Library

2012-09-11

CAPE CANAVERAL, Fla. – At Fire Station 1 at NASA’s Kennedy Space Center in Florida, a horseless carriage in memory of firefighters lost on 9/11 is on display during the 9/11 memorial dedication ceremony. Kennedy Fire and Rescue Services commemorated the 11th anniversary of 9/11 with a ceremony that included a minute of silence at 10:28 a.m., which was the moment of collapse of the north tower of the World Trade Center. Kennedy center-wide emergency units dispatched by Fire Control engaged in one-minute sirens, the new memorial was dedicated and the Honor Guard performed a flag-folding ceremony. Photo credit: NASA/Dimitri Gerondidakis

KSC-2012-4930

NASA Image and Video Library

2012-09-11

CAPE CANAVERAL, Fla. – At Fire Station 1 at NASA’s Kennedy Space Center in Florida, Fire and Rescue personnel salute as the American flag is raised during the 9/11 memorial dedication ceremony. Kennedy Fire and Rescue Services commemorated the 11th anniversary of 9/11 with a ceremony that included a minute of silence at 10:28 a.m., which was the moment of collapse of the north tower of the World Trade Center. Kennedy center-wide emergency units dispatched by Fire Control engaged in one-minute sirens, the new memorial was dedicated and the Honor Guard performed a flag-folding ceremony. Photo credit: NASA/Dimitri Gerondidakis

KSC-2012-4925

NASA Image and Video Library

2012-09-11

CAPE CANAVERAL, Fla. – At Fire Station 1 at NASA’s Kennedy Space Center in Florida, Fire and Rescue personnel stand at attention as Kennedy Director Robert Cabana participates in a 9/11 memorial dedication at Fire Station 1. Kennedy Fire and Rescue Services commemorated the 11th anniversary of 9/11 with a ceremony that included a minute of silence at 10:28 a.m., which was the moment of collapse of the north tower of the World Trade Center. Kennedy center-wide emergency units dispatched by Fire Control engaged in one-minute sirens, the new memorial was dedicated and the Honor Guard performed a flag-folding ceremony. Photo credit: NASA/Dimitri Gerondidakis

KSC-2012-4934

NASA Image and Video Library

2012-09-11

CAPE CANAVERAL, Fla. – At Fire Station 1 at NASA’s Kennedy Space Center in Florida, Fire and Rescue personnel salute or stand at attention as the American flag is raised during the 9/11 memorial dedication ceremony. Kennedy Fire and Rescue Services commemorated the 11th anniversary of 9/11 with a ceremony that included a minute of silence at 10:28 a.m., which was the moment of collapse of the north tower of the World Trade Center. Kennedy center-wide emergency units dispatched by Fire Control engaged in one-minute sirens, the new memorial was dedicated and the Honor Guard performed a flag-folding ceremony. Photo credit: NASA/Dimitri Gerondidakis

KSC-2012-4924

NASA Image and Video Library

2012-09-11

CAPE CANAVERAL, Fla. – At Fire Station 1 at NASA’s Kennedy Space Center in Florida, Fire and Rescue personnel stand at attention as Kennedy Director Robert Cabana, at right, participates in a 9/11 memorial dedication at Fire Station 1. Kennedy Fire and Rescue Services commemorated the 11th anniversary of 9/11 with a ceremony that included a minute of silence at 10:28 a.m., which was the moment of collapse of the north tower of the World Trade Center. Kennedy center-wide emergency units dispatched by Fire Control engaged in one-minute sirens, the new memorial was dedicated and the Honor Guard performed a flag-folding ceremony. Photo credit: NASA/Dimitri Gerondidakis

KSC-2012-4932

NASA Image and Video Library

2012-09-11

CAPE CANAVERAL, Fla. – At Fire Station 1 at NASA’s Kennedy Space Center in Florida, Fire and Rescue personnel salute as the American flag is raised during the 9/11 memorial dedication ceremony. Kennedy Fire and Rescue Services commemorated the 11th anniversary of 9/11 with a ceremony that included a minute of silence at 10:28 a.m., which was the moment of collapse of the north tower of the World Trade Center. Kennedy center-wide emergency units dispatched by Fire Control engaged in one-minute sirens, the new memorial was dedicated and the Honor Guard performed a flag-folding ceremony. Photo credit: NASA/Dimitri Gerondidakis

KSC-2012-4926

NASA Image and Video Library

2012-09-11

CAPE CANAVERAL, Fla. – At Fire Station 1 at NASA’s Kennedy Space Center in Florida, a new 9/11 memorial was dedicated during a ceremony held by Kennedy’s Fire and Rescue personnel. Kennedy Fire and Rescue Services commemorated the 11th anniversary of 9/11 with a ceremony that included a minute of silence at 10:28 a.m., which was the moment of collapse of the north tower of the World Trade Center. Kennedy center-wide emergency units dispatched by Fire Control engaged in one-minute sirens, the new memorial was dedicated and the Honor Guard performed a flag-folding ceremony. Photo credit: NASA/Dimitri Gerondidakis

Assessment of tissue allograft safety monitoring with administrative healthcare databases: a pilot project using Medicare data.

PubMed

Dhakal, Sanjaya; Burwen, Dale R; Polakowski, Laura L; Zinderman, Craig E; Wise, Robert P

2014-03-01

Assess whether Medicare data are useful for monitoring tissue allograft safety and utilization. We used health care claims (billing) data from 2007 for 35 million fee-for-service Medicare beneficiaries, a predominantly elderly population. Using search terms for transplant-related procedures, we generated lists of ICD-9-CM and CPT(®) codes and assessed the frequency of selected allograft procedures. Step 1 used inpatient data and ICD-9-CM procedure codes. Step 2 added non-institutional provider (e.g., physician) claims, outpatient institutional claims, and CPT codes. We assembled preliminary lists of diagnosis codes for infections after selected allograft procedures. Many ICD-9-CM codes were ambiguous as to whether the procedure involved an allograft. Among 1.3 million persons with a procedure ascertained using the list of ICD-9-CM codes, only 1,886 claims clearly involved an allograft. CPT codes enabled better ascertainment of some allograft procedures (over 17,000 persons had corneal transplants and over 2,700 had allograft skin transplants). For spinal fusion procedures, CPT codes improved specificity for allografts; of nearly 100,000 patients with ICD-9-CM codes for spinal fusions, more than 34,000 had CPT codes indicating allograft use. Monitoring infrequent events (infections) after infrequent exposures (tissue allografts) requires large study populations. A strength of the large Medicare databases is the substantial number of certain allograft procedures. Limitations include lack of clinical detail and donor information. Medicare data can potentially augment passive reporting systems and may be useful for monitoring tissue allograft safety and utilization where codes clearly identify allograft use and coding algorithms can effectively screen for infections.

A multidisciplinary approach to vascular surgery procedure coding improves coding accuracy, work relative value unit assignment, and reimbursement.

PubMed

Aiello, Francesco A; Judelson, Dejah R; Messina, Louis M; Indes, Jeffrey; FitzGerald, Gordon; Doucet, Danielle R; Simons, Jessica P; Schanzer, Andres

2016-08-01

Vascular surgery procedural reimbursement depends on accurate procedural coding and documentation. Despite the critical importance of correct coding, there has been a paucity of research focused on the effect of direct physician involvement. We hypothesize that direct physician involvement in procedural coding will lead to improved coding accuracy, increased work relative value unit (wRVU) assignment, and increased physician reimbursement. This prospective observational cohort study evaluated procedural coding accuracy of fistulograms at an academic medical institution (January-June 2014). All fistulograms were coded by institutional coders (traditional coding) and by a single vascular surgeon whose codes were verified by two institution coders (multidisciplinary coding). The coding methods were compared, and differences were translated into revenue and wRVUs using the Medicare Physician Fee Schedule. Comparison between traditional and multidisciplinary coding was performed for three discrete study periods: baseline (period 1), after a coding education session for physicians and coders (period 2), and after a coding education session with implementation of an operative dictation template (period 3). The accuracy of surgeon operative dictations during each study period was also assessed. An external validation at a second academic institution was performed during period 1 to assess and compare coding accuracy. During period 1, traditional coding resulted in a 4.4% (P = .004) loss in reimbursement and a 5.4% (P = .01) loss in wRVUs compared with multidisciplinary coding. During period 2, no significant difference was found between traditional and multidisciplinary coding in reimbursement (1.3% loss; P = .24) or wRVUs (1.8% loss; P = .20). During period 3, traditional coding yielded a higher overall reimbursement (1.3% gain; P = .26) than multidisciplinary coding. This increase, however, was due to errors by institution coders, with six inappropriately used codes resulting in a higher overall reimbursement that was subsequently corrected. Assessment of physician documentation showed improvement, with decreased documentation errors at each period (11% vs 3.1% vs 0.6%; P = .02). Overall, between period 1 and period 3, multidisciplinary coding resulted in a significant increase in additional reimbursement ($17.63 per procedure; P = .004) and wRVUs (0.50 per procedure; P = .01). External validation at a second academic institution was performed to assess coding accuracy during period 1. Similar to institution 1, traditional coding revealed an 11% loss in reimbursement ($13,178 vs $14,630; P = .007) and a 12% loss in wRVU (293 vs 329; P = .01) compared with multidisciplinary coding. Physician involvement in the coding of endovascular procedures leads to improved procedural coding accuracy, increased wRVU assignments, and increased physician reimbursement. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Differentiation of ileostomy from colostomy procedures: assessing the accuracy of current procedural terminology codes and the utility of natural language processing.

PubMed

Vo, Elaine; Davila, Jessica A; Hou, Jason; Hodge, Krystle; Li, Linda T; Suliburk, James W; Kao, Lillian S; Berger, David H; Liang, Mike K

2013-08-01

Large databases provide a wealth of information for researchers, but identifying patient cohorts often relies on the use of current procedural terminology (CPT) codes. In particular, studies of stoma surgery have been limited by the accuracy of CPT codes in identifying and differentiating ileostomy procedures from colostomy procedures. It is important to make this distinction because the prevalence of complications associated with stoma formation and reversal differ dramatically between types of stoma. Natural language processing (NLP) is a process that allows text-based searching. The Automated Retrieval Console is an NLP-based software that allows investigators to design and perform NLP-assisted document classification. In this study, we evaluated the role of CPT codes and NLP in differentiating ileostomy from colostomy procedures. Using CPT codes, we conducted a retrospective study that identified all patients undergoing a stoma-related procedure at a single institution between January 2005 and December 2011. All operative reports during this time were reviewed manually to abstract the following variables: formation or reversal and ileostomy or colostomy. Sensitivity and specificity for validation of the CPT codes against the mastery surgery schedule were calculated. Operative reports were evaluated by use of NLP to differentiate ileostomy- from colostomy-related procedures. Sensitivity and specificity for identifying patients with ileostomy or colostomy procedures were calculated for CPT codes and NLP for the entire cohort. CPT codes performed well in identifying stoma procedures (sensitivity 87.4%, specificity 97.5%). A total of 664 stoma procedures were identified by CPT codes between 2005 and 2011. The CPT codes were adequate in identifying stoma formation (sensitivity 97.7%, specificity 72.4%) and stoma reversal (sensitivity 74.1%, specificity 98.7%), but they were inadequate in identifying ileostomy (sensitivity 35.0%, specificity 88.1%) and colostomy (75.2% and 80.9%). NLP performed with greater sensitivity, specificity, and accuracy than CPT codes in identifying stoma procedures and stoma types. Major differences where NLP outperformed CPT included identifying ileostomy (specificity 95.8%, sensitivity 88.3%, and accuracy 91.5%) and colostomy (97.6%, 90.5%, and 92.8%, respectively). CPT codes can identify effectively patients who have had stoma procedures and are adequate in distinguishing between formation and reversal; however, CPT codes cannot differentiate ileostomy from colostomy. NLP can be used to differentiate between ileostomy- and colostomy-related procedures. The role of NLP in conjunction with electronic medical records in data retrieval warrants further investigation. Published by Mosby, Inc.

42 CFR 414.502 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... laboratory test for which a new or substantially revised Healthcare Common Procedure Coding System Code is assigned on or after January 1, 2005. Substantially Revised Healthcare Common Procedure Coding System Code...

42 CFR 414.502 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... laboratory test for which a new or substantially revised Healthcare Common Procedure Coding System Code is assigned on or after January 1, 2005. Substantially Revised Healthcare Common Procedure Coding System Code...

KSC-2014-3262

NASA Image and Video Library

2014-07-23

CAPE CANAVERAL, Fla. – A view looking down from one of the higher levels in the Vehicle Assembly Building, or VAB, reveals High Bay 3 at NASA’s Kennedy Space Center in Florida. Banners note the heights of the Saturn V, Space Launch System, or SLS, and shuttle on the steel structure. Modifications are underway to prepare High Bay 3 for a new platform system. The modifications are part of a centerwide refurbishment initiative under the Ground Systems Development and Operations Program. High bay 3 is being refurbished to accommodate NASA’s Space Launch System and a variety of other spacecraft. For more information, visit http://www.nasa.gov/exploration/systems/ground/index.html. Photo credit: NASA/Dimitri Gerondidakis

KSC-2014-3264

NASA Image and Video Library

2014-07-23

CAPE CANAVERAL, Fla. – Steel structures surround High Bay 3 inside the Vehicle Assembly Building, or VAB, at NASA’s Kennedy Space Center in Florida. In view, high above, is the 175-ton crane. Banners note the heights of the Saturn V, Space Launch System, or SLS, and shuttle on the steel structure. Modifications are underway in the VAB to prepare High Bay 3 for a new platform system. The modifications are part of a centerwide refurbishment initiative under the Ground Systems Development and Operations Program. High bay 3 is being refurbished to accommodate NASA’s Space Launch System and a variety of other spacecraft. For more information, visit http://www.nasa.gov/exploration/systems/ground/index.html. Photo credit: NASA/Dimitri Gerondidakis

Development of code evaluation criteria for assessing predictive capability and performance

NASA Technical Reports Server (NTRS)

Lin, Shyi-Jang; Barson, S. L.; Sindir, M. M.; Prueger, G. H.

1993-01-01

Computational Fluid Dynamics (CFD), because of its unique ability to predict complex three-dimensional flows, is being applied with increasing frequency in the aerospace industry. Currently, no consistent code validation procedure is applied within the industry. Such a procedure is needed to increase confidence in CFD and reduce risk in the use of these codes as a design and analysis tool. This final contract report defines classifications for three levels of code validation, directly relating the use of CFD codes to the engineering design cycle. Evaluation criteria by which codes are measured and classified are recommended and discussed. Criteria for selecting experimental data against which CFD results can be compared are outlined. A four phase CFD code validation procedure is described in detail. Finally, the code validation procedure is demonstrated through application of the REACT CFD code to a series of cases culminating in a code to data comparison on the Space Shuttle Main Engine High Pressure Fuel Turbopump Impeller.

Locality-preserving logical operators in topological stabilizer codes

NASA Astrophysics Data System (ADS)

Webster, Paul; Bartlett, Stephen D.

2018-01-01

Locality-preserving logical operators in topological codes are naturally fault tolerant, since they preserve the correctability of local errors. Using a correspondence between such operators and gapped domain walls, we describe a procedure for finding all locality-preserving logical operators admitted by a large and important class of topological stabilizer codes. In particular, we focus on those equivalent to a stack of a finite number of surface codes of any spatial dimension, where our procedure fully specifies the group of locality-preserving logical operators. We also present examples of how our procedure applies to codes with different boundary conditions, including color codes and toric codes, as well as more general codes such as Abelian quantum double models and codes with fermionic excitations in more than two dimensions.

21 CFR 106.90 - Coding.

Code of Federal Regulations, 2010 CFR

2010-04-01

... CONSUMPTION INFANT FORMULA QUALITY CONTROL PROCEDURES Quality Control Procedures for Assuring Nutrient Content of Infant Formulas § 106.90 Coding. The manufacturer shall code all infant formulas in conformity...

42 CFR 414.502 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... diagnostic laboratory test for which a new or substantially revised Healthcare Common Procedure Coding System Code is assigned on or after January 1, 2005. Substantially Revised Healthcare Common Procedure Coding...

42 CFR 414.502 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... diagnostic laboratory test for which a new or substantially revised Healthcare Common Procedure Coding System Code is assigned on or after January 1, 2005. Substantially Revised Healthcare Common Procedure Coding...

42 CFR 414.502 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... diagnostic laboratory test for which a new or substantially revised Healthcare Common Procedure Coding System Code is assigned on or after January 1, 2005. Substantially Revised Healthcare Common Procedure Coding...

13 CFR 121.1103 - What are the procedures for appealing a NAICS code designation?

Code of Federal Regulations, 2010 CFR

2010-01-01

... appealing a NAICS code designation? 121.1103 Section 121.1103 Business Credit and Assistance SMALL BUSINESS... Determinations and Naics Code Designations § 121.1103 What are the procedures for appealing a NAICS code... code designation and applicable size standard must be served and filed within 10 calendar days after...

Business Management System Support Analysis

NASA Technical Reports Server (NTRS)

Parikh, Jay

2008-01-01

The purpose of this research project was to develop a searchable database compiled with internal and external audit findings/observations. The data will correspond to the findings and observations from the date of Center-wide implementation of the ISO 9001-2000 standard to the present (2003-2008). It was derived and extracted from several sources and was in multiple formats. Once extracted, categorization of the findings/observations would be possible. The final data was mapped to the ISO 9001-2000 standard with the understanding that it will be displayed graphically. The data will be used to verify trends, associate risks, and establish timelines to identify strengths and weaknesses to determine areas of improvement in the Kennedy Space Center Business Management System Internal Audit Program.

KSC-2012-4935

NASA Image and Video Library

2012-09-11

CAPE CANAVERAL, Fla. – At NASA’s Kennedy Space Center in Florida, from left, Thomas Keller, program manager with Chenega Security and Support Solutions on the Kennedy Protective Services contract, and Kennedy Space Center Director Robert Cabana stand at attention during the 9/11 memorial dedication ceremony at Fire Station 1. Kennedy Fire and Rescue Services commemorated the 11th anniversary of 9/11 with a ceremony that included a minute of silence at 10:28 a.m., which was the moment of collapse of the north tower of the World Trade Center. Kennedy center-wide emergency units dispatched by Fire Control engaged in one-minute sirens, the new memorial was dedicated and the Honor Guard performed a flag-folding ceremony. Photo credit: NASA/Dimitri Gerondidakis

KSC-2012-5016

NASA Image and Video Library

2012-09-06

CAPE CANAVERAL, Fla. – During NASA's Innovation Expo at the Kennedy Space Center in Florida, Annie Williams, of NASA's Medical and Environmental Management Division, proposes an innovation to recycling space hardware as art. Kennedy Kick-Start Chair Mike Conroy looks on from the left. As Kennedy continues developing programs and infrastructure to become a 21st century spaceport, many employees are devising ways to do their jobs better and more efficiently. On Sept. 6, 2012, 16 Kennedy employees pitched their innovative ideas for improving the center at the Kennedy Kick-Start event. The competition was part of a center-wide effort designed to increase exposure for innovative ideas and encourage their implementation. For more information, visit http://www.nasa.gov/centers/kennedy/news/kick-start_competition.html Photo credit: NASA/Gianni Woods

[Code of civil procedure for medical workers -the essential principles of proceedings and expediting of trials-].

PubMed

Kageyama, Kyoko; Jimba, Koichi; Hashimoto, Satoru

2013-04-01

Code of civil procedure is started when a plaintiff appeals to the law. Conversely, if a suit is not appealed, it is not started. We explain the essential principles of the code of civil procedure, and present systems associated with expediting trials (a brief, preliminary oral arguments, preparatory proceedings, inquiry to opponent, organized proceedings, technical adviser system, etc.). Amendment of law is repeated for the purpose of aiming suitably expediting trials. We should utilize the present code of civil procedure suitably, and expect the quick conclusion of trials.

Improving the accuracy of operation coding in surgical discharge summaries

PubMed Central

Martinou, Eirini; Shouls, Genevieve; Betambeau, Nadine

2014-01-01

Procedural coding in surgical discharge summaries is extremely important; as well as communicating to healthcare staff which procedures have been performed, it also provides information that is used by the hospital's coding department. The OPCS code (Office of Population, Censuses and Surveys Classification of Surgical Operations and Procedures) is used to generate the tariff that allows the hospital to be reimbursed for the procedure. We felt that the OPCS coding on discharge summaries was often incorrect within our breast and endocrine surgery department. A baseline measurement over two months demonstrated that 32% of operations had been incorrectly coded, resulting in an incorrect tariff being applied and an estimated loss to the Trust of £17,000. We developed a simple but specific OPCS coding table in collaboration with the clinical coding team and breast surgeons that summarised all operations performed within our department. This table was disseminated across the team, specifically to the junior doctors who most frequently complete the discharge summaries. Re-audit showed 100% of operations were accurately coded, demonstrating the effectiveness of the coding table. We suggest that specifically designed coding tables be introduced across each surgical department to ensure accurate OPCS codes are used to produce better quality surgical discharge summaries and to ensure correct reimbursement to the Trust. PMID:26734286

Evaluating a Dental Diagnostic Terminology in an Electronic Health Record

PubMed Central

White, Joel M.; Kalenderian, Elsbeth; Stark, Paul C.; Ramoni, Rachel L.; Vaderhobli, Ram; Walji, Muhammad F.

2011-01-01

Standardized treatment procedure codes and terms are routinely used in dentistry. Utilization of a diagnostic terminology is common in medicine, but there is not a satisfactory or commonly standardized dental diagnostic terminology available at this time. Recent advances in dental informatics have provided an opportunity for inclusion of diagnostic codes and terms as part of treatment planning and documentation in the patient treatment history. This article reports the results of the use of a diagnostic coding system in a large dental school’s predoctoral clinical practice. A list of diagnostic codes and terms, called Z codes, was developed by dental faculty members. The diagnostic codes and terms were implemented into an electronic health record (EHR) for use in a predoctoral dental clinic. The utilization of diagnostic terms was quantified. The validity of Z code entry was evaluated by comparing the diagnostic term entered to the procedure performed, where valid diagnosis-procedure associations were determined by consensus among three calibrated academically based dentists. A total of 115,004 dental procedures were entered into the EHR during the year sampled. Of those, 43,053 were excluded from this analysis because they represent diagnosis or other procedures unrelated to treatments. Among the 71,951 treatment procedures, 27,973 had diagnoses assigned to them with an overall utilization of 38.9 percent. Of the 147 available Z codes, ninety-three were used (63.3 percent). There were 335 unique procedures provided and 2,127 procedure/diagnosis pairs captured in the EHR. Overall, 76.7 percent of the diagnoses entered were valid. We conclude that dental diagnostic terminology can be incorporated within an electronic health record and utilized in an academic clinical environment. Challenges remain in the development of terms and implementation and ease of use that, if resolved, would improve the utilization. PMID:21546594

Audit of Clinical Coding of Major Head and Neck Operations

PubMed Central

Mitra, Indu; Malik, Tass; Homer, Jarrod J; Loughran, Sean

2009-01-01

INTRODUCTION Within the NHS, operations are coded using the Office of Population Censuses and Surveys (OPCS) classification system. These codes, together with diagnostic codes, are used to generate Healthcare Resource Group (HRG) codes, which correlate to a payment bracket. The aim of this study was to determine whether allocated procedure codes for major head and neck operations were correct and reflective of the work undertaken. HRG codes generated were assessed to determine accuracy of remuneration. PATIENTS AND METHODS The coding of consecutive major head and neck operations undertaken in a tertiary referral centre over a retrospective 3-month period were assessed. Procedure codes were initially ascribed by professional hospital coders. Operations were then recoded by the surgical trainee in liaison with the head of clinical coding. The initial and revised procedure codes were compared and used to generate HRG codes, to determine whether the payment banding had altered. RESULTS A total of 34 cases were reviewed. The number of procedure codes generated initially by the clinical coders was 99, whereas the revised codes generated 146. Of the original codes, 47 of 99 (47.4%) were incorrect. In 19 of the 34 cases reviewed (55.9%), the HRG code remained unchanged, thus resulting in the correct payment. Six cases were never coded, equating to £15,300 loss of payment. CONCLUSIONS These results highlight the inadequacy of this system to reward hospitals for the work carried out within the NHS in a fair and consistent manner. The current coding system was found to be complicated, ambiguous and inaccurate, resulting in loss of remuneration. PMID:19220944

The Social Interactive Coding System (SICS): An On-Line, Clinically Relevant Descriptive Tool.

ERIC Educational Resources Information Center

Rice, Mabel L.; And Others

1990-01-01

The Social Interactive Coding System (SICS) assesses the continuous verbal interactions of preschool children as a function of play areas, addressees, script codes, and play levels. This paper describes the 26 subjects and the setting involved in SICS development, coding definitions and procedures, training procedures, reliability, sample…

Comparing the coding of complications in Queensland and Victorian admitted patient data.

PubMed

Michel, Jude L; Cheng, Diana; Jackson, Terri J

2011-08-01

To examine differences between Queensland and Victorian coding of hospital-acquired conditions and suggest ways to improve the usefulness of these data in the monitoring of patient safety events. Secondary analysis of admitted patient episode data collected in Queensland and Victoria. Comparison of depth of coding, and patterns in the coding of ten commonly coded complications of five elective procedures. Comparison of the mean complication codes assigned per episode revealed Victoria assigns more valid codes than Queensland for all procedures, with the difference between the states being significantly different in all cases. The proportion of the codes flagged as complications was consistently lower for Queensland when comparing 10 common complications for each of the five selected elective procedures. The estimated complication rates for the five procedures showed Victoria to have an apparently higher complication rate than Queensland for 35 of the 50 complications examined. Our findings demonstrate that the coding of complications is more comprehensive in Victoria than in Queensland. It is known that inconsistencies exist between states in routine hospital data quality. Comparative use of patient safety indicators should be viewed with caution until standards are improved across Australia. More exploration of data quality issues is needed to identify areas for improvement.

Standard interface files and procedures for reactor physics codes, version III

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carmichael, B.M.

Standards and procedures for promoting the exchange of reactor physics codes are updated to Version-III status. Standards covering program structure, interface files, file handling subroutines, and card input format are included. The implementation status of the standards in codes and the extension of the standards to new code areas are summarized. (15 references) (auth)

KSC-2012-5019

NASA Image and Video Library

2012-09-06

PE CANAVERAL, Fla. – During NASA's Innovation Expo at the Kennedy Space Center in Florida, Priscilla Elfrey, of NASA's Computational Sciences Branch, proposes that NASA to partner with two organizations to help improve minority employment. Kennedy Kick-Start Chair Mike Conroy looks on from the left. As Kennedy continues developing programs and infrastructure to become a 21st century spaceport, many employees are devising ways to do their jobs better and more efficiently. On Sept. 6, 2012, 16 Kennedy employees pitched their innovative ideas for improving the center at the Kennedy Kick-Start event. The competition was part of a center-wide effort designed to increase exposure for innovative ideas and encourage their implementation. For more information, visit http://www.nasa.gov/centers/kennedy/news/kick-start_competition.html Photo credit: NASA/Gianni Woods

KSC-2012-5017

NASA Image and Video Library

2012-09-06

CAPE CANAVERAL, Fla. – During NASA's Innovation Expo at the Kennedy Space Center in Florida, William Merrill, of NASA's Communications Infrastructure Services Division, proposes an innovation that would make mission audio available by way of an Internet radio stream. Kennedy Kick-Start Chair Mike Conroy looks on from the left. As Kennedy continues developing programs and infrastructure to become a 21st century spaceport, many employees are devising ways to do their jobs better and more efficiently. On Sept. 6, 2012, 16 Kennedy employees pitched their innovative ideas for improving the center at the Kennedy Kick-Start event. The competition was part of a center-wide effort designed to increase exposure for innovative ideas and encourage their implementation. For more information, visit http://www.nasa.gov/centers/kennedy/news/kick-start_competition.html Photo credit: NASA/Gianni Woods

KSC-2012-2599

NASA Image and Video Library

2012-04-27

CAPE CANAVERAL, Fla. – At NASA’s Kennedy Space Center in Florida, cable trays wind their way along the grating in high bay 3 in the Vehicle Assembly Building, or VAB, during part of a centerwide refurbishment initiative under the Ground Systems Development and Operations GSDO Program. The cable replacement project is under way in high bays 1 and 3 on the east side of the building, facing Launch Complex 39’s pads A and B. Approximately 150 miles of existing Apollo/shuttle era cabling is being removed to make room for installation of state-of-the-art command, communication and control systems that will be needed by future users to perform vehicle testing and verification prior to rollout to the launch pad. For more information, visit http://go.nasa.gov/groundsystems. Photo credit: NASA/Jim Grossmann

KSC-2012-2595

NASA Image and Video Library

2012-04-27

CAPE CANAVERAL, Fla. – At NASA’s Kennedy Space Center in Florida, old racks are being excessed in high bay 3 in the Vehicle Assembly Building, or VAB, as part of a centerwide refurbishment initiative under the Ground Systems Development and Operations GSDO Program The cable replacement project is under way in high bays 1 and 3 on the east side of the building, facing Launch Complex 39’s pads A and B. Approximately 150 miles of existing Apollo/shuttle era cabling is being removed to make room for installation of state-of-the-art command, communication and control systems that will be needed by future users to perform vehicle testing and verification prior to rollout to the launch pad. For more information, visit http://go.nasa.gov/groundsystems. Photo credit: NASA/Jim Grossmann

KSC-2012-2594

NASA Image and Video Library

2012-04-27

CAPE CANAVERAL, Fla. – At NASA’s Kennedy Space Center in Florida, old cabling is being pulled from high bay 3 in the Vehicle Assembly Building, or VAB, as part of a centerwide refurbishment initiative under the Ground Systems Development and Operations GSDO Program. The cable replacement project is under way in high bays 1 and 3 on the east side of the building, facing Launch Complex 39’s pads A and B. Approximately 150 miles of existing Apollo/shuttle era cabling is being removed to make room for installation of state-of-the-art command, communication and control systems that will be needed by future users to perform vehicle testing and verification prior to rollout to the launch pad. For more information, visit http://go.nasa.gov/groundsystems. Photo credit: NASA/Jim Grossmann

KSC-2012-2597

NASA Image and Video Library

2012-04-27

CAPE CANAVERAL, Fla. – At NASA’s Kennedy Space Center in Florida, cable trays run along the walls in high bay 3 in the Vehicle Assembly Building, or VAB, as part of a centerwide refurbishment initiative under the Ground Systems Development and Operations GSDO Program. The cable replacement project is under way in high bays 1 and 3 on the east side of the building, facing Launch Complex 39’s pads A and B. Approximately 150 miles of existing Apollo/shuttle era cabling is being removed to make room for installation of state-of-the-art command, communication and control systems that will be needed by future users to perform vehicle testing and verification prior to rollout to the launch pad. For more information, visit http://go.nasa.gov/groundsystems. Photo credit: NASA/Jim Grossmann

Greater physician involvement improves coding outcomes in endobronchial ultrasound-guided transbronchial needle aspiration procedures.

PubMed

Pillai, Anilkumar; Medford, Andrew R L

2013-01-01

Correct coding is essential for accurate reimbursement for clinical activity. Published data confirm that significant aberrations in coding occur, leading to considerable financial inaccuracies especially in interventional procedures such as endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Previous data reported a 15% coding error for EBUS-TBNA in a U.K. service. We hypothesised that greater physician involvement with coders would reduce EBUS-TBNA coding errors and financial disparity. The study was done as a prospective cohort study in the tertiary EBUS-TBNA service in Bristol. 165 consecutive patients between October 2009 and March 2012 underwent EBUS-TBNA for evaluation of unexplained mediastinal adenopathy on computed tomography. The chief coder was prospectively electronically informed of all procedures and cross-checked on a prospective database and by Trust Informatics. Cost and coding analysis was performed using the 2010-2011 tariffs. All 165 procedures (100%) were coded correctly as verified by Trust Informatics. This compares favourably with the 14.4% coding inaccuracy rate for EBUS-TBNA in a previous U.K. prospective cohort study [odds ratio 201.1 (1.1-357.5), p = 0.006]. Projected income loss was GBP 40,000 per year in the previous study, compared to a GBP 492,195 income here with no coding-attributable loss in revenue. Greater physician engagement with coders prevents coding errors and financial losses which can be significant especially in interventional specialties. The intervention can be as cheap, quick and simple as a prospective email to the coding team with cross-checks by Trust Informatics and against a procedural database. We suggest that all specialties should engage more with their coders using such a simple intervention to prevent revenue losses. Copyright © 2013 S. Karger AG, Basel.

28 CFR 36.604 - Procedure following preliminary determination of equivalency.

Code of Federal Regulations, 2014 CFR

2014-07-01

... State Laws or Local Building Codes § 36.604 Procedure following preliminary determination of equivalency... of the preliminary determination of equivalency with respect to the particular code, and invite... enforcement of the code, at which interested individuals, including individuals with disabilities, are...

28 CFR 36.604 - Procedure following preliminary determination of equivalency.

Code of Federal Regulations, 2011 CFR

2011-07-01

... State Laws or Local Building Codes § 36.604 Procedure following preliminary determination of equivalency... of the preliminary determination of equivalency with respect to the particular code, and invite... enforcement of the code, at which interested individuals, including individuals with disabilities, are...

28 CFR 36.604 - Procedure following preliminary determination of equivalency.

Code of Federal Regulations, 2012 CFR

2012-07-01

... State Laws or Local Building Codes § 36.604 Procedure following preliminary determination of equivalency... of the preliminary determination of equivalency with respect to the particular code, and invite... enforcement of the code, at which interested individuals, including individuals with disabilities, are...

28 CFR 36.604 - Procedure following preliminary determination of equivalency.

Code of Federal Regulations, 2013 CFR

2013-07-01

... State Laws or Local Building Codes § 36.604 Procedure following preliminary determination of equivalency... of the preliminary determination of equivalency with respect to the particular code, and invite... enforcement of the code, at which interested individuals, including individuals with disabilities, are...

A Semantic Analysis Method for Scientific and Engineering Code

NASA Technical Reports Server (NTRS)

Stewart, Mark E. M.

1998-01-01

This paper develops a procedure to statically analyze aspects of the meaning or semantics of scientific and engineering code. The analysis involves adding semantic declarations to a user's code and parsing this semantic knowledge with the original code using multiple expert parsers. These semantic parsers are designed to recognize formulae in different disciplines including physical and mathematical formulae and geometrical position in a numerical scheme. In practice, a user would submit code with semantic declarations of primitive variables to the analysis procedure, and its semantic parsers would automatically recognize and document some static, semantic concepts and locate some program semantic errors. A prototype implementation of this analysis procedure is demonstrated. Further, the relationship between the fundamental algebraic manipulations of equations and the parsing of expressions is explained. This ability to locate some semantic errors and document semantic concepts in scientific and engineering code should reduce the time, risk, and effort of developing and using these codes.

75 FR 78707 - Medicare Program; First Semi-Annual Meeting of the Advisory Panel on Ambulatory Payment...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-16

... hospital payment systems; hospital medical care delivery systems; provider billing and accounting systems; APC groups; Current Procedural Terminology codes; Health Care Common Procedure Coding System (HCPCS) codes; the use of, and payment for, drugs, medical devices, and other services in the outpatient setting...

Development of probabilistic multimedia multipathway computer codes.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yu, C.; LePoire, D.; Gnanapragasam, E.

2002-01-01

The deterministic multimedia dose/risk assessment codes RESRAD and RESRAD-BUILD have been widely used for many years for evaluation of sites contaminated with residual radioactive materials. The RESRAD code applies to the cleanup of sites (soils) and the RESRAD-BUILD code applies to the cleanup of buildings and structures. This work describes the procedure used to enhance the deterministic RESRAD and RESRAD-BUILD codes for probabilistic dose analysis. A six-step procedure was used in developing default parameter distributions and the probabilistic analysis modules. These six steps include (1) listing and categorizing parameters; (2) ranking parameters; (3) developing parameter distributions; (4) testing parameter distributionsmore » for probabilistic analysis; (5) developing probabilistic software modules; and (6) testing probabilistic modules and integrated codes. The procedures used can be applied to the development of other multimedia probabilistic codes. The probabilistic versions of RESRAD and RESRAD-BUILD codes provide tools for studying the uncertainty in dose assessment caused by uncertain input parameters. The parameter distribution data collected in this work can also be applied to other multimedia assessment tasks and multimedia computer codes.« less

Evaluation of Factors Influencing Accuracy of Principal Procedure Coding Based on ICD-9-CM: An Iranian Study

PubMed Central

Farzandipour, Mehrdad; Sheikhtaheri, Abbas

2009-01-01

To evaluate the accuracy of procedural coding and the factors that influence it, 246 records were randomly selected from four teaching hospitals in Kashan, Iran. “Recodes” were assigned blindly and then compared to the original codes. Furthermore, the coders' professional behaviors were carefully observed during the coding process. Coding errors were classified as major or minor. The relations between coding accuracy and possible effective factors were analyzed by χ2 or Fisher exact tests as well as the odds ratio (OR) and the 95 percent confidence interval for the OR. The results showed that using a tabular index for rechecking codes reduces errors (83 percent vs. 72 percent accuracy). Further, more thorough documentation by the clinician positively affected coding accuracy, though this relation was not significant. Readability of records decreased errors overall (p = .003), including major ones (p = .012). Moreover, records with no abbreviations had fewer major errors (p = .021). In conclusion, not using abbreviations, ensuring more readable documentation, and paying more attention to available information increased coding accuracy and the quality of procedure databases. PMID:19471647

76 FR 12600 - Review of the Emergency Alert System

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-08

... appropriate, various administrative procedures for national tests, including test codes to be used and pre... administrative procedures for national tests, including test codes to be used and pre-test outreach. B. Summary... test codes to be used and pre-test outreach, the Commission has instructed the Bureau to factor in the...

28 CFR 36.605 - Procedure following preliminary denial of certification.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Local Building Codes § 36.605 Procedure following preliminary denial of certification. (a) If the Assistant Attorney General makes a preliminary determination to deny certification of a code under § 36.603... specification of the manner in which the code could be amended in order to qualify for certification. (b) The...

28 CFR 36.605 - Procedure following preliminary denial of certification.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Local Building Codes § 36.605 Procedure following preliminary denial of certification. (a) If the Assistant Attorney General makes a preliminary determination to deny certification of a code under § 36.603... specification of the manner in which the code could be amended in order to qualify for certification. (b) The...

28 CFR 36.605 - Procedure following preliminary denial of certification.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Local Building Codes § 36.605 Procedure following preliminary denial of certification. (a) If the Assistant Attorney General makes a preliminary determination to deny certification of a code under § 36.603... specification of the manner in which the code could be amended in order to qualify for certification. (b) The...

28 CFR 36.605 - Procedure following preliminary denial of certification.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Local Building Codes § 36.605 Procedure following preliminary denial of certification. (a) If the Assistant Attorney General makes a preliminary determination to deny certification of a code under § 36.603... specification of the manner in which the code could be amended in order to qualify for certification. (b) The...

28 CFR 36.606 - Procedure following preliminary denial of certification.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Local Building Codes § 36.606 Procedure following preliminary denial of certification. (a) If the Assistant Attorney General makes a Preliminary determination to deny certification of a code under § 36.604... specification of the manner in which the code could be amended in order to qualify for certification. (b) The...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR GLOBAL CODING FOR SCANNED FORMS (UA-D-31.1)

EPA Science Inventory

The purpose of this SOP is to define the strategy for the Global Coding of Scanned Forms. This procedure applies to the Arizona NHEXAS project and the "Border" study. Keywords: Coding; scannable forms.

The National Human Exposure Assessment Survey (NHEXAS) is a federal interag...

75 FR 51465 - Medicare Program; Announcement of Five New Members to the Advisory Panel on Ambulatory Payment...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-20

... Panel. This expertise encompasses hospital payment systems; hospital medical-care delivery systems; provider billing systems; APC groups, Current Procedural Terminology codes, and alpha-numeric Healthcare Common Procedure Coding System codes; and the use of, and payment for, drugs and medical devices in the...

Automatic Coding of Dialogue Acts in Collaboration Protocols

ERIC Educational Resources Information Center

Erkens, Gijsbert; Janssen, Jeroen

2008-01-01

Although protocol analysis can be an important tool for researchers to investigate the process of collaboration and communication, the use of this method of analysis can be time consuming. Hence, an automatic coding procedure for coding dialogue acts was developed. This procedure helps to determine the communicative function of messages in online…

Audit of accuracy of clinical coding in oral surgery.

PubMed

Naran, S; Hudovsky, A; Antscherl, J; Howells, S; Nouraei, S A R

2014-10-01

We aimed to study the accuracy of clinical coding within oral surgery and to identify ways in which it can be improved. We undertook did a multidisciplinary audit of a sample of 646 day case patients who had had oral surgery procedures between 2011 and 2012. We compared the codes given with their case notes and amended any discrepancies. The accuracy of coding was assessed for primary and secondary diagnoses and procedures, and for health resource groupings (HRGs). The financial impact of coding Subjectivity, Variability and Error (SVE) was assessed by reference to national tariffs. The audit resulted in 122 (19%) changes to primary diagnoses. The codes for primary procedures changed in 224 (35%) cases; 310 (48%) morbidities and complications had been missed, and 266 (41%) secondary procedures had been missed or were incorrect. This led to at least one change of coding in 496 (77%) patients, and to the HRG changes in 348 (54%) patients. The financial impact of this was £114 in lost revenue per patient. There is a high incidence of coding errors in oral surgery because of the large number of day cases, a lack of awareness by clinicians of coding issues, and because clinical coders are not always familiar with the large number of highly specialised abbreviations used. Accuracy of coding can be improved through the use of a well-designed proforma, and standards can be maintained by the use of an ongoing data quality assurance programme. Copyright © 2014. Published by Elsevier Ltd.

Evaluating the performance of two neutron spectrum unfolding codes based on iterative procedures and artificial neural networks

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ortiz-Rodriguez, J. M.; Reyes Alfaro, A.; Reyes Haro, A.

In this work the performance of two neutron spectrum unfolding codes based on iterative procedures and artificial neural networks is evaluated. The first one code based on traditional iterative procedures and called Neutron spectrometry and dosimetry from the Universidad Autonoma de Zacatecas (NSDUAZ) use the SPUNIT iterative algorithm and was designed to unfold neutron spectrum and calculate 15 dosimetric quantities and 7 IAEA survey meters. The main feature of this code is the automated selection of the initial guess spectrum trough a compendium of neutron spectrum compiled by the IAEA. The second one code known as Neutron spectrometry and dosimetrymore » with artificial neural networks (NDSann) is a code designed using neural nets technology. The artificial intelligence approach of neural net does not solve mathematical equations. By using the knowledge stored at synaptic weights on a neural net properly trained, the code is capable to unfold neutron spectrum and to simultaneously calculate 15 dosimetric quantities, needing as entrance data, only the rate counts measured with a Bonner spheres system. Similarities of both NSDUAZ and NSDann codes are: they follow the same easy and intuitive user's philosophy and were designed in a graphical interface under the LabVIEW programming environment. Both codes unfold the neutron spectrum expressed in 60 energy bins, calculate 15 dosimetric quantities and generate a full report in HTML format. Differences of these codes are: NSDUAZ code was designed using classical iterative approaches and needs an initial guess spectrum in order to initiate the iterative procedure. In NSDUAZ, a programming routine was designed to calculate 7 IAEA instrument survey meters using the fluence-dose conversion coefficients. NSDann code use artificial neural networks for solving the ill-conditioned equation system of neutron spectrometry problem through synaptic weights of a properly trained neural network. Contrary to iterative procedures, in neural net approach it is possible to reduce the rate counts used to unfold the neutron spectrum. To evaluate these codes a computer tool called Neutron Spectrometry and dosimetry computer tool was designed. The results obtained with this package are showed. The codes here mentioned are freely available upon request to the authors.« less

Evaluating the performance of two neutron spectrum unfolding codes based on iterative procedures and artificial neural networks

NASA Astrophysics Data System (ADS)

Ortiz-Rodríguez, J. M.; Reyes Alfaro, A.; Reyes Haro, A.; Solís Sánches, L. O.; Miranda, R. Castañeda; Cervantes Viramontes, J. M.; Vega-Carrillo, H. R.

2013-07-01

In this work the performance of two neutron spectrum unfolding codes based on iterative procedures and artificial neural networks is evaluated. The first one code based on traditional iterative procedures and called Neutron spectrometry and dosimetry from the Universidad Autonoma de Zacatecas (NSDUAZ) use the SPUNIT iterative algorithm and was designed to unfold neutron spectrum and calculate 15 dosimetric quantities and 7 IAEA survey meters. The main feature of this code is the automated selection of the initial guess spectrum trough a compendium of neutron spectrum compiled by the IAEA. The second one code known as Neutron spectrometry and dosimetry with artificial neural networks (NDSann) is a code designed using neural nets technology. The artificial intelligence approach of neural net does not solve mathematical equations. By using the knowledge stored at synaptic weights on a neural net properly trained, the code is capable to unfold neutron spectrum and to simultaneously calculate 15 dosimetric quantities, needing as entrance data, only the rate counts measured with a Bonner spheres system. Similarities of both NSDUAZ and NSDann codes are: they follow the same easy and intuitive user's philosophy and were designed in a graphical interface under the LabVIEW programming environment. Both codes unfold the neutron spectrum expressed in 60 energy bins, calculate 15 dosimetric quantities and generate a full report in HTML format. Differences of these codes are: NSDUAZ code was designed using classical iterative approaches and needs an initial guess spectrum in order to initiate the iterative procedure. In NSDUAZ, a programming routine was designed to calculate 7 IAEA instrument survey meters using the fluence-dose conversion coefficients. NSDann code use artificial neural networks for solving the ill-conditioned equation system of neutron spectrometry problem through synaptic weights of a properly trained neural network. Contrary to iterative procedures, in neural net approach it is possible to reduce the rate counts used to unfold the neutron spectrum. To evaluate these codes a computer tool called Neutron Spectrometry and dosimetry computer tool was designed. The results obtained with this package are showed. The codes here mentioned are freely available upon request to the authors.

Monitoring the use and outcomes of new devices and procedures: how does coding affect what Hospital Episode Statistics contribute? Lessons from 12 emerging procedures 2006-10.

PubMed

Patrick, Hannah; Sims, Andrew; Burn, Julie; Bousfield, Derek; Colechin, Elaine; Reay, Christopher; Alderson, Neil; Goode, Stephen; Cunningham, David; Campbell, Bruce

2013-03-01

New devices and procedures are often introduced into health services when the evidence base for their efficacy and safety is limited. The authors sought to assess the availability and accuracy of routinely collected Hospital Episodes Statistics (HES) data in the UK and their potential contribution to the monitoring of new procedures. Four years of HES data (April 2006-March 2010) were analysed to identify episodes of hospital care involving a sample of 12 new interventional procedures. HES data were cross checked against other relevant sources including national or local registers and manufacturers' information. HES records were available for all 12 procedures during the entire study period. Comparative data sources were available from national (5), local (2) and manufacturer (2) registers. Factors found to affect comparisons were miscoding, alternative coding and inconsistent use of subsidiary codes. The analysis of provider coverage showed that HES is sensitive at detecting centres which carry out procedures, but specificity is poor in some cases. Routinely collected HES data have the potential to support quality improvements and evidence-based commissioning of devices and procedures in health services but achievement of this potential depends upon the accurate coding of procedures.

Identifying complications of interventional procedures from UK routine healthcare databases: a systematic search for methods using clinical codes.

PubMed

Keltie, Kim; Cole, Helen; Arber, Mick; Patrick, Hannah; Powell, John; Campbell, Bruce; Sims, Andrew

2014-11-28

Several authors have developed and applied methods to routine data sets to identify the nature and rate of complications following interventional procedures. But, to date, there has been no systematic search for such methods. The objective of this article was to find, classify and appraise published methods, based on analysis of clinical codes, which used routine healthcare databases in a United Kingdom setting to identify complications resulting from interventional procedures. A literature search strategy was developed to identify published studies that referred, in the title or abstract, to the name or acronym of a known routine healthcare database and to complications from procedures or devices. The following data sources were searched in February and March 2013: Cochrane Methods Register, Conference Proceedings Citation Index - Science, Econlit, EMBASE, Health Management Information Consortium, Health Technology Assessment database, MathSciNet, MEDLINE, MEDLINE in-process, OAIster, OpenGrey, Science Citation Index Expanded and ScienceDirect. Of the eligible papers, those which reported methods using clinical coding were classified and summarised in tabular form using the following headings: routine healthcare database; medical speciality; method for identifying complications; length of follow-up; method of recording comorbidity. The benefits and limitations of each approach were assessed. From 3688 papers identified from the literature search, 44 reported the use of clinical codes to identify complications, from which four distinct methods were identified: 1) searching the index admission for specified clinical codes, 2) searching a sequence of admissions for specified clinical codes, 3) searching for specified clinical codes for complications from procedures and devices within the International Classification of Diseases 10th revision (ICD-10) coding scheme which is the methodology recommended by NHS Classification Service, and 4) conducting manual clinical review of diagnostic and procedure codes. The four distinct methods identifying complication from codified data offer great potential in generating new evidence on the quality and safety of new procedures using routine data. However the most robust method, using the methodology recommended by the NHS Classification Service, was the least frequently used, highlighting that much valuable observational data is being ignored.

The accuracy of real-time procedure coding by theatre nurses: a comparison with the central national system.

PubMed

Maclean, Donald; Younes, Hakim Ben; Forrest, Margaret; Towers, Hazel K

2012-03-01

Accurate and timely clinical data are required for clinical and organisational purposes and is especially important for patient management, audit of surgical performance and the electronic health record. The recent introduction of computerised theatre management systems has enabled real-time (point-of-care) operative procedure coding by clinical staff. However the accuracy of these data is unknown. The aim of this Scottish study was to compare the accuracy of theatre nurses' real-time coding on the local theatre management system with the central Scottish Morbidity Record (SMR01). Paired procedural codes were recorded, qualitatively graded for precision and compared (n = 1038). In this study, real-time, point-of-care coding by theatre nurses resulted in significant coding errors compared with the central SMR01 database. Improved collaboration between full-time coders and clinical staff using computerised decision support systems is suggested.

Association of code status discussion with invasive procedures among advanced-stage cancer and noncancer patients.

PubMed

Sasaki, Akinori; Hiraoka, Eiji; Homma, Yosuke; Takahashi, Osamu; Norisue, Yasuhiro; Kawai, Koji; Fujitani, Shigeki

2017-01-01

Code status discussion is associated with a decrease in invasive procedures among terminally ill cancer patients. We investigated the association between code status discussion on admission and incidence of invasive procedures, cardiopulmonary resuscitation (CPR), and opioid use among inpatients with advanced stages of cancer and noncancer diseases. We performed a retrospective cohort study in a single center, Ito Municipal Hospital, Japan. Participants were patients who were admitted to the Department of Internal Medicine between October 1, 2013 and August 30, 2015, with advanced-stage cancer and noncancer. We collected demographic data and inquired the presence or absence of code status discussion within 24 hours of admission and whether invasive procedures, including central venous catheter placement, intubation with mechanical ventilation, and CPR for cardiac arrest, and opioid treatment were performed. We investigated the factors associated with CPR events by using multivariate logistic regression analysis. Among the total 232 patients, code status was discussed with 115 patients on admission, of which 114 (99.1%) patients had do-not-resuscitate (DNR) orders. The code status was not discussed with the remaining 117 patients on admission, of which 69 (59%) patients had subsequent code status discussion with resultant DNR orders. Code status discussion on admission decreased the incidence of central venous catheter placement, intubation with mechanical ventilation, and CPR in both cancer and noncancer patients. It tended to increase the rate of opioid use. Code status discussion on admission was the only factor associated with the decreased use of CPR ( P <0.001, odds ratio =0.03, 95% CI =0.004-0.21), which was found by using multivariate logistic regression analysis. Code status discussion on admission is associated with a decrease in invasive procedures and CPR in cancer and noncancer patients. Physicians should be educated about code status discussion to improve end-of-life care.

28 CFR 36.605 - Procedure following preliminary determination of equivalency.

Code of Federal Regulations, 2010 CFR

2010-07-01

... State Laws or Local Building Codes § 36.605 Procedure following preliminary determination of equivalency... of the preliminary determination of equivalency with respect to the particular code, and invite...

KSC-2012-2598

NASA Image and Video Library

2012-04-27

CAPE CANAVERAL, Fla. – At NASA’s Kennedy Space Center in Florida, cable is being pulled from the cable trays lining the walls of high bay 3 in the Vehicle Assembly Building, or VAB, as part of a centerwide refurbishment initiative under the Ground Systems Development and Operations GSDO Program. The cable replacement project is under way in high bays 1 and 3 on the east side of the building, facing Launch Complex 39’s pads A and B. Approximately 150 miles of existing Apollo/shuttle era cabling is being removed to make room for installation of state-of-the-art command, communication and control systems that will be needed by future users to perform vehicle testing and verification prior to rollout to the launch pad. For more information, visit http://go.nasa.gov/groundsystems. Photo credit: NASA/Jim Grossmann

KSC-2012-2601

NASA Image and Video Library

2012-04-27

CAPE CANAVERAL, Fla. – At NASA’s Kennedy Space Center in Florida, workers pull cables between the 26th and 29th floors of high bay 3 in the 525-foot-tall Vehicle Assembly Building, or VAB, during part of a centerwide refurbishment initiative under the Ground Systems Development and Operations GSDO Program. The cable replacement project is under way in high bays 1 and 3 on the east side of the building, facing Launch Complex 39’s pads A and B. Approximately 150 miles of existing Apollo/shuttle era cabling is being removed to make room for installation of state-of-the-art command, communication and control systems that will be needed by future users to perform vehicle testing and verification prior to rollout to the launch pad. For more information, visit http://go.nasa.gov/groundsystems. Photo credit: NASA/Jim Grossmann

KSC-2012-2596

NASA Image and Video Library

2012-04-27

CAPE CANAVERAL, Fla. – At NASA’s Kennedy Space Center in Florida, refurbishment of high bay 3 is under way in the Vehicle Assembly Building, or VAB, as part of a centerwide refurbishment initiative under the Ground Systems Development and Operations GSDO Program. It is 525 feet from the bay’s ceiling to the floor. The cable replacement project is under way in high bays 1 and 3 on the east side of the building, facing Launch Complex 39’s pads A and B. Approximately 150 miles of existing Apollo/shuttle era cabling is being removed to make room for installation of state-of-the-art command, communication and control systems that will be needed by future users to perform vehicle testing and verification prior to rollout to the launch pad. For more information, visit http://go.nasa.gov/groundsystems. Photo credit: NASA/Jim Grossmann

KSC-2012-2600

NASA Image and Video Library

2012-04-27

CAPE CANAVERAL, Fla. – At NASA’s Kennedy Space Center in Florida, workers remove cables between the 26th and 29th floors of high bay 3 in the 525-foot-tall Vehicle Assembly Building, or VAB, during part of a centerwide refurbishment initiative under the Ground Systems Development and Operations GSDO Program. The cable replacement project is under way in high bays 1 and 3 on the east side of the building, facing Launch Complex 39’s pads A and B. Approximately 150 miles of existing Apollo/shuttle era cabling is being removed to make room for installation of state-of-the-art command, communication and control systems that will be needed by future users to perform vehicle testing and verification prior to rollout to the launch pad. For more information, visit http://go.nasa.gov/groundsystems. Photo credit: NASA/Jim Grossmann

A qualitative study of DRG coding practice in hospitals under the Thai Universal Coverage scheme.

PubMed

Pongpirul, Krit; Walker, Damian G; Winch, Peter J; Robinson, Courtland

2011-04-08

In the Thai Universal Coverage health insurance scheme, hospital providers are paid for their inpatient care using Diagnosis Related Group-based retrospective payment, for which quality of the diagnosis and procedure codes is crucial. However, there has been limited understandings on which health care professions are involved and how the diagnosis and procedure coding is actually done within hospital settings. The objective of this study is to detail hospital coding structure and process, and to describe the roles of key hospital staff, and other related internal dynamics in Thai hospitals that affect quality of data submitted for inpatient care reimbursement. Research involved qualitative semi-structured interview with 43 participants at 10 hospitals chosen to represent a range of hospital sizes (small/medium/large), location (urban/rural), and type (public/private). Hospital Coding Practice has structural and process components. While the structural component includes human resources, hospital committee, and information technology infrastructure, the process component comprises all activities from patient discharge to submission of the diagnosis and procedure codes. At least eight health care professional disciplines are involved in the coding process which comprises seven major steps, each of which involves different hospital staff: 1) Discharge Summarization, 2) Completeness Checking, 3) Diagnosis and Procedure Coding, 4) Code Checking, 5) Relative Weight Challenging, 6) Coding Report, and 7) Internal Audit. The hospital coding practice can be affected by at least five main factors: 1) Internal Dynamics, 2) Management Context, 3) Financial Dependency, 4) Resource and Capacity, and 5) External Factors. Hospital coding practice comprises both structural and process components, involves many health care professional disciplines, and is greatly varied across hospitals as a result of five main factors.

A qualitative study of DRG coding practice in hospitals under the Thai Universal Coverage Scheme

PubMed Central

2011-01-01

Background In the Thai Universal Coverage health insurance scheme, hospital providers are paid for their inpatient care using Diagnosis Related Group-based retrospective payment, for which quality of the diagnosis and procedure codes is crucial. However, there has been limited understandings on which health care professions are involved and how the diagnosis and procedure coding is actually done within hospital settings. The objective of this study is to detail hospital coding structure and process, and to describe the roles of key hospital staff, and other related internal dynamics in Thai hospitals that affect quality of data submitted for inpatient care reimbursement. Methods Research involved qualitative semi-structured interview with 43 participants at 10 hospitals chosen to represent a range of hospital sizes (small/medium/large), location (urban/rural), and type (public/private). Results Hospital Coding Practice has structural and process components. While the structural component includes human resources, hospital committee, and information technology infrastructure, the process component comprises all activities from patient discharge to submission of the diagnosis and procedure codes. At least eight health care professional disciplines are involved in the coding process which comprises seven major steps, each of which involves different hospital staff: 1) Discharge Summarization, 2) Completeness Checking, 3) Diagnosis and Procedure Coding, 4) Code Checking, 5) Relative Weight Challenging, 6) Coding Report, and 7) Internal Audit. The hospital coding practice can be affected by at least five main factors: 1) Internal Dynamics, 2) Management Context, 3) Financial Dependency, 4) Resource and Capacity, and 5) External Factors. Conclusions Hospital coding practice comprises both structural and process components, involves many health care professional disciplines, and is greatly varied across hospitals as a result of five main factors. PMID:21477310

Unitary reconstruction of secret for stabilizer-based quantum secret sharing

NASA Astrophysics Data System (ADS)

Matsumoto, Ryutaroh

2017-08-01

We propose a unitary procedure to reconstruct quantum secret for a quantum secret sharing scheme constructed from stabilizer quantum error-correcting codes. Erasure correcting procedures for stabilizer codes need to add missing shares for reconstruction of quantum secret, while unitary reconstruction procedures for certain class of quantum secret sharing are known to work without adding missing shares. The proposed procedure also works without adding missing shares.

Proposal for a new content model for the Austrian Procedure Catalogue.

PubMed

Neururer, Sabrina B; Pfeiffer, Karl P

2013-01-01

The Austrian Procedure Catalogue is used for procedure coding in Austria. Its architecture and content has some major weaknesses. The aim of this study is the presentation of a new potential content model for this classification system consisting of main characteristics of health interventions. It is visualized using a UML class diagram. Based on this proposition, an implementation of an ontology for procedure coding is planned.

Miscoding and other user errors: importance of ongoing education for proper blood glucose monitoring procedures.

PubMed

Schrock, Linda E

2008-07-01

This article reviews the literature to date and reports on a new study that documented the frequency of manual code-requiring blood glucose (BG) meters that were miscoded at the time of the patient's initial appointment in a hospital-based outpatient diabetes education program. Between January 1 and May 31, 2007, the type of BG meter and the accuracy of the patient's meter code (if required) and procedure for checking BG were checked during the initial appointment with the outpatient diabetes educator. If indicated, reeducation regarding the procedure for the BG meter code entry and/or BG test was provided. Of the 65 patients who brought their meter requiring manual entry of a code number or code chip to the initial appointment, 16 (25%) were miscoded at the time of the appointment. Two additional problems, one of dead batteries and one of improperly stored test strips, were identified and corrected at the first appointment. These findings underscore the importance of checking the patient's BG meter code (if required) and procedure for testing BG at each encounter with a health care professional or providing the patient with a meter that does not require manual entry of a code number or chip to match the container of test strips (i.e., an autocode meter).

Progress in The Semantic Analysis of Scientific Code

NASA Technical Reports Server (NTRS)

Stewart, Mark

2000-01-01

This paper concerns a procedure that analyzes aspects of the meaning or semantics of scientific and engineering code. This procedure involves taking a user's existing code, adding semantic declarations for some primitive variables, and parsing this annotated code using multiple, independent expert parsers. These semantic parsers encode domain knowledge and recognize formulae in different disciplines including physics, numerical methods, mathematics, and geometry. The parsers will automatically recognize and document some static, semantic concepts and help locate some program semantic errors. These techniques may apply to a wider range of scientific codes. If so, the techniques could reduce the time, risk, and effort required to develop and modify scientific codes.

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR GLOBAL CODING FOR SCANNED FORMS (UA-D-31.1)

EPA Science Inventory

The purpose of this SOP is to define the strategy for the global coding of scanned forms. This procedure applies to the Arizona NHEXAS project and the Border study. Keywords: Coding; scannable forms.

The U.S.-Mexico Border Program is sponsored by the Environmental Health Workg...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR GLOBAL CODING USED BY NHEXAS ARIZONA (HAND ENTRY) (UA-D-5.0)

EPA Science Inventory

The purpose of this SOP is to define the global coding scheme to used in the working and master databases. This procedure applies to all of the databases used during the Arizona NHEXAS project and the "Border" study. Keywords: data; coding; databases.

The National Human Exposu...

[The Patient Rights Act (PatRG)--part 1: legislative procedure, treatment contract, contracting parties and their obligations to cooperate and inform].

PubMed

Parzeller, Markus; Zedler, Barbara

2013-01-01

The article deals with the new regulations in the German Civil Code (BGB) which came into effect in Germany on 26 Feb 2013 as the Patient Rights Act (PatRG). In Part I, the legislative procedure, the treatment contract and the contracting parties (Section 630a Civil Code), the applicable regulations (Section 630b Civil Code) and the obligations to cooperate and inform (Section 630c Civil Code) are discussed and critically analysed.

Validation of Living Donor Nephrectomy Codes

PubMed Central

Lam, Ngan N.; Lentine, Krista L.; Klarenbach, Scott; Sood, Manish M.; Kuwornu, Paul J.; Naylor, Kyla L.; Knoll, Gregory A.; Kim, S. Joseph; Young, Ann; Garg, Amit X.

2018-01-01

Background: Use of administrative data for outcomes assessment in living kidney donors is increasing given the rarity of complications and challenges with loss to follow-up. Objective: To assess the validity of living donor nephrectomy in health care administrative databases compared with the reference standard of manual chart review. Design: Retrospective cohort study. Setting: 5 major transplant centers in Ontario, Canada. Patients: Living kidney donors between 2003 and 2010. Measurements: Sensitivity and positive predictive value (PPV). Methods: Using administrative databases, we conducted a retrospective study to determine the validity of diagnostic and procedural codes for living donor nephrectomies. The reference standard was living donor nephrectomies identified through the province’s tissue and organ procurement agency, with verification by manual chart review. Operating characteristics (sensitivity and PPV) of various algorithms using diagnostic, procedural, and physician billing codes were calculated. Results: During the study period, there were a total of 1199 living donor nephrectomies. Overall, the best algorithm for identifying living kidney donors was the presence of 1 diagnostic code for kidney donor (ICD-10 Z52.4) and 1 procedural code for kidney procurement/excision (1PC58, 1PC89, 1PC91). Compared with the reference standard, this algorithm had a sensitivity of 97% and a PPV of 90%. The diagnostic and procedural codes performed better than the physician billing codes (sensitivity 60%, PPV 78%). Limitations: The donor chart review and validation study was performed in Ontario and may not be generalizable to other regions. Conclusions: An algorithm consisting of 1 diagnostic and 1 procedural code can be reliably used to conduct health services research that requires the accurate determination of living kidney donors at the population level. PMID:29662679

Nonlinear, nonbinary cyclic group codes

NASA Technical Reports Server (NTRS)

Solomon, G.

1992-01-01

New cyclic group codes of length 2(exp m) - 1 over (m - j)-bit symbols are introduced. These codes can be systematically encoded and decoded algebraically. The code rates are very close to Reed-Solomon (RS) codes and are much better than Bose-Chaudhuri-Hocquenghem (BCH) codes (a former alternative). The binary (m - j)-tuples are identified with a subgroup of the binary m-tuples which represents the field GF(2 exp m). Encoding is systematic and involves a two-stage procedure consisting of the usual linear feedback register (using the division or check polynomial) and a small table lookup. For low rates, a second shift-register encoding operation may be invoked. Decoding uses the RS error-correcting procedures for the m-tuple codes for m = 4, 5, and 6.

An Experiment in Scientific Code Semantic Analysis

NASA Technical Reports Server (NTRS)

Stewart, Mark E. M.

1998-01-01

This paper concerns a procedure that analyzes aspects of the meaning or semantics of scientific and engineering code. This procedure involves taking a user's existing code, adding semantic declarations for some primitive variables, and parsing this annotated code using multiple, distributed expert parsers. These semantic parser are designed to recognize formulae in different disciplines including physical and mathematical formulae and geometrical position in a numerical scheme. The parsers will automatically recognize and document some static, semantic concepts and locate some program semantic errors. Results are shown for a subroutine test case and a collection of combustion code routines. This ability to locate some semantic errors and document semantic concepts in scientific and engineering code should reduce the time, risk, and effort of developing and using these codes.

Endobronchial Ultrasound: Clinical Uses and Professional Reimbursements.

PubMed

Gildea, Thomas R; Nicolacakis, Katina

2016-12-01

Endobronchial ultrasonography (EBUS) has become an invaluable tool in the diagnosis of patients with a variety of thoracic abnormalities. The majority of EBUS procedures are used to diagnose and stage mediastinal and hilar abnormalities, as well as peripheral pulmonary targets, with a probe-based technology. Nearly 1,000 articles have been written about its use and utility. New Current Procedural Terminology (CPT) codes have been introduced in 2016 to better capture the work and clinical use associated with the various types of EBUS procedures. The existing 31620 code has been deleted and replaced by three new codes: 31652, 31653, and 31654. These new codes have been through the valuation process, and the new rule for reimbursement has been active since January 1, 2016 with National Correct Coding Initiative correction as of April 1, 2016. The impact of these new codes will result in a net reduction in professional and technical reimbursement. This article describes the current use of EBUS and explains the current codes and professional reimbursement. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

A Quantitative Analysis of the Relationship between Medicare Payment and Service Volume for Glaucoma Procedures from 2005 through 2009.

PubMed

Gong, Dan; Jun, Lin; Tsai, James C

2015-05-01

To calculate the association between Medicare payment and service volume for 6 commonly performed glaucoma procedures. Retrospective, longitudinal database study. A 100% dataset of all glaucoma procedures performed on Medicare Part B beneficiaries within the United States from 2005 to 2009. Fixed-effects regression model using Medicare Part B carrier data for all 50 states and the District of Columbia, controlling for time-invariant carrier-specific characteristics, national trends in glaucoma service volume, Medicare beneficiary population, number of ophthalmologists, and income per capita. Payment-volume elasticities, defined as the percent change in service volume per 1% change in Medicare payment, for laser trabeculoplasty (Current Procedural Terminology [CPT] code 65855), trabeculectomy without previous surgery (CPT code 66170), trabeculectomy with previous surgery (CPT code 66172), aqueous shunt to reservoir (CPT code 66180), laser iridotomy (CPT code 66761), and scleral reinforcement with graft (CPT code 67255). The payment-volume elasticity was nonsignificant for 4 of 6 procedures studied: laser trabeculoplasty (elasticity, -0.27; 95% confidence interval [CI], -1.31 to 0.77; P = 0.61), trabeculectomy without previous surgery (elasticity, -0.42; 95% CI, -0.85 to 0.01; P = 0.053), trabeculectomy with previous surgery (elasticity, -0.28; 95% CI, -0.83 to 0.28; P = 0.32), and aqueous shunt to reservoir (elasticity, -0.47; 95% CI, -3.32 to 2.37; P = 0.74). Two procedures yielded significant associations between Medicare payment and service volume. For laser iridotomy, the payment-volume elasticity was -1.06 (95% CI, -1.39 to -0.72; P < 0.001): for every 1% decrease in CPT code 66761 payment, laser iridotomy service volume increased by 1.06%. For scleral reinforcement with graft, the payment-volume elasticity was -2.92 (95% CI, -5.72 to -0.12; P = 0.041): for every 1% decrease in CPT code 67255 payment, scleral reinforcement with graft service volume increased by 2.92%. This study calculated the association between Medicare payment and service volume for 6 commonly performed glaucoma procedures and found varying magnitudes of payment-volume elasticities, suggesting that the volume response to changes in Medicare payments, if present, is not uniform across all Medicare procedures. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

ICD-10 procedure codes produce transition challenges.

PubMed

Boyd, Andrew D; Li, Jianrong 'John'; Kenost, Colleen; Zaim, Samir Rachid; Krive, Jacob; Mittal, Manish; Satava, Richard A; Burton, Michael; Smith, Jacob; Lussier, Yves A

2018-01-01

The transition of procedure coding from ICD-9-CM-Vol-3 to ICD-10-PCS has generated problems for the medical community at large resulting from the lack of clarity required to integrate two non-congruent coding systems. We hypothesized that quantifying these issues with network topology analyses offers a better understanding of the issues, and therefore we developed solutions (online tools) to empower hospital administrators and researchers to address these challenges. Five topologies were identified: "identity"(I), "class-to-subclass"(C2S), "subclass-toclass"(S2C), "convoluted(C)", and "no mapping"(NM). The procedure codes in the 2010 Illinois Medicaid dataset (3,290 patients, 116 institutions) were categorized as C=55%, C2S=40%, I=3%, NM=2%, and S2C=1%. Majority of the problematic and ambiguous mappings (convoluted) pertained to operations in ophthalmology cardiology, urology, gyneco-obstetrics, and dermatology. Finally, the algorithms were expanded into a user-friendly tool to identify problematic topologies and specify lists of procedural codes utilized by medical professionals and researchers for mitigating error-prone translations, simplifying research, and improving quality.http://www.lussiergroup.org/transition-to-ICD10PCS.

Decision Process to Identify Lessons for Transition to a Distributed (or Blended) Learning Instructional Format

DTIC Science & Technology

2009-09-01

instructional format. Using a mixed- method coding and analysis approach, the sample of POIs were categorized, coded, statistically analyzed, and a... Method SECURITY CLASSIFICATION OF 19. LIMITATION OF 20. NUMBER 21. RESPONSIBLE PERSON 16. REPORT Unclassified 17. ABSTRACT...transition to a distributed (or blended) learning format. Procedure: A mixed- methods approach, combining qualitative coding procedures with basic

Code OK3 - An upgraded version of OK2 with beam wobbling function

NASA Astrophysics Data System (ADS)

Ogoyski, A. I.; Kawata, S.; Popov, P. H.

2010-07-01

For computer simulations on heavy ion beam (HIB) irradiation onto a target with an arbitrary shape and structure in heavy ion fusion (HIF), the code OK2 was developed and presented in Computer Physics Communications 161 (2004). Code OK3 is an upgrade of OK2 including an important capability of wobbling beam illumination. The wobbling beam introduces a unique possibility for a smooth mechanism of inertial fusion target implosion, so that sufficient fusion energy is released to construct a fusion reactor in future. New version program summaryProgram title: OK3 Catalogue identifier: ADST_v3_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/ADST_v3_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 221 517 No. of bytes in distributed program, including test data, etc.: 2 471 015 Distribution format: tar.gz Programming language: C++ Computer: PC (Pentium 4, 1 GHz or more recommended) Operating system: Windows or UNIX RAM: 2048 MBytes Classification: 19.7 Catalogue identifier of previous version: ADST_v2_0 Journal reference of previous version: Comput. Phys. Comm. 161 (2004) 143 Does the new version supersede the previous version?: Yes Nature of problem: In heavy ion fusion (HIF), ion cancer therapy, material processing, etc., a precise beam energy deposition is essentially important [1]. Codes OK1 and OK2 have been developed to simulate the heavy ion beam energy deposition in three-dimensional arbitrary shaped targets [2, 3]. Wobbling beam illumination is important to smooth the beam energy deposition nonuniformity in HIF, so that a uniform target implosion is realized and a sufficient fusion output energy is released. Solution method: OK3 code works on the base of OK1 and OK2 [2, 3]. The code simulates a multi-beam illumination on a target with arbitrary shape and structure, including beam wobbling function. Reasons for new version: The code OK3 is based on OK2 [3] and uses the same algorithm with some improvements, the most important one is the beam wobbling function. Summary of revisions:In the code OK3, beams are subdivided on many bunches. The displacement of each bunch center from the initial beam direction is calculated. Code OK3 allows the beamlet number to vary from bunch to bunch. That reduces the calculation error especially in case of very complicated mesh structure with big internal holes. The target temperature rises during the time of energy deposition. Some procedures are improved to perform faster. The energy conservation is checked up on each step of calculation process and corrected if necessary. New procedures included in OK3 Procedure BeamCenterRot( ) rotates the beam axis around the impinging direction of each beam. Procedure BeamletRot( ) rotates the beamlet axes that belong to each beam. Procedure Rotation( ) sets the coordinates of rotated beams and beamlets in chamber and pellet systems. Procedure BeamletOut( ) calculates the lost energy of ions that have not impinged on the target. Procedure TargetT( ) sets the temperature of the target layer of energy deposition during the irradiation process. Procedure ECL( ) checks up the energy conservation law at each step of the energy deposition process. Procedure ECLt( ) performs the final check up of the energy conservation law at the end of deposition process. Modified procedures in OK3 Procedure InitBeam( ): This procedure initializes the beam radius and coefficients A1, A2, A3, A4 and A5 for Gauss distributed beams [2]. It is enlarged in OK3 and can set beams with radii from 1 to 20 mm. Procedure kBunch( ) is modified to allow beamlet number variation from bunch to bunch during the deposition. Procedure ijkSp( ) and procedure Hole( ) are modified to perform faster. Procedure Espl( ) and procedure ChechE( ) are modified to increase the calculation accuracy. Procedure SD( ) calculates the total relative root-mean-square (RMS) deviation and the total relative peak-to-valley (PTV) deviation in energy deposition non-uniformity. This procedure is not included in code OK2 because of its limited applications (for spherical targets only). It is taken from code OK1 and modified to perform with code OK3. Running time: The execution time depends on the pellet mesh number and the number of beams in the simulated illumination as well as on the beam characteristics (beam radius on the pellet surface, beam subdivision, projectile particle energy and so on). In almost all of the practical running tests performed, the typical running time for one beam deposition is about 30 s on a PC with a CPU of Pentium 4, 2.4 GHz. References:A.I. Ogoyski, et al., Heavy ion beam irradiation non-uniformity in inertial fusion, Phys. Lett. A 315 (2003) 372-377. A.I. Ogoyski, et al., Code OK1 - Simulation of multi-beam irradiation on a spherical target in heavy ion fusion, Comput. Phys. Comm. 157 (2004) 160-172. A.I. Ogoyski, et al., Code OK2 - A simulation code of ion-beam illumination on an arbitrary shape and structure target, Comput. Phys. Comm. 161 (2004) 143-150.

Psychometric challenges and proposed solutions when scoring facial emotion expression codes.

PubMed

Olderbak, Sally; Hildebrandt, Andrea; Pinkpank, Thomas; Sommer, Werner; Wilhelm, Oliver

2014-12-01

Coding of facial emotion expressions is increasingly performed by automated emotion expression scoring software; however, there is limited discussion on how best to score the resulting codes. We present a discussion of facial emotion expression theories and a review of contemporary emotion expression coding methodology. We highlight methodological challenges pertinent to scoring software-coded facial emotion expression codes and present important psychometric research questions centered on comparing competing scoring procedures of these codes. Then, on the basis of a time series data set collected to assess individual differences in facial emotion expression ability, we derive, apply, and evaluate several statistical procedures, including four scoring methods and four data treatments, to score software-coded emotion expression data. These scoring procedures are illustrated to inform analysis decisions pertaining to the scoring and data treatment of other emotion expression questions and under different experimental circumstances. Overall, we found applying loess smoothing and controlling for baseline facial emotion expression and facial plasticity are recommended methods of data treatment. When scoring facial emotion expression ability, maximum score is preferred. Finally, we discuss the scoring methods and data treatments in the larger context of emotion expression research.

A method for modeling co-occurrence propensity of clinical codes with application to ICD-10-PCS auto-coding.

PubMed

Subotin, Michael; Davis, Anthony R

2016-09-01

Natural language processing methods for medical auto-coding, or automatic generation of medical billing codes from electronic health records, generally assign each code independently of the others. They may thus assign codes for closely related procedures or diagnoses to the same document, even when they do not tend to occur together in practice, simply because the right choice can be difficult to infer from the clinical narrative. We propose a method that injects awareness of the propensities for code co-occurrence into this process. First, a model is trained to estimate the conditional probability that one code is assigned by a human coder, given than another code is known to have been assigned to the same document. Then, at runtime, an iterative algorithm is used to apply this model to the output of an existing statistical auto-coder to modify the confidence scores of the codes. We tested this method in combination with a primary auto-coder for International Statistical Classification of Diseases-10 procedure codes, achieving a 12% relative improvement in F-score over the primary auto-coder baseline. The proposed method can be used, with appropriate features, in combination with any auto-coder that generates codes with different levels of confidence. The promising results obtained for International Statistical Classification of Diseases-10 procedure codes suggest that the proposed method may have wider applications in auto-coding. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Validation of an advanced analytical procedure applied to the measurement of environmental radioactivity.

PubMed

Thanh, Tran Thien; Vuong, Le Quang; Ho, Phan Long; Chuong, Huynh Dinh; Nguyen, Vo Hoang; Tao, Chau Van

2018-04-01

In this work, an advanced analytical procedure was applied to calculate radioactivity in spiked water samples in a close geometry gamma spectroscopy. It included MCNP-CP code in order to calculate the coincidence summing correction factor (CSF). The CSF results were validated by a deterministic method using ETNA code for both p-type HPGe detectors. It showed that a good agreement for both codes. Finally, the validity of the developed procedure was confirmed by a proficiency test to calculate the activities of various radionuclides. The results of the radioactivity measurement with both detectors using the advanced analytical procedure were received the ''Accepted'' statuses following the proficiency test. Copyright © 2018 Elsevier Ltd. All rights reserved.

An Experiment in Scientific Program Understanding

NASA Technical Reports Server (NTRS)

Stewart, Mark E. M.; Owen, Karl (Technical Monitor)

2000-01-01

This paper concerns a procedure that analyzes aspects of the meaning or semantics of scientific and engineering code. This procedure involves taking a user's existing code, adding semantic declarations for some primitive variables, and parsing this annotated code using multiple, independent expert parsers. These semantic parsers encode domain knowledge and recognize formulae in different disciplines including physics, numerical methods, mathematics, and geometry. The parsers will automatically recognize and document some static, semantic concepts and help locate some program semantic errors. Results are shown for three intensively studied codes and seven blind test cases; all test cases are state of the art scientific codes. These techniques may apply to a wider range of scientific codes. If so, the techniques could reduce the time, risk, and effort required to develop and modify scientific codes.

Characterizing output bottlenecks in a supercomputer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xie, Bing; Chase, Jeffrey; Dillow, David A

2012-01-01

Supercomputer I/O loads are often dominated by writes. HPC (High Performance Computing) file systems are designed to absorb these bursty outputs at high bandwidth through massive parallelism. However, the delivered write bandwidth often falls well below the peak. This paper characterizes the data absorption behavior of a center-wide shared Lustre parallel file system on the Jaguar supercomputer. We use a statistical methodology to address the challenges of accurately measuring a shared machine under production load and to obtain the distribution of bandwidth across samples of compute nodes, storage targets, and time intervals. We observe and quantify limitations from competing traffic,more » contention on storage servers and I/O routers, concurrency limitations in the client compute node operating systems, and the impact of variance (stragglers) on coupled output such as striping. We then examine the implications of our results for application performance and the design of I/O middleware systems on shared supercomputers.« less

Correct coding for laboratory procedures during assisted reproductive technology cycles.

PubMed

2016-04-01

This document provides updated coding information for services related to assisted reproductive technology procedures. This document replaces the 2012 ASRM document of the same name. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Utilization of an Academic Nursing Center.

ERIC Educational Resources Information Center

Cole, Frank L.; Mackey, Thomas

1996-01-01

Using data from an academic nursing center that cared for 3,263 patients over eight months, diseases were classified using International Classification of Diseases codes, and procedures were classified using Current Procedural Terminology codes. Patterns of health care emerged, with implications for clinical teaching. (SK)

Model Children's Code.

ERIC Educational Resources Information Center

New Mexico Univ., Albuquerque. American Indian Law Center.

The Model Children's Code was developed to provide a legally correct model code that American Indian tribes can use to enact children's codes that fulfill their legal, cultural and economic needs. Code sections cover the court system, jurisdiction, juvenile offender procedures, minor-in-need-of-care, and termination. Almost every Code section is…

DRG benchmarking study establishes national coding norms.

PubMed

Vaul, J H

1998-05-01

With the increase in fraud and abuse investigations, healthcare financial managers should examine their organization's medical record coding procedures. The Federal government and third-party payers are looking specifically for improper billing of outpatient services, unbundling of procedures to increase payment, assigning higher-paying DRG codes for inpatient claims, and other abuses. A recent benchmarking study of Medicare Provider Analysis and Review (MEDPAR) data has established national norms for hospital coding and case mix based on DRGs and has revealed the majority of atypical coding cases fall into six DRG pairs. Organizations with a greater percentage of atypical cases--those more likely to be scrutinized by Federal investigators--will want to conduct suitable review and be sure appropriate documentation exists to justify the coding.

The impact of ICD-9 revascularization procedure codes on estimates of racial disparities in ischemic stroke.

PubMed

Boan, Andrea D; Voeks, Jenifer H; Feng, Wuwei Wayne; Bachman, David L; Jauch, Edward C; Adams, Robert J; Ovbiagele, Bruce; Lackland, Daniel T

2014-01-01

The use of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9) diagnostic codes can identify racial disparities in ischemic stroke hospitalizations; however, inclusion of revascularization procedure codes as acute stroke events may affect the magnitude of the risk difference. This study assesses the impact of excluding revascularization procedure codes in the ICD-9 definition of ischemic stroke, compared with the traditional inclusive definition, on racial disparity estimates for stroke incidence and recurrence. Patients discharged with a diagnosis of ischemic stroke (ICD-9 codes 433.00-434.91 and 436) were identified from a statewide inpatient discharge database from 2010 to 2012. Race-age specific disparity estimates of stroke incidence and recurrence and 1-year cumulative recurrent stroke rates were compared between the routinely used traditional classification and a modified classification of stroke that excluded primary ICD-9 cerebral revascularization procedures codes (38.12, 00.61, and 00.63). The traditional classification identified 7878 stroke hospitalizations, whereas the modified classification resulted in 18% fewer hospitalizations (n = 6444). The age-specific black to white rate ratios were significantly higher in the modified than in the traditional classification for stroke incidence (rate ratio, 1.50; 95% confidence interval [CI], 1.43-1.58 vs. rate ratio, 1.24; 95% CI, 1.18-1.30, respectively). In whites, the 1-year cumulative recurrence rate was significantly reduced by 46% (45-64 years) and 49% (≥ 65 years) in the modified classification, largely explained by a higher rate of cerebral revascularization procedures among whites. There were nonsignificant reductions of 14% (45-64 years) and 19% (≥ 65 years) among blacks. Including cerebral revascularization procedure codes overestimates hospitalization rates for ischemic stroke and significantly underestimates the racial disparity estimates in stroke incidence and recurrence. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

21 CFR 106.90 - Coding.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 2 2013-04-01 2013-04-01 false Coding. 106.90 Section 106.90 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION INFANT FORMULA QUALITY CONTROL PROCEDURES Quality Control Procedures for Assuring Nutrient Content...

21 CFR 106.90 - Coding.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Coding. 106.90 Section 106.90 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION INFANT FORMULA QUALITY CONTROL PROCEDURES Quality Control Procedures for Assuring Nutrient Content...

21 CFR 106.90 - Coding.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Coding. 106.90 Section 106.90 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION INFANT FORMULA QUALITY CONTROL PROCEDURES Quality Control Procedures for Assuring Nutrient Content...

Trends in Utilization of Vocal Fold Injection Procedures.

PubMed

Rosow, David E

2015-11-01

Office-based vocal fold injections have become increasingly popular over the past 15 years. Examination of trends in procedure coding for vocal fold injections in the United States from 2000 to 2012 was undertaken to see if they reflect this shift. The US Part B Medicare claims database was queried from 2000 through 2012 for multiple Current Procedural Terminology codes. Over the period studied, the number of nonoperative laryngoscopic injections (31513, 31570) and operative medialization laryngoplasties (31588) remained constant. Operative vocal fold injection (31571) demonstrated marked linear growth over the 12-year study period, from 744 procedures in 2000 to 4788 in 2012-an increase >640%. The dramatic increased incidence in the use of code 31571 reflects an increasing share of vocal fold injections being performed in the operating room and not in an office setting, running counter to the prevailing trend toward awake, office-based injection procedures. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

Optimizing a liquid propellant rocket engine with an automated combustor design code (AUTOCOM)

NASA Technical Reports Server (NTRS)

Hague, D. S.; Reichel, R. H.; Jones, R. T.; Glatt, C. R.

1972-01-01

A procedure for automatically designing a liquid propellant rocket engine combustion chamber in an optimal fashion is outlined. The procedure is contained in a digital computer code, AUTOCOM. The code is applied to an existing engine, and design modifications are generated which provide a substantial potential payload improvement over the existing design. Computer time requirements for this payload improvement were small, approximately four minutes in the CDC 6600 computer.

ICD-10 procedure codes produce transition challenges

PubMed Central

Boyd, Andrew D.; Li, Jianrong ‘John’; Kenost, Colleen; Zaim, Samir Rachid; Krive, Jacob; Mittal, Manish; Satava, Richard A.; Burton, Michael; Smith, Jacob; Lussier, Yves A.

2018-01-01

The transition of procedure coding from ICD-9-CM-Vol-3 to ICD-10-PCS has generated problems for the medical community at large resulting from the lack of clarity required to integrate two non-congruent coding systems. We hypothesized that quantifying these issues with network topology analyses offers a better understanding of the issues, and therefore we developed solutions (online tools) to empower hospital administrators and researchers to address these challenges. Five topologies were identified: “identity”(I), “class-to-subclass”(C2S), “subclass-toclass”(S2C), “convoluted(C)”, and “no mapping”(NM). The procedure codes in the 2010 Illinois Medicaid dataset (3,290 patients, 116 institutions) were categorized as C=55%, C2S=40%, I=3%, NM=2%, and S2C=1%. Majority of the problematic and ambiguous mappings (convoluted) pertained to operations in ophthalmology cardiology, urology, gyneco-obstetrics, and dermatology. Finally, the algorithms were expanded into a user-friendly tool to identify problematic topologies and specify lists of procedural codes utilized by medical professionals and researchers for mitigating error-prone translations, simplifying research, and improving quality.http://www.lussiergroup.org/transition-to-ICD10PCS PMID:29888037

Development of a turbomachinery design optimization procedure using a multiple-parameter nonlinear perturbation method

NASA Technical Reports Server (NTRS)

Stahara, S. S.

1984-01-01

An investigation was carried out to complete the preliminary development of a combined perturbation/optimization procedure and associated computational code for designing optimized blade-to-blade profiles of turbomachinery blades. The overall purpose of the procedures developed is to provide demonstration of a rapid nonlinear perturbation method for minimizing the computational requirements associated with parametric design studies of turbomachinery flows. The method combines the multiple parameter nonlinear perturbation method, successfully developed in previous phases of this study, with the NASA TSONIC blade-to-blade turbomachinery flow solver, and the COPES-CONMIN optimization procedure into a user's code for designing optimized blade-to-blade surface profiles of turbomachinery blades. Results of several design applications and a documented version of the code together with a user's manual are provided.

From Novice to Expert: Problem Solving in ICD-10-PCS Procedural Coding

PubMed Central

Rousse, Justin Thomas

2013-01-01

The benefits of converting to ICD-10-CM/PCS have been well documented in recent years. One of the greatest challenges in the conversion, however, is how to train the workforce in the code sets. The International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) has been described as a language requiring higher-level reasoning skills because of the system's increased granularity. Training and problem-solving strategies required for correct procedural coding are unclear. The objective of this article is to propose that the acquisition of rule-based logic will need to be augmented with self-evaluative and critical thinking. Awareness of how this process works is helpful for established coders as well as for a new generation of coders who will master the complexities of the system. PMID:23861674

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CODING AND CODING VERIFICATION (HAND ENTRY) (UA-D-14.0)

EPA Science Inventory

The purpose of this SOP is to define the coding strategy for coding and coding verification of hand-entered data. It applies to the coding of all physical forms, especially those coded by hand. The strategy was developed for use in the Arizona NHEXAS project and the "Border" st...

26 CFR 301.6331-2 - Procedures and restrictions on levies.

Code of Federal Regulations, 2010 CFR

2010-04-01

... certified mail to the taxpayer's last known address. For further guidance regarding the definition of last...— (i) The Internal Revenue Code provisions and the procedures relating to levy and sale of property... (including the use of an installment agreement under section 6159); and (iv) The Internal Revenue Code...

26 CFR 301.6331-2 - Procedures and restrictions on levies.

Code of Federal Regulations, 2011 CFR

2011-04-01

... certified mail to the taxpayer's last known address. For further guidance regarding the definition of last...— (i) The Internal Revenue Code provisions and the procedures relating to levy and sale of property... (including the use of an installment agreement under section 6159); and (iv) The Internal Revenue Code...

26 CFR 301.6331-2 - Procedures and restrictions on levies.

Code of Federal Regulations, 2012 CFR

2012-04-01

... certified mail to the taxpayer's last known address. For further guidance regarding the definition of last...— (i) The Internal Revenue Code provisions and the procedures relating to levy and sale of property... (including the use of an installment agreement under section 6159); and (iv) The Internal Revenue Code...

26 CFR 301.6331-2 - Procedures and restrictions on levies.

Code of Federal Regulations, 2014 CFR

2014-04-01

... certified mail to the taxpayer's last known address. For further guidance regarding the definition of last...— (i) The Internal Revenue Code provisions and the procedures relating to levy and sale of property... (including the use of an installment agreement under section 6159); and (iv) The Internal Revenue Code...

Critical Care Coding for Neurologists.

PubMed

Nuwer, Marc R; Vespa, Paul M

2015-10-01

Accurate coding is an important function of neurologic practice. This contribution to Continuum is part of an ongoing series that presents helpful coding information along with examples related to the issue topic. Tips for diagnosis coding, Evaluation and Management coding, procedure coding, or a combination are presented, depending on which is most applicable to the subject area of the issue.

Coding of Neuroinfectious Diseases.

PubMed

Barkley, Gregory L

2015-12-01

Accurate coding is an important function of neurologic practice. This contribution to Continuum is part of an ongoing series that presents helpful coding information along with examples related to the issue topic. Tips for diagnosis coding, Evaluation and Management coding, procedure coding, or a combination are presented, depending on which is most applicable to the subject area of the issue.

Diagnostic Coding for Epilepsy.

PubMed

Williams, Korwyn; Nuwer, Marc R; Buchhalter, Jeffrey R

2016-02-01

Accurate coding is an important function of neurologic practice. This contribution to Continuum is part of an ongoing series that presents helpful coding information along with examples related to the issue topic. Tips for diagnosis coding, Evaluation and Management coding, procedure coding, or a combination are presented, depending on which is most applicable to the subject area of the issue.

SU-A-210-04: Panel Discussion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stanford, J.

The purpose of this student annual meeting is to address topics that are becoming more relevant to medical physicists, but are not frequently addressed, especially for students and trainees just entering the field. The talk is divided into two parts: medical billing and regulations. Hsinshun Wu – Why should we learn radiation oncology billing? Many medical physicists do not like to be involved with medical billing or coding during their career. They believe billing is not their responsibility and sometimes they even refuse to participate in the billing process if given the chance. This presentation will talk about a physicist’smore » long career and share his own experience that knowing medical billing is not only important and necessary for every young medical physicist, but that good billing knowledge could provide a valuable contribution to his/her medical physics development. Learning Objectives: The audience will learn the basic definition of Current Procedural Terminology (CPT) codes performed in a Radiation Oncology Department. Understand the differences between hospital coding and physician-based or freestanding coding. Apply proper CPT coding for each Radiation Oncology procedure. Each procedure with its specific CPT code will be discussed in detail. The talk will focus on the process of care and use of actual workflow to understand each CPT code. Example coding of a typical Radiation Oncology procedure. Special procedure coding such as brachytherapy, proton therapy, radiosurgery, and SBRT. Maryann Abogunde – Medical physics opportunities at the Nuclear Regulatory Commission (NRC) The NRC’s responsibilities include the regulation of medical uses of byproduct (radioactive) materials and oversight of medical use end-users (licensees) through a combination of regulatory requirements, licensing, safety oversight including inspection and enforcement, operational experience evaluation, and regulatory support activities. This presentation will explore the career options for medical physicists in the NRC, how the NRC interacts with clinical medical physicists, and a physicist’s experience as a regulator. Learning Objectives: Explore non-clinical career pathways for medical physics students and trainees at the Nuclear Regulatory Commission. Overview of NRC medical applications and medical use regulations. Understand the skills needed for physicists as regulators. Abogunde is funded to attend the meeting by her employer, the NRC.« less

SU-A-210-03: Panel Discussion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rodrigues, A.

The purpose of this student annual meeting is to address topics that are becoming more relevant to medical physicists, but are not frequently addressed, especially for students and trainees just entering the field. The talk is divided into two parts: medical billing and regulations. Hsinshun Wu – Why should we learn radiation oncology billing? Many medical physicists do not like to be involved with medical billing or coding during their career. They believe billing is not their responsibility and sometimes they even refuse to participate in the billing process if given the chance. This presentation will talk about a physicist’smore » long career and share his own experience that knowing medical billing is not only important and necessary for every young medical physicist, but that good billing knowledge could provide a valuable contribution to his/her medical physics development. Learning Objectives: The audience will learn the basic definition of Current Procedural Terminology (CPT) codes performed in a Radiation Oncology Department. Understand the differences between hospital coding and physician-based or freestanding coding. Apply proper CPT coding for each Radiation Oncology procedure. Each procedure with its specific CPT code will be discussed in detail. The talk will focus on the process of care and use of actual workflow to understand each CPT code. Example coding of a typical Radiation Oncology procedure. Special procedure coding such as brachytherapy, proton therapy, radiosurgery, and SBRT. Maryann Abogunde – Medical physics opportunities at the Nuclear Regulatory Commission (NRC) The NRC’s responsibilities include the regulation of medical uses of byproduct (radioactive) materials and oversight of medical use end-users (licensees) through a combination of regulatory requirements, licensing, safety oversight including inspection and enforcement, operational experience evaluation, and regulatory support activities. This presentation will explore the career options for medical physicists in the NRC, how the NRC interacts with clinical medical physicists, and a physicist’s experience as a regulator. Learning Objectives: Explore non-clinical career pathways for medical physics students and trainees at the Nuclear Regulatory Commission. Overview of NRC medical applications and medical use regulations. Understand the skills needed for physicists as regulators. Abogunde is funded to attend the meeting by her employer, the NRC.« less

Application of advanced computational procedures for modeling solar-wind interactions with Venus: Theory and computer code

NASA Technical Reports Server (NTRS)

Stahara, S. S.; Klenke, D.; Trudinger, B. C.; Spreiter, J. R.

1980-01-01

Computational procedures are developed and applied to the prediction of solar wind interaction with nonmagnetic terrestrial planet atmospheres, with particular emphasis to Venus. The theoretical method is based on a single fluid, steady, dissipationless, magnetohydrodynamic continuum model, and is appropriate for the calculation of axisymmetric, supersonic, super-Alfvenic solar wind flow past terrestrial planets. The procedures, which consist of finite difference codes to determine the gasdynamic properties and a variety of special purpose codes to determine the frozen magnetic field, streamlines, contours, plots, etc. of the flow, are organized into one computational program. Theoretical results based upon these procedures are reported for a wide variety of solar wind conditions and ionopause obstacle shapes. Plasma and magnetic field comparisons in the ionosheath are also provided with actual spacecraft data obtained by the Pioneer Venus Orbiter.

Sensitivity of Claims-Based Algorithms to Ascertain Smoking Status More Than Doubled with Meaningful Use.

PubMed

Huo, Jinhai; Yang, Ming; Tina Shih, Ya-Chen

2018-03-01

The "meaningful use of certified electronic health record" policy requires eligible professionals to record smoking status for more than 50% of all individuals aged 13 years or older in 2011 to 2012. To explore whether the coding to document smoking behavior has increased over time and to assess the accuracy of smoking-related diagnosis and procedure codes in identifying previous and current smokers. We conducted an observational study with 5,423,880 enrollees from the year 2009 to 2014 in the Truven Health Analytics database. Temporal trends of smoking coding, sensitivity, specificity, positive predictive value, and negative predictive value were measured. The rate of coding of smoking behavior improved significantly by the end of the study period. The proportion of patients in the claims data recorded as current smokers increased 2.3-fold and the proportion of patients recorded as previous smokers increased 4-fold during the 6-year period. The sensitivity of each International Classification of Diseases, Ninth Revision, Clinical Modification code was generally less than 10%. The diagnosis code of tobacco use disorder (305.1X) was the most sensitive code (9.3%) for identifying smokers. The specificities of these codes and the Current Procedural Terminology codes were all more than 98%. A large improvement in the coding of current and previous smoking behavior has occurred since the inception of the meaningful use policy. Nevertheless, the use of diagnosis and procedure codes to identify smoking behavior in administrative data is still unreliable. This suggests that quality improvements toward medical coding on smoking behavior are needed to enhance the capability of claims data for smoking-related outcomes research. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

The positive financial impact of using an Intensive Care Information System in a tertiary Intensive Care Unit.

PubMed

Levesque, Eric; Hoti, Emir; de La Serna, Sofia; Habouchi, Houssam; Ichai, Philippe; Saliba, Faouzi; Samuel, Didier; Azoulay, Daniel

2013-03-01

In the French healthcare system, the intensive care budget allocated is directly dependent on the activity level of the center. To evaluate this activity level, it is necessary to code the medical diagnoses and procedures performed on Intensive Care Unit (ICU) patients. The aim of this study was to evaluate the effects of using an Intensive Care Information System (ICIS) on the incidence of coding errors and its impact on the ICU budget allocated. Since 2005, the documentation on and monitoring of every patient admitted to our ICU has been carried out using an ICIS. However, the coding process was performed manually until 2008. This study focused on two periods: the period of manual coding (year 2007) and the period of computerized coding (year 2008) which covered a total of 1403 ICU patients. The time spent on the coding process, the rate of coding errors (defined as patients missed/not coded or wrongly identified as undergoing major procedure/s) and the financial impact were evaluated for these two periods. With computerized coding, the time per admission decreased significantly (from 6.8 ± 2.8 min in 2007 to 3.6 ± 1.9 min in 2008, p<0.001). Similarly, a reduction in coding errors was observed (7.9% vs. 2.2%, p<0.001). This decrease in coding errors resulted in a reduced difference between the potential and real ICU financial supplements obtained in the respective years (€194,139 loss in 2007 vs. a €1628 loss in 2008). Using specific computer programs improves the intensive process of manual coding by shortening the time required as well as reducing errors, which in turn positively impacts the ICU budget allocation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Hand washing compliance among retail food establishment workers in Minnesota.

PubMed

Allwood, Paul B; Jenkins, Timothy; Paulus, Colleen; Johnson, Lars; Hedberg, Craig W

2004-12-01

Inadequate hand washing by food workers is an important contributing factor to foodborne disease outbreaks in retail food establishments (RFEs). We conducted a survey of RFEs to investigate the effect of hand washing training, availability of hand washing facilities, and the ability of the person in charge (PIC) to describe hand washing according to the Minnesota Food Code (food code) on workers' ability to demonstrate food code-compliant hand washing. Only 52% of the PICs could describe the hand washing procedure outlined in the food code, and only 48% of workers could demonstrate code-compliant hand washing. The most common problems observed were failure to wash for 20 s and failure to use a fingernail brush. There was a strong positive association between the PIC being a certified food manager and being able to describe the food code hand washing procedure (odds ratio [OR], 5.5; 95% confidence interval [CI], 2.2 to 13.7), and there was an even stronger association between the PIC being able to describe hand washing and workers being able to demonstrate code-compliant hand washing (OR, 15; 95% CI, 6 to 37). Significant associations were detected among correct hand washing demonstration, physical infrastructure for hand washing, and the hand washing training methods used by the establishment. However, the principal determinant of successful hand washing demonstration was the PIC's ability to describe proper hand washing procedure. These results suggest that improving hand washing practices among food workers will require interventions that address PIC knowledge of hand washing requirement and procedure and the development and implementation of effective hand washing training methods.

A CFD/CSD Interaction Methodology for Aircraft Wings

NASA Technical Reports Server (NTRS)

Bhardwaj, Manoj K.

1997-01-01

With advanced subsonic transports and military aircraft operating in the transonic regime, it is becoming important to determine the effects of the coupling between aerodynamic loads and elastic forces. Since aeroelastic effects can contribute significantly to the design of these aircraft, there is a strong need in the aerospace industry to predict these aero-structure interactions computationally. To perform static aeroelastic analysis in the transonic regime, high fidelity computational fluid dynamics (CFD) analysis tools must be used in conjunction with high fidelity computational structural fluid dynamics (CSD) analysis tools due to the nonlinear behavior of the aerodynamics in the transonic regime. There is also a need to be able to use a wide variety of CFD and CSD tools to predict these aeroelastic effects in the transonic regime. Because source codes are not always available, it is necessary to couple the CFD and CSD codes without alteration of the source codes. In this study, an aeroelastic coupling procedure is developed which will perform static aeroelastic analysis using any CFD and CSD code with little code integration. The aeroelastic coupling procedure is demonstrated on an F/A-18 Stabilator using NASTD (an in-house McDonnell Douglas CFD code) and NASTRAN. In addition, the Aeroelastic Research Wing (ARW-2) is used for demonstration of the aeroelastic coupling procedure by using ENSAERO (NASA Ames Research Center CFD code) and a finite element wing-box code (developed as part of this research).

Development of a thermal and structural analysis procedure for cooled radial turbines

NASA Technical Reports Server (NTRS)

Kumar, Ganesh N.; Deanna, Russell G.

1988-01-01

A procedure for computing the rotor temperature and stress distributions in a cooled radial turbine is considered. Existing codes for modeling the external mainstream flow and the internal cooling flow are used to compute boundary conditions for the heat transfer and stress analyses. An inviscid, quasi three-dimensional code computes the external free stream velocity. The external velocity is then used in a boundary layer analysis to compute the external heat transfer coefficients. Coolant temperatures are computed by a viscous one-dimensional internal flow code for the momentum and energy equation. These boundary conditions are input to a three-dimensional heat conduction code for calculation of rotor temperatures. The rotor stress distribution may be determined for the given thermal, pressure and centrifugal loading. The procedure is applied to a cooled radial turbine which will be tested at the NASA Lewis Research Center. Representative results from this case are included.

Shaping electromagnetic waves using software-automatically-designed metasurfaces.

PubMed

Zhang, Qian; Wan, Xiang; Liu, Shuo; Yuan Yin, Jia; Zhang, Lei; Jun Cui, Tie

2017-06-15

We present a fully digital procedure of designing reflective coding metasurfaces to shape reflected electromagnetic waves. The design procedure is completely automatic, controlled by a personal computer. In details, the macro coding units of metasurface are automatically divided into several types (e.g. two types for 1-bit coding, four types for 2-bit coding, etc.), and each type of the macro coding units is formed by discretely random arrangement of micro coding units. By combining an optimization algorithm and commercial electromagnetic software, the digital patterns of the macro coding units are optimized to possess constant phase difference for the reflected waves. The apertures of the designed reflective metasurfaces are formed by arranging the macro coding units with certain coding sequence. To experimentally verify the performance, a coding metasurface is fabricated by automatically designing two digital 1-bit unit cells, which are arranged in array to constitute a periodic coding metasurface to generate the required four-beam radiations with specific directions. Two complicated functional metasurfaces with circularly- and elliptically-shaped radiation beams are realized by automatically designing 4-bit macro coding units, showing excellent performance of the automatic designs by software. The proposed method provides a smart tool to realize various functional devices and systems automatically.

Spectral fitting, shock layer modeling, and production of nitrogen oxides and excited nitrogen

NASA Technical Reports Server (NTRS)

Blackwell, H. E.

1991-01-01

An analysis was made of N2 emission from 8.72 MJ/kg shock layer at 2.54, 1.91, and 1.27 cm positions and vibrational state distributions, temperatures, and relative electronic state populations was obtained from data sets. Other recorded arc jet N2 and air spectral data were reviewed and NO emission characteristics were studied. A review of operational procedures of the DSMC code was made. Information on other appropriate codes and modifications, including ionization, were made as well as a determination of the applicability of codes reviewed to task requirement. A review was also made of computational procedures used in CFD codes of Li and other codes on JSC computers. An analysis was made of problems associated with integration of specific chemical kinetics applicable to task into CFD codes.

Nonequilibrium chemistry boundary layer integral matrix procedure

NASA Technical Reports Server (NTRS)

Tong, H.; Buckingham, A. C.; Morse, H. L.

1973-01-01

The development of an analytic procedure for the calculation of nonequilibrium boundary layer flows over surfaces of arbitrary catalycities is described. An existing equilibrium boundary layer integral matrix code was extended to include nonequilibrium chemistry while retaining all of the general boundary condition features built into the original code. For particular application to the pitch-plane of shuttle type vehicles, an approximate procedure was developed to estimate the nonequilibrium and nonisentropic state at the edge of the boundary layer.

Using Procedure Codes to Define Radiation Toxicity in Administrative Data: The Devil is in the Details.

PubMed

Meyer, Anne-Marie; Kuo, Tzy-Mey; Chang, YunKyung; Carpenter, William R; Chen, Ronald C; Sturmer, Til

2017-05-01

Systematic coding systems are used to define clinically meaningful outcomes when leveraging administrative claims data for research. How and when these codes are applied within a research study can have implications for the study validity and their specificity can vary significantly depending on treatment received. Data are from the Surveillance, Epidemiology, and End Results-Medicare linked dataset. We use propensity score methods in a retrospective cohort of prostate cancer patients first examined in a recently published radiation oncology comparative effectiveness study. With the narrowly defined outcome definition, the toxicity event outcome rate ratio was 0.88 per 100 person-years (95% confidence interval, 0.71-1.08). With the broadly defined outcome, the rate ratio was comparable, with 0.89 per 100 person-years (95% confidence interval, 0.76-1.04), although individual event rates were doubled. Some evidence of surveillance bias was suggested by a higher rate of endoscopic procedures the first year of follow-up in patients who received proton therapy compared with those receiving intensity-modulated radiation treatment (11.15 vs. 8.90, respectively). This study demonstrates the risk of introducing bias through subjective application of procedure codes. Careful consideration is required when using procedure codes to define outcomes in administrative data.

Accuracy of clinical coding for procedures in oral and maxillofacial surgery.

PubMed

Khurram, S A; Warner, C; Henry, A M; Kumar, A; Mohammed-Ali, R I

2016-10-01

Clinical coding has important financial implications, and discrepancies in the assigned codes can directly affect the funding of a department and hospital. Over the last few years, numerous oversights have been noticed in the coding of oral and maxillofacial (OMF) procedures. To establish the accuracy and completeness of coding, we retrospectively analysed the records of patients during two time periods: March to May 2009 (324 patients), and January to March 2014 (200 patients). Two investigators independently collected and analysed the data to ensure accuracy and remove bias. A large proportion of operations were not assigned all the relevant codes, and only 32% - 33% were correct in both cycles. To our knowledge, this is the first reported audit of clinical coding in OMFS, and it highlights serious shortcomings that have substantial financial implications. Better input by the surgical team and improved communication between the surgical and coding departments will improve accuracy. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

[Complexity level simulation in the German diagnosis-related groups system: the financial effect of coding of comorbidity diagnostics in urology].

PubMed

Wenke, A; Gaber, A; Hertle, L; Roeder, N; Pühse, G

2012-07-01

Precise and complete coding of diagnoses and procedures is of value for optimizing revenues within the German diagnosis-related groups (G-DRG) system. The implementation of effective structures for coding is cost-intensive. The aim of this study was to prove whether higher costs can be refunded by complete acquisition of comorbidities and complications. Calculations were based on DRG data of the Department of Urology, University Hospital of Münster, Germany, covering all patients treated in 2009. The data were regrouped and subjected to a process of simulation (increase and decrease of patient clinical complexity levels, PCCL) with the help of recently developed software. In urology a strong dependency of quantity and quality of coding of secondary diagnoses on PCCL and subsequent profits was found. Departmental budgetary procedures can be optimized when coding is effective. The new simulation tool can be a valuable aid to improve profits available for distribution. Nevertheless, calculation of time use and financial needs by this procedure are subject to specific departmental terms and conditions. Completeness of coding of (secondary) diagnoses must be the ultimate administrative goal of patient case documentation in urology.

An implementation framework for the feedback of individual research results and incidental findings in research.

PubMed

Thorogood, Adrian; Joly, Yann; Knoppers, Bartha Maria; Nilsson, Tommy; Metrakos, Peter; Lazaris, Anthoula; Salman, Ayat

2014-12-23

This article outlines procedures for the feedback of individual research data to participants. This feedback framework was developed in the context of a personalized medicine research project in Canada. Researchers in this domain have an ethical obligation to return individual research results and/or material incidental findings that are clinically significant, valid and actionable to participants. Communication of individual research data must proceed in an ethical and efficient manner. Feedback involves three procedural steps: assessing the health relevance of a finding, re-identifying the affected participant, and communicating the finding. Re-identification requires researchers to break the code in place to protect participant identities. Coding systems replace personal identifiers with a numerical code. Double coding systems provide added privacy protection by separating research data from personal identifying data with a third "linkage" database. A trusted and independent intermediary, the "keyholder", controls access to this linkage database. Procedural guidelines for the return of individual research results and incidental findings are lacking. This article outlines a procedural framework for the three steps of feedback: assessment, re-identification, and communication. This framework clarifies the roles of the researcher, Research Ethics Board, and keyholder in the process. The framework also addresses challenges posed by coding systems. Breaking the code involves privacy risks and should only be carried out in clearly defined circumstances. Where a double coding system is used, the keyholder plays an important role in balancing the benefits of individual feedback with the privacy risks of re-identification. Feedback policies should explicitly outline procedures for the assessment of findings, and the re-identification and contact of participants. The responsibilities of researchers, the Research Ethics Board, and the keyholder must be clearly defined. We provide general guidelines for keyholders involved in feedback. We also recommend that Research Ethics Boards should not be directly involved in the assessment of individual findings. Hospitals should instead establish formal, interdisciplinary clinical advisory committees to help researchers determine whether or not an uncertain finding should be returned.

Verification and Validation: High Charge and Energy (HZE) Transport Codes and Future Development

NASA Technical Reports Server (NTRS)

Wilson, John W.; Tripathi, Ram K.; Mertens, Christopher J.; Blattnig, Steve R.; Clowdsley, Martha S.; Cucinotta, Francis A.; Tweed, John; Heinbockel, John H.; Walker, Steven A.; Nealy, John E.

2005-01-01

In the present paper, we give the formalism for further developing a fully three-dimensional HZETRN code using marching procedures but also development of a new Green's function code is discussed. The final Green's function code is capable of not only validation in the space environment but also in ground based laboratories with directed beams of ions of specific energy and characterized with detailed diagnostic particle spectrometer devices. Special emphasis is given to verification of the computational procedures and validation of the resultant computational model using laboratory and spaceflight measurements. Due to historical requirements, two parallel development paths for computational model implementation using marching procedures and Green s function techniques are followed. A new version of the HZETRN code capable of simulating HZE ions with either laboratory or space boundary conditions is under development. Validation of computational models at this time is particularly important for President Bush s Initiative to develop infrastructure for human exploration with first target demonstration of the Crew Exploration Vehicle (CEV) in low Earth orbit in 2008.

78 FR 72878 - Revisions to Procedural Regulations Governing Filing, Indexing and Service by Oil Pipelines...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-04

...-5-000] Revisions to Procedural Regulations Governing Filing, Indexing and Service by Oil Pipelines, Electronic Tariff Filings; Notice of Changes to eTariff Part 341 Type of Filing Codes Order No. 780... available eTariff Type of Filing Codes (TOFC) will be modified as follows: \\2\\ \\1\\ Filing, Indexing and...

FDA Procedures for Standardization and Certification of Retail Food Inspection/Training Officers, 2000.

ERIC Educational Resources Information Center

Food and Drug Administration (DHHS/PHS), Rockville, MD.

This document provides information, standards, and behavioral objectives for standardization and certification of retail food inspection personnel in the Food and Drug Administration (FDA). The procedures described in the document are based on the FDA Food Code, updated to reflect current Food Code provisions and to include a more refined focus on…

Ethical and educational considerations in coding hand surgeries.

PubMed

Lifchez, Scott D; Leinberry, Charles F; Rivlin, Michael; Blazar, Philip E

2014-07-01

To assess treatment coding knowledge and practices among residents, fellows, and attending hand surgeons. Through the use of 6 hypothetical cases, we developed a coding survey to assess coding knowledge and practices. We e-mailed this survey to residents, fellows, and attending hand surgeons. In additionally, we asked 2 professional coders to code these cases. A total of 71 participants completed the survey out of 134 people to whom the survey was sent (response rate = 53%). We observed marked disparity in codes chosen among surgeons and among professional coders. Results of this study indicate that coding knowledge, not just its ethical application, had a major role in coding procedures accurately. Surgical coding is an essential part of a hand surgeon's practice and is not well learned during residency or fellowship. Whereas ethical issues such as deliberate unbundling and upcoding may have a role in inaccurate coding, lack of knowledge among surgeons and coders has a major role as well. Coding has a critical role in every hand surgery practice. Inconstancies among those polled in this study reveal that an increase in education on coding during training and improvement in the clarity and consistency of the Current Procedural Terminology coding rules themselves are needed. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Toward a CFD nose-to-tail capability - Hypersonic unsteady Navier-Stokes code validation

NASA Technical Reports Server (NTRS)

Edwards, Thomas A.; Flores, Jolen

1989-01-01

Computational fluid dynamics (CFD) research for hypersonic flows presents new problems in code validation because of the added complexity of the physical models. This paper surveys code validation procedures applicable to hypersonic flow models that include real gas effects. The current status of hypersonic CFD flow analysis is assessed with the Compressible Navier-Stokes (CNS) code as a case study. The methods of code validation discussed to beyond comparison with experimental data to include comparisons with other codes and formulations, component analyses, and estimation of numerical errors. Current results indicate that predicting hypersonic flows of perfect gases and equilibrium air are well in hand. Pressure, shock location, and integrated quantities are relatively easy to predict accurately, while surface quantities such as heat transfer are more sensitive to the solution procedure. Modeling transition to turbulence needs refinement, though preliminary results are promising.

Evaluating Coding Accuracy in General Surgery Residents' Accreditation Council for Graduate Medical Education Procedural Case Logs.

PubMed

Balla, Fadi; Garwe, Tabitha; Motghare, Prasenjeet; Stamile, Tessa; Kim, Jennifer; Mahnken, Heidi; Lees, Jason

The Accreditation Council for Graduate Medical Education (ACGME) case log captures resident operative experience based on Current Procedural Terminology (CPT) codes and is used to track operative experience during residency. With increasing emphasis on resident operative experiences, coding is more important than ever. It has been shown in other surgical specialties at similar institutions that the residents' ACGME case log may not accurately reflect their operative experience. What barriers may influence this remains unclear. As the only objective measure of resident operative experience, an accurate case log is paramount in representing one's operative experience. This study aims to determine the accuracy of procedural coding by general surgical residents at a single institution. Data were collected from 2 consecutive graduating classes of surgical residents' ACGME case logs from 2008 to 2014. A total of 5799 entries from 7 residents were collected. The CPT codes entered by residents were compared to departmental billing records submitted by the attending surgeon for each procedure. Assigned CPT codes by institutional American Academy of Professional Coders certified abstract coders were considered the "gold standard." A total of 4356 (75.12%) of 5799 entries were identified in billing records. Excel 2010 and SAS 9.3 were used for analysis. In the event of multiple codes for the same patient, any match between resident codes and billing record codes was considered a "correct" entry. A 4-question survey was distributed to all current general surgical residents at our institution for feedback on coding habits, limitations to accurate coding, and opinions on ACGME case log representation of their operative experience. All 7 residents had a low percentage of correctly entered CPT codes. The overall accuracy proportion for all residents was 52.82% (range: 43.32%-60.07%). Only 1 resident showed significant improvement in accuracy during his/her training (p = 0.0043). The survey response rate was 100%. Survey results indicated that inability to find the precise code within the ACGME search interface and unfamiliarity with available CPT codes were by far the most common perceived barriers to accuracy. Survey results also indicated that most residents (74%) believe that they code accurately most of the time and agree that their case log would accurately represent their operative experience (66.6%). This is the first study to evaluate correctness of residents' ACGME case logs in general surgery. The degree of inaccuracy found here necessitates further investigation into the etiology of these discrepancies. Instruction on coding practices should also benefit the residents after graduation. Optimizing communication among attendings and residents, improving ACGME coding search interface, and implementing consistent coding practices could improve accuracy giving a more realistic view of residents' operative experience. Published by Elsevier Inc.

Procedure of recovery of pin-by-pin fields of energy release in the core of VVER-type reactor for the BIPR-8 code

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gordienko, P. V., E-mail: gorpavel@vver.kiae.ru; Kotsarev, A. V.; Lizorkin, M. P.

2014-12-15

The procedure of recovery of pin-by-pin energy-release fields for the BIPR-8 code and the algorithm of the BIPR-8 code which is used in nodal computation of the reactor core and on which the recovery of pin-by-pin fields of energy release is based are briefly described. The description and results of the verification using the module of recovery of pin-by-pin energy-release fields and the TVS-M program are given.

[The DRG responsible physician in trauma and orthopedic surgery. Surgeon, encoder, and link to medical controlling].

PubMed

Ruffing, T; Huchzermeier, P; Muhm, M; Winkler, H

2014-05-01

Precise coding is an essential requirement in order to generate a valid DRG. The aim of our study was to evaluate the quality of the initial coding of surgical procedures, as well as to introduce our "hybrid model" of a surgical specialist supervising medical coding and a nonphysician for case auditing. The department's DRG responsible physician as a surgical specialist has profound knowledge both in surgery and in DRG coding. At a Level 1 hospital, 1000 coded cases of surgical procedures were checked. In our department, the DRG responsible physician who is both a surgeon and encoder has proven itself for many years. The initial surgical DRG coding had to be corrected by the DRG responsible physician in 42.2% of cases. On average, one hour per working day was necessary. The implementation of a DRG responsible physician is a simple, effective way to connect medical and business expertise without interface problems. Permanent feedback promotes both medical and economic sensitivity for the improvement of coding quality.

Optical encryption and QR codes: secure and noise-free information retrieval.

PubMed

Barrera, John Fredy; Mira, Alejandro; Torroba, Roberto

2013-03-11

We introduce for the first time the concept of an information "container" before a standard optical encrypting procedure. The "container" selected is a QR code which offers the main advantage of being tolerant to pollutant speckle noise. Besides, the QR code can be read by smartphones, a massively used device. Additionally, QR code includes another secure step to the encrypting benefits the optical methods provide. The QR is generated by means of worldwide free available software. The concept development probes that speckle noise polluting the outcomes of normal optical encrypting procedures can be avoided, then making more attractive the adoption of these techniques. Actual smartphone collected results are shown to validate our proposal.

A Study of Clinical Coding Accuracy in Surgery: Implications for the Use of Administrative Big Data for Outcomes Management.

PubMed

Nouraei, S A R; Hudovsky, A; Frampton, A E; Mufti, U; White, N B; Wathen, C G; Sandhu, G S; Darzi, A

2015-06-01

Clinical coding is the translation of clinical activity into a coded language. Coded data drive hospital reimbursement and are used for audit and research, and benchmarking and outcomes management purposes. We undertook a 2-center audit of coding accuracy across surgery. Clinician-auditor multidisciplinary teams reviewed the coding of 30,127 patients and assessed accuracy at primary and secondary diagnosis and procedure levels, morbidity level, complications assignment, and financial variance. Postaudit data of a randomly selected sample of 400 cases were reaudited by an independent team. At least 1 coding change occurred in 15,402 patients (51%). There were 3911 (13%) and 3620 (12%) changes to primary diagnoses and procedures, respectively. In 5183 (17%) patients, the Health Resource Grouping changed, resulting in income variance of £3,974,544 (+6.2%). The morbidity level changed in 2116 (7%) patients (P < 0.001). The number of assigned complications rose from 2597 (8.6%) to 2979 (9.9%) (P < 0.001). Reaudit resulted in further primary diagnosis and procedure changes in 8.7% and 4.8% of patients, respectively. The coded data are a key engine for knowledge-driven health care provision. They are used, increasingly at individual surgeon level, to benchmark performance. Surgical clinical coding is prone to subjectivity, variability, and error (SVE). Having a specialty-by-specialty understanding of the nature and clinical significance of informatics variability and adopting strategies to reduce it, are necessary to allow accurate assumptions and informed decisions to be made concerning the scope and clinical applicability of administrative data in surgical outcomes improvement.

SU-A-210-01: Why Should We Learn Radiation Oncology Billing?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wu, H.

The purpose of this student annual meeting is to address topics that are becoming more relevant to medical physicists, but are not frequently addressed, especially for students and trainees just entering the field. The talk is divided into two parts: medical billing and regulations. Hsinshun Wu – Why should we learn radiation oncology billing? Many medical physicists do not like to be involved with medical billing or coding during their career. They believe billing is not their responsibility and sometimes they even refuse to participate in the billing process if given the chance. This presentation will talk about a physicist’smore » long career and share his own experience that knowing medical billing is not only important and necessary for every young medical physicist, but that good billing knowledge could provide a valuable contribution to his/her medical physics development. Learning Objectives: The audience will learn the basic definition of Current Procedural Terminology (CPT) codes performed in a Radiation Oncology Department. Understand the differences between hospital coding and physician-based or freestanding coding. Apply proper CPT coding for each Radiation Oncology procedure. Each procedure with its specific CPT code will be discussed in detail. The talk will focus on the process of care and use of actual workflow to understand each CPT code. Example coding of a typical Radiation Oncology procedure. Special procedure coding such as brachytherapy, proton therapy, radiosurgery, and SBRT. Maryann Abogunde – Medical physics opportunities at the Nuclear Regulatory Commission (NRC) The NRC’s responsibilities include the regulation of medical uses of byproduct (radioactive) materials and oversight of medical use end-users (licensees) through a combination of regulatory requirements, licensing, safety oversight including inspection and enforcement, operational experience evaluation, and regulatory support activities. This presentation will explore the career options for medical physicists in the NRC, how the NRC interacts with clinical medical physicists, and a physicist’s experience as a regulator. Learning Objectives: Explore non-clinical career pathways for medical physics students and trainees at the Nuclear Regulatory Commission. Overview of NRC medical applications and medical use regulations. Understand the skills needed for physicists as regulators. Abogunde is funded to attend the meeting by her employer, the NRC.« less

SU-A-210-02: Medical Physics Opportunities at the NRC

DOE Office of Scientific and Technical Information (OSTI.GOV)

Abogunde, M.

The purpose of this student annual meeting is to address topics that are becoming more relevant to medical physicists, but are not frequently addressed, especially for students and trainees just entering the field. The talk is divided into two parts: medical billing and regulations. Hsinshun Wu – Why should we learn radiation oncology billing? Many medical physicists do not like to be involved with medical billing or coding during their career. They believe billing is not their responsibility and sometimes they even refuse to participate in the billing process if given the chance. This presentation will talk about a physicist’smore » long career and share his own experience that knowing medical billing is not only important and necessary for every young medical physicist, but that good billing knowledge could provide a valuable contribution to his/her medical physics development. Learning Objectives: The audience will learn the basic definition of Current Procedural Terminology (CPT) codes performed in a Radiation Oncology Department. Understand the differences between hospital coding and physician-based or freestanding coding. Apply proper CPT coding for each Radiation Oncology procedure. Each procedure with its specific CPT code will be discussed in detail. The talk will focus on the process of care and use of actual workflow to understand each CPT code. Example coding of a typical Radiation Oncology procedure. Special procedure coding such as brachytherapy, proton therapy, radiosurgery, and SBRT. Maryann Abogunde – Medical physics opportunities at the Nuclear Regulatory Commission (NRC) The NRC’s responsibilities include the regulation of medical uses of byproduct (radioactive) materials and oversight of medical use end-users (licensees) through a combination of regulatory requirements, licensing, safety oversight including inspection and enforcement, operational experience evaluation, and regulatory support activities. This presentation will explore the career options for medical physicists in the NRC, how the NRC interacts with clinical medical physicists, and a physicist’s experience as a regulator. Learning Objectives: Explore non-clinical career pathways for medical physics students and trainees at the Nuclear Regulatory Commission. Overview of NRC medical applications and medical use regulations. Understand the skills needed for physicists as regulators. Abogunde is funded to attend the meeting by her employer, the NRC.« less

SU-A-210-00: AAPM Medical Physics Student Meeting: Medical Billing and Regulations: Everything You Always Wanted To Know, But Were Too Afraid To Ask

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

The purpose of this student annual meeting is to address topics that are becoming more relevant to medical physicists, but are not frequently addressed, especially for students and trainees just entering the field. The talk is divided into two parts: medical billing and regulations. Hsinshun Wu – Why should we learn radiation oncology billing? Many medical physicists do not like to be involved with medical billing or coding during their career. They believe billing is not their responsibility and sometimes they even refuse to participate in the billing process if given the chance. This presentation will talk about a physicist’smore » long career and share his own experience that knowing medical billing is not only important and necessary for every young medical physicist, but that good billing knowledge could provide a valuable contribution to his/her medical physics development. Learning Objectives: The audience will learn the basic definition of Current Procedural Terminology (CPT) codes performed in a Radiation Oncology Department. Understand the differences between hospital coding and physician-based or freestanding coding. Apply proper CPT coding for each Radiation Oncology procedure. Each procedure with its specific CPT code will be discussed in detail. The talk will focus on the process of care and use of actual workflow to understand each CPT code. Example coding of a typical Radiation Oncology procedure. Special procedure coding such as brachytherapy, proton therapy, radiosurgery, and SBRT. Maryann Abogunde – Medical physics opportunities at the Nuclear Regulatory Commission (NRC) The NRC’s responsibilities include the regulation of medical uses of byproduct (radioactive) materials and oversight of medical use end-users (licensees) through a combination of regulatory requirements, licensing, safety oversight including inspection and enforcement, operational experience evaluation, and regulatory support activities. This presentation will explore the career options for medical physicists in the NRC, how the NRC interacts with clinical medical physicists, and a physicist’s experience as a regulator. Learning Objectives: Explore non-clinical career pathways for medical physics students and trainees at the Nuclear Regulatory Commission. Overview of NRC medical applications and medical use regulations. Understand the skills needed for physicists as regulators. Abogunde is funded to attend the meeting by her employer, the NRC.« less

Systemic inaccuracies in the National Surgical Quality Improvement Program database: Implications for accuracy and validity for neurosurgery outcomes research.

PubMed

Rolston, John D; Han, Seunggu J; Chang, Edward F

2017-03-01

The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) provides a rich database of North American surgical procedures and their complications. Yet no external source has validated the accuracy of the information within this database. Using records from the 2006 to 2013 NSQIP database, we used two methods to identify errors: (1) mismatches between the Current Procedural Terminology (CPT) code that was used to identify the surgical procedure, and the International Classification of Diseases (ICD-9) post-operative diagnosis: i.e., a diagnosis that is incompatible with a certain procedure. (2) Primary anesthetic and CPT code mismatching: i.e., anesthesia not indicated for a particular procedure. Analyzing data for movement disorders, epilepsy, and tumor resection, we found evidence of CPT code and postoperative diagnosis mismatches in 0.4-100% of cases, depending on the CPT code examined. When analyzing anesthetic data from brain tumor, epilepsy, trauma, and spine surgery, we found evidence of miscoded anesthesia in 0.1-0.8% of cases. National databases like NSQIP are an important tool for quality improvement. Yet all databases are subject to errors, and measures of internal consistency show that errors affect up to 100% of case records for certain procedures in NSQIP. Steps should be taken to improve data collection on the frontend of NSQIP, and also to ensure that future studies with NSQIP take steps to exclude erroneous cases from analysis. Copyright © 2016 Elsevier Ltd. All rights reserved.

New procedures to evaluate visually lossless compression for display systems

NASA Astrophysics Data System (ADS)

Stolitzka, Dale F.; Schelkens, Peter; Bruylants, Tim

2017-09-01

Visually lossless image coding in isochronous display streaming or plesiochronous networks reduces link complexity and power consumption and increases available link bandwidth. A new set of codecs developed within the last four years promise a new level of coding quality, but require new techniques that are sufficiently sensitive to the small artifacts or color variations induced by this new breed of codecs. This paper begins with a summary of the new ISO/IEC 29170-2, a procedure for evaluation of lossless coding and reports the new work by JPEG to extend the procedure in two important ways, for HDR content and for evaluating the differences between still images, panning images and image sequences. ISO/IEC 29170-2 relies on processing test images through a well-defined process chain for subjective, forced-choice psychophysical experiments. The procedure sets an acceptable quality level equal to one just noticeable difference. Traditional image and video coding evaluation techniques, such as, those used for television evaluation have not proven sufficiently sensitive to the small artifacts that may be induced by this breed of codecs. In 2015, JPEG received new requirements to expand evaluation of visually lossless coding for high dynamic range images, slowly moving images, i.e., panning, and image sequences. These requirements are the basis for new amendments of the ISO/IEC 29170-2 procedures described in this paper. These amendments promise to be highly useful for the new content in television and cinema mezzanine networks. The amendments passed the final ballot in April 2017 and are on track to be published in 2018.

Observation and Coding Manual for the Longitudinal Study of Reading Comprehension and Science Concept Acquisition (Third Edition). Technical Report No. L-1.

ERIC Educational Resources Information Center

Meyer, Linda A.; And Others

This manual describes the model--specifically the observation procedures and coding systems--used in a longitudinal study of how children learn to comprehend what they read, with particular emphasis on science texts. Included are procedures for the following: identifying students; observing--recording observations and diagraming the room; writing…

[Genetic research with stored human tissue: a coding procedure with optimal use of information and protection of privacy].

PubMed

Schmidt, M K; van Leeuwen, F E; Klaren, H M; Tollenaar, R A; van 't Veer, L J

2004-03-20

To answer research questions concerning the course of disease and the optimal treatment of hereditary breast cancer, genetic typing together with the clinical and tumour characteristics of breast cancer patients are an important source of information. Part of the incidence of breast cancer can be explained by BRCA1 and BRCA2 germline mutations, which with current techniques can be retrospectively analysed in stored, paraffin-embedded tissue samples. In view of the implications of BRCA1- or BRCA2-carrier status for patients and other family members and the lack of clear legal regulations regarding the procedures to be followed when analysis is performed on historical material and no individual informed consent can be asked from the patients, an appropriate procedure for coding such data or rendering it anonymous is of great importance. By using the coding procedure described in this article, it becomes possible to follow and to work out in greater detail the guidelines of the code for 'Proper secondary use of human tissue' of the Federation of Biomedical Scientific Societies and to use these valuable databases again in the future.

Speech coding at low to medium bit rates

NASA Astrophysics Data System (ADS)

Leblanc, Wilfred Paul

1992-09-01

Improved search techniques coupled with improved codebook design methodologies are proposed to improve the performance of conventional code-excited linear predictive coders for speech. Improved methods for quantizing the short term filter are developed by employing a tree search algorithm and joint codebook design to multistage vector quantization. Joint codebook design procedures are developed to design locally optimal multistage codebooks. Weighting during centroid computation is introduced to improve the outlier performance of the multistage vector quantizer. Multistage vector quantization is shown to be both robust against input characteristics and in the presence of channel errors. Spectral distortions of about 1 dB are obtained at rates of 22-28 bits/frame. Structured codebook design procedures for excitation in code-excited linear predictive coders are compared to general codebook design procedures. Little is lost using significant structure in the excitation codebooks while greatly reducing the search complexity. Sparse multistage configurations are proposed for reducing computational complexity and memory size. Improved search procedures are applied to code-excited linear prediction which attempt joint optimization of the short term filter, the adaptive codebook, and the excitation. Improvements in signal to noise ratio of 1-2 dB are realized in practice.

47 CFR 11.61 - Tests of EAS procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... EAS header codes, Attention Signal, Test Script and EOM code. (i) Tests in odd numbered months shall... substitute for a monthly test, activation must include transmission of the EAS header codes, Attention Signal, emergency message and EOM code and comply with the visual message requirements in § 11.51. To substitute for...

Experimental QR code optical encryption: noise-free data recovering.

PubMed

Barrera, John Fredy; Mira-Agudelo, Alejandro; Torroba, Roberto

2014-05-15

We report, to our knowledge for the first time, the experimental implementation of a quick response (QR) code as a "container" in an optical encryption system. A joint transform correlator architecture in an interferometric configuration is chosen as the experimental scheme. As the implementation is not possible in a single step, a multiplexing procedure to encrypt the QR code of the original information is applied. Once the QR code is correctly decrypted, the speckle noise present in the recovered QR code is eliminated by a simple digital procedure. Finally, the original information is retrieved completely free of any kind of degradation after reading the QR code. Additionally, we propose and implement a new protocol in which the reception of the encrypted QR code and its decryption, the digital block processing, and the reading of the decrypted QR code are performed employing only one device (smartphone, tablet, or computer). The overall method probes to produce an outcome far more attractive to make the adoption of the technique a plausible option. Experimental results are presented to demonstrate the practicality of the proposed security system.

Software Certification - Coding, Code, and Coders

NASA Technical Reports Server (NTRS)

Havelund, Klaus; Holzmann, Gerard J.

2011-01-01

We describe a certification approach for software development that has been adopted at our organization. JPL develops robotic spacecraft for the exploration of the solar system. The flight software that controls these spacecraft is considered to be mission critical. We argue that the goal of a software certification process cannot be the development of "perfect" software, i.e., software that can be formally proven to be correct under all imaginable and unimaginable circumstances. More realistically, the goal is to guarantee a software development process that is conducted by knowledgeable engineers, who follow generally accepted procedures to control known risks, while meeting agreed upon standards of workmanship. We target three specific issues that must be addressed in such a certification procedure: the coding process, the code that is developed, and the skills of the coders. The coding process is driven by standards (e.g., a coding standard) and tools. The code is mechanically checked against the standard with the help of state-of-the-art static source code analyzers. The coders, finally, are certified in on-site training courses that include formal exams.

Coded excitation ultrasonic needle tracking: An in vivo study.

PubMed

Xia, Wenfeng; Ginsberg, Yuval; West, Simeon J; Nikitichev, Daniil I; Ourselin, Sebastien; David, Anna L; Desjardins, Adrien E

2016-07-01

Accurate and efficient guidance of medical devices to procedural targets lies at the heart of interventional procedures. Ultrasound imaging is commonly used for device guidance, but determining the location of the device tip can be challenging. Various methods have been proposed to track medical devices during ultrasound-guided procedures, but widespread clinical adoption has remained elusive. With ultrasonic tracking, the location of a medical device is determined by ultrasonic communication between the ultrasound imaging probe and a transducer integrated into the medical device. The signal-to-noise ratio (SNR) of the transducer data is an important determinant of the depth in tissue at which tracking can be performed. In this paper, the authors present a new generation of ultrasonic tracking in which coded excitation is used to improve the SNR without spatial averaging. A fiber optic hydrophone was integrated into the cannula of a 20 gauge insertion needle. This transducer received transmissions from the ultrasound imaging probe, and the data were processed to obtain a tracking image of the needle tip. Excitation using Barker or Golay codes was performed to improve the SNR, and conventional bipolar excitation was performed for comparison. The performance of the coded excitation ultrasonic tracking system was evaluated in an in vivo ovine model with insertions to the brachial plexus and the uterine cavity. Coded excitation significantly increased the SNRs of the tracking images, as compared with bipolar excitation. During an insertion to the brachial plexus, the SNR was increased by factors of 3.5 for Barker coding and 7.1 for Golay coding. During insertions into the uterine cavity, these factors ranged from 2.9 to 4.2 for Barker coding and 5.4 to 8.5 for Golay coding. The maximum SNR was 670, which was obtained with Golay coding during needle withdrawal from the brachial plexus. Range sidelobe artifacts were observed in tracking images obtained with Barker coded excitation, and they were visually absent with Golay coded excitation. The spatial tracking accuracy was unaffected by coded excitation. Coded excitation is a viable method for improving the SNR in ultrasonic tracking without compromising spatial accuracy. This method provided SNR increases that are consistent with theoretical expectations, even in the presence of physiological motion. With the ultrasonic tracking system in this study, the SNR increases will have direct clinical implications in a broad range of interventional procedures by improving visibility of medical devices at large depths.

A simplified procedure for correcting both errors and erasures of a Reed-Solomon code using the Euclidean algorithm

NASA Technical Reports Server (NTRS)

Truong, T. K.; Hsu, I. S.; Eastman, W. L.; Reed, I. S.

1987-01-01

It is well known that the Euclidean algorithm or its equivalent, continued fractions, can be used to find the error locator polynomial and the error evaluator polynomial in Berlekamp's key equation needed to decode a Reed-Solomon (RS) code. A simplified procedure is developed and proved to correct erasures as well as errors by replacing the initial condition of the Euclidean algorithm by the erasure locator polynomial and the Forney syndrome polynomial. By this means, the errata locator polynomial and the errata evaluator polynomial can be obtained, simultaneously and simply, by the Euclidean algorithm only. With this improved technique the complexity of time domain RS decoders for correcting both errors and erasures is reduced substantially from previous approaches. As a consequence, decoders for correcting both errors and erasures of RS codes can be made more modular, regular, simple, and naturally suitable for both VLSI and software implementation. An example illustrating this modified decoding procedure is given for a (15, 9) RS code.

Identifying Vasopressor and Inotrope Use for Health Services Research

PubMed Central

Fawzy, Ashraf; Bradford, Mark; Lindenauer, Peter K.

2016-01-01

Rationale: Identifying vasopressor and inotrope (vasopressor) use from administrative claims data may provide an important resource to study the epidemiology of shock. Objectives: Determine accuracy of identifying vasopressor use using International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) coding. Methods: Using administrative data enriched with pharmacy billing files (Premier, Inc., Charlotte, NC), we identified two cohorts: adult patients admitted with a diagnosis of sepsis from 2010 to 2013 or pulmonary embolism (PE) from 2008 to 2011. Vasopressor administration was obtained using pharmacy billing files (dopamine, dobutamine, epinephrine, milrinone, norepinephrine, phenylephrine, vasopressin) and compared with ICD-9-CM procedure code for vasopressor administration (00.17). We estimated performance characteristics of the ICD-9-CM code and compared patients’ characteristics and mortality rates according to vasopressor identification method. Measurements and Main Results: Using either pharmacy data or the ICD-9-CM procedure code, 29% of 541,144 patients in the sepsis cohort and 5% of 81,588 patients in the PE cohort were identified as receiving a vasopressor. In the sepsis cohort, the ICD-9-CM procedure code had low sensitivity (9.4%; 95% confidence interval, 9.2–9.5), which increased over time. Results were similar in the PE cohort (sensitivity, 5.8%; 95% confidence interval, 5.1–6.6). The ICD-9-CM code exhibited high specificity in the sepsis (99.8%) and PE (100%) cohorts. However, patients identified as receiving vasopressors by ICD-9-CM code had significantly higher unadjusted in-hospital mortality, had more acute organ failures, and were more likely hospitalized in the Northeast and West. Conclusions: The ICD-9-CM procedure code for vasopressor administration has low sensitivity and selects for higher severity of illness in studies of shock. Temporal changes in sensitivity would likely make longitudinal shock surveillance using ICD-9-CM inaccurate. PMID:26653145

Probability Quantization for Multiplication-Free Binary Arithmetic Coding

NASA Technical Reports Server (NTRS)

Cheung, K. -M.

1995-01-01

A method has been developed to improve on Witten's binary arithmetic coding procedure of tracking a high value and a low value. The new method approximates the probability of the less probable symbol, which improves the worst-case coding efficiency.

Characteristics of health interventions: a systematic analysis of the Austrian Procedure Catalogue.

PubMed

Neururer, Sabrina B; Pfeiffer, Karl-Peter

2012-01-01

The Austrian Procedure Catalogue contains 1,500 codes for health interventions used for performance-oriented hospital financing in Austria. It offers a multiaxial taxonomy. The aim of this study is to identify characteristics of medical procedures. Therefore a definition analysis followed by a typological analysis was conducted. Search strings were generated out of code descriptions regarding the heart, large vessels and cardiovascular system. Their definitions were looked up in the Pschyrembel Clinical Dictionary and documented. Out of these definitions, types which represent characteristics of health interventions were abstracted. The three axes of the Austrian Procedure Catalogue were approved as well as new, relevant information identified. The results are the foundation of a further enhancement of the Austrian Procedure Catalogue.

I/O Router Placement and Fine-Grained Routing on Titan to Support Spider II

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ezell, Matthew A; Dillow, David; Oral, H Sarp

2014-01-01

The Oak Ridge Leadership Computing Facility (OLCF) introduced the concept of Fine-Grained Routing in 2008 to improve I/O performance between the Jaguar supercomputer and Spider, OLCF s center-wide Lustre file system. Fine-grained routing organizes I/O paths to minimize congestion. Jaguar has since been upgraded to Titan, providing more than a ten-fold improvement in peak performance. To support the center s increased computational capacity and I/O demand, the Spider file system has been replaced with Spider II. Building on the lessons learned from Spider, an improved method for placing LNET routers was developed and implemented for Spider II. The fine-grained routingmore » scripts and configuration have been updated to provide additional optimizations and better match the system setup. This paper presents a brief history of fine-grained routing at OLCF, an introduction to the architectures of Titan and Spider II, methods for placing routers in Titan, and details about the fine-grained routing configuration.« less

Does incorporation of a clinical support template in the electronic medical record improve capture of wound care data in a cohort of veterans with diabetic foot ulcers?

PubMed

Lowe, Jeanne R; Raugi, Gregory J; Reiber, Gayle E; Whitney, Joanne D

2013-01-01

The purpose of this cohort study was to evaluate the effect of a 1-year intervention of an electronic medical record wound care template on the completeness of wound care documentation and medical coding compared to a similar time interval for the fiscal year preceding the intervention. From October 1, 2006, to September 30, 2007, a "good wound care" intervention was implemented at a rural Veterans Affairs facility to prevent amputations in veterans with diabetes and foot ulcers. The study protocol included a template with foot ulcer variables embedded in the electronic medical record to facilitate data collection, support clinical decision making, and improve ordering and medical coding. The intervention group showed significant differences in complete documentation of good wound care compared to the historic control group (χ = 15.99, P < .001), complete documentation of coding for diagnoses and procedures (χ = 30.23, P < .001), and complete documentation of both good wound care and coding for diagnoses and procedures (χ = 14.96, P < .001). An electronic wound care template improved documentation of evidence-based interventions and facilitated coding for wound complexity and procedures.

A multidisciplinary audit of clinical coding accuracy in otolaryngology: financial, managerial and clinical governance considerations under payment-by-results.

PubMed

Nouraei, S A R; O'Hanlon, S; Butler, C R; Hadovsky, A; Donald, E; Benjamin, E; Sandhu, G S

2009-02-01

To audit the accuracy of otolaryngology clinical coding and identify ways of improving it. Prospective multidisciplinary audit, using the 'national standard clinical coding audit' methodology supplemented by 'double-reading and arbitration'. Teaching-hospital otolaryngology and clinical coding departments. Otolaryngology inpatient and day-surgery cases. Concordance between initial coding performed by a coder (first cycle) and final coding by a clinician-coder multidisciplinary team (MDT; second cycle) for primary and secondary diagnoses and procedures, and Health Resource Groupings (HRG) assignment. 1250 randomly-selected cases were studied. Coding errors occurred in 24.1% of cases (301/1250). The clinician-coder MDT reassigned 48 primary diagnoses and 186 primary procedures and identified a further 209 initially-missed secondary diagnoses and procedures. In 203 cases, patient's initial HRG changed. Incorrect coding caused an average revenue loss of 174.90 pounds per patient (14.7%) of which 60% of the total income variance was due to miscoding of a eight highly-complex head and neck cancer cases. The 'HRG drift' created the appearance of disproportionate resource utilisation when treating 'simple' cases. At our institution the total cost of maintaining a clinician-coder MDT was 4.8 times lower than the income regained through the double-reading process. This large audit of otolaryngology practice identifies a large degree of error in coding on discharge. This leads to significant loss of departmental revenue, and given that the same data is used for benchmarking and for making decisions about resource allocation, it distorts the picture of clinical practice. These can be rectified through implementing a cost-effective clinician-coder double-reading multidisciplinary team as part of a data-assurance clinical governance framework which we recommend should be established in hospitals.

Coding in Muscle Disease.

PubMed

Jones, Lyell K; Ney, John P

2016-12-01

Accurate coding is critically important for clinical practice and research. Ongoing changes to diagnostic and billing codes require the clinician to stay abreast of coding updates. Payment for health care services, data sets for health services research, and reporting for medical quality improvement all require accurate administrative coding. This article provides an overview of administrative coding for patients with muscle disease and includes a case-based review of diagnostic and Evaluation and Management (E/M) coding principles in patients with myopathy. Procedural coding for electrodiagnostic studies and neuromuscular ultrasound is also reviewed.

Reconciliation of international administrative coding systems for comparison of colorectal surgery outcome.

PubMed

Munasinghe, A; Chang, D; Mamidanna, R; Middleton, S; Joy, M; Penninckx, F; Darzi, A; Livingston, E; Faiz, O

2014-07-01

Significant variation in colorectal surgery outcomes exists between different countries. Better understanding of the sources of variable outcomes using administrative data requires alignment of differing clinical coding systems. We aimed to map similar diagnoses and procedures across administrative coding systems used in different countries. Administrative data were collected in a central database as part of the Global Comparators (GC) Project. In order to unify these data, a systematic translation of diagnostic and procedural codes was undertaken. Codes for colorectal diagnoses, resections, operative complications and reoperative interventions were mapped across the respective national healthcare administrative coding systems. Discharge data from January 2006 to June 2011 for patients who had undergone colorectal surgical resections were analysed to generate risk-adjusted models for mortality, length of stay, readmissions and reoperations. In all, 52 544 case records were collated from 31 institutions in five countries. Mapping of all the coding systems was achieved so that diagnosis and procedures from the participant countries could be compared. Using the aligned coding systems to develop risk-adjusted models, the 30-day mortality rate for colorectal surgery was 3.95% (95% CI 0.86-7.54), the 30-day readmission rate was 11.05% (5.67-17.61), the 28-day reoperation rate was 6.13% (3.68-9.66) and the mean length of stay was 14 (7.65-46.76) days. The linkage of international hospital administrative data that we developed enabled comparison of documented surgical outcomes between countries. This methodology may facilitate international benchmarking. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

Application of Quantum Gauss-Jordan Elimination Code to Quantum Secret Sharing Code

NASA Astrophysics Data System (ADS)

Diep, Do Ngoc; Giang, Do Hoang; Phu, Phan Huy

2017-12-01

The QSS codes associated with a MSP code are based on finding an invertible matrix V, solving the system vATMB (s a) = s. We propose a quantum Gauss-Jordan Elimination Procedure to produce such a pivotal matrix V by using the Grover search code. The complexity of solving is of square-root order of the cardinal number of the unauthorized set √ {2^{|B|}}.

Application of Quantum Gauss-Jordan Elimination Code to Quantum Secret Sharing Code

NASA Astrophysics Data System (ADS)

Diep, Do Ngoc; Giang, Do Hoang; Phu, Phan Huy

2018-03-01

The QSS codes associated with a MSP code are based on finding an invertible matrix V, solving the system vATMB (s a)=s. We propose a quantum Gauss-Jordan Elimination Procedure to produce such a pivotal matrix V by using the Grover search code. The complexity of solving is of square-root order of the cardinal number of the unauthorized set √ {2^{|B|}}.

Aerodynamic characterization of the jet of an arc wind tunnel

NASA Astrophysics Data System (ADS)

Zuppardi, Gennaro; Esposito, Antonio

2016-11-01

It is well known that, due to a very aggressive environment and to a rather high rarefaction level of the arc wind tunnel jet, the measurement of fluid-dynamic parameters is difficult. For this reason, the aerodynamic characterization of the jet relies also on computer codes, simulating the operation of the tunnel. The present authors already used successfully such a kind of computing procedure for the tests in the arc wind tunnel (SPES) in Naples (Italy). In the present work an improved procedure is proposed. Like the former procedure also the present procedure relies on two codes working in tandem: 1) one-dimensional code simulating the inviscid and thermally not-conducting flow field in the torch, in the mix-chamber and in the nozzle up to the position, along the nozzle axis, of the continuum breakdown, 2) Direct Simulation Monte Carlo (DSMC) code simulating the flow field in the remaining part of the nozzle. In the present procedure, the DSMC simulation includes the simulation both in the nozzle and in the test chamber. An interesting problem, considered in this paper by means of the present procedure, has been the simulation of the flow field around a Pitot tube and of the related measurement of the stagnation pressure. The measured stagnation pressure, under rarefied conditions, may be even four times the theoretical value. Therefore a substantial correction has to be applied to the measured pressure. In the present paper a correction factor for the stagnation pressure measured in SPES is proposed. The analysis relies on twelve tests made in SPES.

Elective ambulatory surgical care in Ireland-why it needs to be better coded, classified and managed.

PubMed

Keane, Frank; Hammond, Laura; Kelliher, Gerry; Mealy, Ken

2017-12-12

In the year to July 2017, surgical disciplines accounted for 73% of the total national inpatient and day case waiting list and, of these, day cases accounted for 72%. Their proper classification is therefore important so that patients can be managed and treated in the most suitable and efficient setting. We set out to sub-classify the different elective surgical day cases treated in Irish public hospitals in order to assess their need to be managed as day cases and the consistency of practice between hospitals. We analysed all elective day cases that came under the care of surgeons between January 2014 and December 2016 and sub-classified them into those that were (A) true day case surgical procedures; (B) minor surgery or outpatient procedures; (C) gastrointestinal endoscopies; (D) day case, non-surgical interventions and (E) unclassified or having no primary procedure identified. Of 813,236 day case surgical interventions performed over 3 years, 26% were adjudged to accord with group A, 41% with B, 23% with C, 5% with D and 5% with E. The ratio of A to B procedures did not vary significantly across the range of hospital types. However, there were some notable variations in coding and practices between hospitals. Our findings show that many day cases should have been performed as outpatient procedures and that there were variations in coding and practices between hospitals that could not be easily explained. Outpatient procedure coding and a better, more consistent, classification of day cases are both required to better manage this group of patients.

A decoding procedure for the Reed-Solomon codes

NASA Technical Reports Server (NTRS)

Lim, R. S.

1978-01-01

A decoding procedure is described for the (n,k) t-error-correcting Reed-Solomon (RS) code, and an implementation of the (31,15) RS code for the I4-TENEX central system. This code can be used for error correction in large archival memory systems. The principal features of the decoder are a Galois field arithmetic unit implemented by microprogramming a microprocessor, and syndrome calculation by using the g(x) encoding shift register. Complete decoding of the (31,15) code is expected to take less than 500 microsecs. The syndrome calculation is performed by hardware using the encoding shift register and a modified Chien search. The error location polynomial is computed by using Lin's table, which is an interpretation of Berlekamp's iterative algorithm. The error location numbers are calculated by using the Chien search. Finally, the error values are computed by using Forney's method.

Estimating the costs of VA ambulatory care.

PubMed

Phibbs, Ciaran S; Bhandari, Aman; Yu, Wei; Barnett, Paul G

2003-09-01

This article reports how we matched Common Procedure Terminology (CPT) codes with Medicare payment rates and aggregate Veterans Affairs (VA) budget data to estimate the costs of every VA ambulatory encounter. Converting CPT codes to encounter-level costs was more complex than a simple match of Medicare reimbursements to CPT codes. About 40 percent of the CPT codes used in VA, representing about 20 percent of procedures, did not have a Medicare payment rate and required other cost estimates. Reconciling aggregated estimated costs to the VA budget allocations for outpatient care produced final VA cost estimates that were lower than projected Medicare reimbursements. The methods used to estimate costs for encounters could be replicated for other settings. They are potentially useful for any system that does not generate billing data, when CPT codes are simpler to collect than billing data, or when there is a need to standardize cost estimates across data sources.

A general multiblock Euler code for propulsion integration. Volume 3: User guide for the Euler code

NASA Technical Reports Server (NTRS)

Chen, H. C.; Su, T. Y.; Kao, T. J.

1991-01-01

This manual explains the procedures for using the general multiblock Euler (GMBE) code developed under NASA contract NAS1-18703. The code was developed for the aerodynamic analysis of geometrically complex configurations in either free air or wind tunnel environments (vol. 1). The complete flow field is divided into a number of topologically simple blocks within each of which surface fitted grids and efficient flow solution algorithms can easily be constructed. The multiblock field grid is generated with the BCON procedure described in volume 2. The GMBE utilizes a finite volume formulation with an explicit time stepping scheme to solve the Euler equations. A multiblock version of the multigrid method was developed to accelerate the convergence of the calculations. This user guide provides information on the GMBE code, including input data preparations with sample input files and a sample Unix script for program execution in the UNICOS environment.

Reliability of a rating procedure to monitor industry self-regulation codes governing alcohol advertising content.

PubMed

Babor, Thomas F; Xuan, Ziming; Proctor, Dwayne

2008-03-01

The purposes of this study were to develop reliable procedures to monitor the content of alcohol advertisements broadcast on television and in other media, and to detect violations of the content guidelines of the alcohol industry's self-regulation codes. A set of rating-scale items was developed to measure the content guidelines of the 1997 version of the U.S. Beer Institute Code. Six focus groups were conducted with 60 college students to evaluate the face validity of the items and the feasibility of the procedure. A test-retest reliability study was then conducted with 74 participants, who rated five alcohol advertisements on two occasions separated by 1 week. Average correlations across all advertisements using three reliability statistics (r, rho, and kappa) were almost all statistically significant and the kappas were good for most items, which indicated high test-retest agreement. We also found high interrater reliabilities (intraclass correlations) among raters for item-level and guideline-level violations, indicating that regardless of the specific item, raters were consistent in their general evaluations of the advertisements. Naïve (untrained) raters can provide consistent (reliable) ratings of the main content guidelines proposed in the U.S. Beer Institute Code. The rating procedure may have future applications for monitoring compliance with industry self-regulation codes and for conducting research on the ways in which alcohol advertisements are perceived by young adults and other vulnerable populations.

A versatile calibration procedure for portable coded aperture gamma cameras and RGB-D sensors

NASA Astrophysics Data System (ADS)

Paradiso, V.; Crivellaro, A.; Amgarou, K.; de Lanaute, N. Blanc; Fua, P.; Liénard, E.

2018-04-01

The present paper proposes a versatile procedure for the geometrical calibration of coded aperture gamma cameras and RGB-D depth sensors, using only one radioactive point source and a simple experimental set-up. Calibration data is then used for accurately aligning radiation images retrieved by means of the γ-camera with the respective depth images computed with the RGB-D sensor. The system resulting from such a combination is thus able to retrieve, automatically, the distance of radioactive hotspots by means of pixel-wise mapping between gamma and depth images. This procedure is of great interest for a wide number of applications, ranging from precise automatic estimation of the shape and distance of radioactive objects to Augmented Reality systems. Incidentally, the corresponding results validated the choice of a perspective design model for a coded aperture γ-camera.

Evidence-Based Imaging Guidelines and Medicare Payment Policy

PubMed Central

Sistrom, Christopher L; McKay, Niccie L

2008-01-01

Objective This study examines the relationship between evidence-based appropriateness criteria for neurologic imaging procedures and Medicare payment determinations. The primary research question is whether Medicare is more likely to pay for imaging procedures as the level of appropriateness increases. Data Sources The American College of Radiology Appropriateness Criteria (ACRAC) for neurological imaging, ICD-9-CM codes, CPT codes, and payment determinations by the Medicare Part B carrier for Florida and Connecticut. Study Design Cross-sectional study of appropriateness criteria and Medicare Part B payment policy for neurological imaging. In addition to descriptive and bivariate statistics, multivariate logistic regression on payment determination (yes or no) was performed. Data Collection Methods The American College of Radiology Appropriateness Criteria (ACRAC) documents specific to neurological imaging, ICD-9-CM codes, and CPT codes were used to create 2,510 medical condition/imaging procedure combinations, with associated appropriateness scores (coded as low/middle/high). Principal Findings As the level of appropriateness increased, more medical condition/imaging procedure combinations were payable (low = 61 percent, middle = 70 percent, and high = 74 percent). Logistic regression indicated that the odds of a medical condition/imaging procedure combination with a middle level of appropriateness being payable was 48 percent higher than for an otherwise similar combination with a low appropriateness score (95 percent CI on odds ratio=1.19–1.84). The odds ratio for being payable between high and low levels of appropriateness was 2.25 (95 percent CI: 1.66–3.04). Conclusions Medicare could improve its payment determinations by taking advantage of existing clinical guidelines, appropriateness criteria, and other authoritative resources for evidence-based practice. Such an approach would give providers a financial incentive that is aligned with best-practice medicine. In particular, Medicare should review and update its payment policies to reflect current information on the appropriateness of alternative imaging procedures for the same medical condition. PMID:18454778

Water Quality Management Studies. Postimpoundment Study of R.E. ’Bob’ Woodruff Lake, Alabama River, Alabama.

DTIC Science & Technology

1984-08-01

8 3. Water-quality, sediment, and biological parameters, associated units, EPA STORET codes, container type, 0 preservative and methods used for...Section III.B). Water samples were collected and preserved according to * _ approved EPA (1974) or American Public Health Association (APHA) (1975...procedures. Water-quality parameters tested, associated units, EPA STORET codes, test procedures, and preservation tech- niques used throughout the

[Orthopedic and trauma surgery in the German DRG system. Recent developments].

PubMed

Franz, D; Schemmann, F; Selter, D D; Wirtz, D C; Roeder, N; Siebert, H; Mahlke, L

2012-07-01

Orthopedics and trauma surgery are subject to continuous medical advancement. The correct and performance-based case allocation by German diagnosis-related groups (G-DRG) is a major challenge. This article analyzes and assesses current developments in orthopedics and trauma surgery in the areas of coding of diagnoses and medical procedures and the development of the 2012 G-DRG system. The relevant diagnoses, medical procedures and G-DRGs in the versions 2011 and 2012 were analyzed based on the publications of the German DRG Institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes were made for the International Classification of Diseases (ICD) coding of complex cases with medical complications, the procedure coding for spinal surgery and for hand and foot surgery. The G-DRG structures were modified for endoprosthetic surgery on ankle, shoulder and elbow joints. The definition of modular structured endoprostheses was clarified. The G-DRG system for orthopedic and trauma surgery appears to be largely consolidated. The current phase of the evolution of the G-DRG system is primarily aimed at developing most exact descriptions and definitions of the content and mutual delimitation of operation and procedures coding (OPS). This is an essential prerequisite for a correct and performance-based case allocation in the G-DRG system.

7 CFR 1724.50 - Compliance with National Electrical Safety Code (NESC).

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 11 2013-01-01 2013-01-01 false Compliance with National Electrical Safety Code (NESC... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ELECTRIC ENGINEERING, ARCHITECTURAL SERVICES AND DESIGN POLICIES AND PROCEDURES Electric System Design § 1724.50 Compliance with National Electrical Safety Code...

7 CFR 1724.50 - Compliance with National Electrical Safety Code (NESC).

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Compliance with National Electrical Safety Code (NESC... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ELECTRIC ENGINEERING, ARCHITECTURAL SERVICES AND DESIGN POLICIES AND PROCEDURES Electric System Design § 1724.50 Compliance with National Electrical Safety Code...

7 CFR 1724.50 - Compliance with National Electrical Safety Code (NESC).

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 11 2011-01-01 2011-01-01 false Compliance with National Electrical Safety Code (NESC... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ELECTRIC ENGINEERING, ARCHITECTURAL SERVICES AND DESIGN POLICIES AND PROCEDURES Electric System Design § 1724.50 Compliance with National Electrical Safety Code...

7 CFR 1724.50 - Compliance with National Electrical Safety Code (NESC).

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 11 2012-01-01 2012-01-01 false Compliance with National Electrical Safety Code (NESC... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ELECTRIC ENGINEERING, ARCHITECTURAL SERVICES AND DESIGN POLICIES AND PROCEDURES Electric System Design § 1724.50 Compliance with National Electrical Safety Code...

7 CFR 1724.50 - Compliance with National Electrical Safety Code (NESC).

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 11 2014-01-01 2014-01-01 false Compliance with National Electrical Safety Code (NESC... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ELECTRIC ENGINEERING, ARCHITECTURAL SERVICES AND DESIGN POLICIES AND PROCEDURES Electric System Design § 1724.50 Compliance with National Electrical Safety Code...

ON UPGRADING THE NUMERICS IN COMBUSTION CHEMISTRY CODES. (R824970)

EPA Science Inventory

A method of updating and reusing legacy FORTRAN codes for combustion simulations is presented using the DAEPACK software package. The procedure is demonstrated on two codes that come with the CHEMKIN-II package, CONP and SENKIN, for the constant-pressure batch reactor simulati...

Creep and Creep-Fatigue Crack Growth at Structural Discontinuities and Welds

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dr. F. W. Brust; Dr. G. M. Wilkowski; Dr. P. Krishnaswamy

2010-01-27

The subsection ASME NH high temperature design procedure does not admit crack-like defects into the structural components. The US NRC identified the lack of treatment of crack growth within NH as a limitation of the code and thus this effort was undertaken. This effort is broken into two parts. Part 1, summarized here, involved examining all high temperature creep-fatigue crack growth codes being used today and from these, the task objective was to choose a methodology that is appropriate for possible implementation within NH. The second part of this task, which has just started, is to develop design rules formore » possible implementation within NH. This second part is a challenge since all codes require step-by-step analysis procedures to be undertaken in order to assess the crack growth and life of the component. Simple rules for design do not exist in any code at present. The codes examined in this effort included R5, RCC-MR (A16), BS 7910, API 579, and ATK (and some lesser known codes). There are several reasons that the capability for assessing cracks in high temperature nuclear components is desirable. These include: (1) Some components that are part of GEN IV reactors may have geometries that have sharp corners - which are essentially cracks. Design of these components within the traditional ASME NH procedure is quite challenging. It is natural to ensure adequate life design by modeling these features as cracks within a creep-fatigue crack growth procedure. (2) Workmanship flaws in welds sometimes occur and are accepted in some ASME code sections. It can be convenient to consider these as flaws when making a design life assessment. (3) Non-destructive Evaluation (NDE) and inspection methods after fabrication are limited in the size of the crack or flaw that can be detected. It is often convenient to perform a life assessment using a flaw of a size that represents the maximum size that can elude detection. (4) Flaws that are observed using in-service detection methods often need to be addressed as plants age. Shutdown inspection intervals can only be designed using creep and creep-fatigue crack growth techniques. (5) The use of crack growth procedures can aid in examining the seriousness of creep damage in structural components. How cracks grow can be used to assess margins on components and lead to further safe operation. After examining the pros and cons of all these methods, the R5 code was chosen as the most up-to-date and validated high temperature creep and creep fatigue code currently used in the world at present. R5 is considered the leader because the code: (1) has well established and validated rules, (2) has a team of experts continually improving and updating it, (3) has software that can be used by designers, (4) extensive validation in many parts with available data from BE resources as well as input from Imperial college's database, and (5) was specifically developed for use in nuclear plants. R5 was specifically developed for use in gas cooled nuclear reactors which operate in the UK and much of the experience is based on materials and temperatures which are experienced in these reactors. If the next generation advanced reactors to be built in the US used these same materials within the same temperature ranges as these reactors, then R5 may be appropriate for consideration of direct implementation within ASME code NH or Section XI. However, until more verification and validation of these creep/fatigue crack growth rules for the specific materials and temperatures to be used in the GEN IV reactors is complete, ASME should consider delaying this implementation. With this in mind, it is this authors opinion that R5 methods are the best available for code use today. The focus of this work was to examine the literature for creep and creep-fatigue crack growth procedures that are well established in codes in other countries and choose a procedure to consider implementation into ASME NH. It is very important to recognize that all creep and creep fatigue crack growth procedures that are part of high temperature design codes are related and very similar. This effort made no attempt to develop a new creep-fatigue crack growth predictive methodology. Rather examination of current procedures was the only goal. The uncertainties in the R5 crack growth methods and recommendations for more work are summarized here also.« less

Uncommon combinations of ICD10-PCS or ICD-9-CM operative procedure codes account for most inpatient surgery at half of Texas hospitals.

PubMed

O'Neill, Liam; Dexter, Franklin; Park, Sae-Hwan; Epstein, Richard H

2017-09-01

Recently, there has been interest in activity-based cost accounting for inpatient surgical procedures to facilitate "value based" analyses. Research 10-20years ago, performed using data from 3 large teaching hospitals, found that activity-based cost accounting was practical and useful for modeling surgeons and subspecialties, but inaccurate for individual procedures. We hypothesized that these older results would apply to hundreds of hospitals, currently evaluable using administrative databases. Observational study. State of Texas hospital discharge abstract data for 1st quarter of 2016, 4th quarter of 2015, 1st quarter of 2015, and 4th quarter of 2014. Discharged from an acute care hospital in Texas with at least 1 major therapeutic ("operative") procedure. Counts of discharges for each procedure or combination of procedures, classified by ICD-10-PCS or ICD-9-CM. At the average hospital, most surgical discharges were for procedures performed at most once a month at the hospital (54%, 95% confidence interval [CI] 51% to 55%). At the average hospital, approximately 90% of procedures were performed at most once a month at the hospital (93%, CI 93% to 94%). The percentages were insensitive to the quarter of the year. The percentages were 3% to 6% greater with ICD-10-PCS than for the superseded ICD 9 CM. There are many different procedure codes, and many different combinations of codes, relative to the number of different hospital discharges. Since most procedures at most hospitals are performed no more than once a month, activity-based cost accounting with a sample size sufficient to be useful is impractical for the vast majority of procedures, in contrast to analysis by surgeon and/or subspecialty. Copyright © 2017 Elsevier Inc. All rights reserved.

Rural-urban differences in dental service use among children enrolled in a private dental insurance plan in Wisconsin: analysis of administrative data.

PubMed

Bhagavatula, Pradeep; Xiang, Qun; Szabo, Aniko; Eichmiller, Fredrick; Kuthy, Raymond A; Okunseri, Christopher E

2012-12-21

Studies on rural-urban differences in dental care have primarily focused on differences in utilization rates and preventive dental services. Little is known about rural-urban differences in the use of wider range of dental procedures. This study examined patterns of preventive, restorative, endodontic, and extraction procedures provided to children enrolled in Delta Dental of Wisconsin (DDWI). We analyzed DDWI enrollment and claims data for children aged 0-18 years from 2002 to 2008. We modified and used a rural and urban classification based on ZIP codes developed by the Wisconsin Area Health Education Center (AHEC). We categorized the ZIP codes into 6 AHEC categories (3 rural and 3 urban). Descriptive and multivariable analysis using generalized linear mixed models (GLMM) were used to examine the patterns of dental procedures provided to children. Tukey-Kramer adjustment was used to control for multiple comparisons. Approximately, 50%, 67% and 68% of enrollees in inner-city Milwaukee, Rural 1 (less than 2500 people), and suburban-Milwaukee had at least one annual dental visit, respectively. Children in inner city-Milwaukee had the lowest utilization rates for all procedures examined, except for endodontic procedures. Compared to children from inner-city Milwaukee, children in other locations had significantly more preventive procedures. Children in Rural 1-ZIP codes had more restorative, endodontic and extraction procedures, compared to children from all other regions. We found significant geographic variation in dental procedures received by children enrolled in DDWI.

On the symbolic manipulation and code generation for elasto-plastic material matrices

NASA Technical Reports Server (NTRS)

Chang, T. Y.; Saleeb, A. F.; Wang, P. S.; Tan, H. Q.

1991-01-01

A computerized procedure for symbolic manipulations and FORTRAN code generation of an elasto-plastic material matrix for finite element applications is presented. Special emphasis is placed on expression simplifications during intermediate derivations, optimal code generation, and interface with the main program. A systematic procedure is outlined to avoid redundant algebraic manipulations. Symbolic expressions of the derived material stiffness matrix are automatically converted to RATFOR code which is then translated into FORTRAN statements through a preprocessor. To minimize the interface problem with the main program, a template file is prepared so that the translated FORTRAN statements can be merged into the file to form a subroutine (or a submodule). Three constitutive models; namely, von Mises plasticity, Drucker-Prager model, and a concrete plasticity model, are used as illustrative examples.

[Aesthetic surgery].

PubMed

Bruck, Johannes C

2006-01-01

The WHO describes health as physical, mental and social well being. Ever since the establishment of plastic surgery aesthetic surgery has been an integral part of this medical specialty. It aims at reconstructing subjective well-being by employing plastic surgical procedures as described in the educational code and regulations for specialists of plastic surgery. This code confirms that plastic surgery comprises cosmetic procedures for the entire body that have to be applied in respect of psychological exploration and selection criteria. A wide variety of opinions resulting from very different motivations shows how difficult it is to differentiate aesthetic surgery as a therapeutic procedure from beauty surgery as a primarily economic service. Jurisdiction, guidelines for professional conduct and ethical codes have tried to solve this question. Regardless of the intention and ability of the health insurances, it has currently been established that the moral and legal evaluation of advertisements for medical procedures depends on their purpose: advertising with the intent of luring patients into cosmetic procedures that do not aim to reconstruct a subjective physical disorder does not comply with a medical indication. If, however, the initiative originates with the patient requesting the amelioration of a subjective disorder of his body, a medical indication can be assumed.

Federal Logistics Information Systems. FLIS Procedures Manual. Document Identifier Code Input/Output Formats (Variable Length). Volume 9.

DTIC Science & Technology

1997-04-01

DATA COLLABORATORS 0001N B NQ 8380 NUMBER OF DATA RECEIVERS 0001N B NQ 2533 AUTHORIZED ITEM IDENTIFICATION DATA COLLABORATOR CODE 0002 ,X B 03 18 TD...01 NC 8268 DATA ELEMENT TERMINATOR CODE 000iX VT 9505 TYPE OF SCREENING CODE 0001A 01 NC 8268 DATA ELEMENT TERMINATOR CODE 000iX VT 4690 OUTPUT DATA... 9505 TYPE OF SCREENING CODE 0001A 2 89 2910 REFERENCE NUMBER CATEGORY CODE (RNCC) 0001X 2 89 4780 REFERENCE NUMBER VARIATION CODE (RNVC) 0001 N 2 89

[Hand surgery in the German DRG System 2007].

PubMed

Franz, D; Windolf, J; Kaufmann, M; Siebert, C H; Roeder, N

2007-05-01

Hand surgery often needs only a short length of stay in hospital. Patients' comorbidity is low. Many hand surgery procedures do not need inpatient structures. Up until 2006 special procedures of hand surgery could not be coded. The DRG structure did not separate very complex and less complex operations. Specialized hospitals needed a proper case allocation of their patients within the G-DRG system. The DRG structure concerning hand surgery increased in version 2007 of the G-DRG system. The main parameter of DRG splitting is the complexity of the operation. Furthermore additional criteria such as more than one significant OR procedure, the patients' age, or special diagnoses influence case allocation. A special OPS code for complex cases treated with hand surgery was implemented. The changes in the DRG structure and the implementation of the new OPS code for complex cases establish a strong basis for the identification of different patient costs. Different case allocation leads to different economic impacts on departments of hand surgery. Whether the new OPS code becomes a DRG splitting parameter has to be calculated by the German DRG Institute for further DRG versions.

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CODING: DESCRIPTIVE QUESTIONNAIRE (UA-D-6.0)

EPA Science Inventory

This purpose of this SOP is to define the coding strategy for the Descriptive Questionnaire. This questionnaire was developed for use in the Arizona NHEXAS project and the "Border" study. Keywords: data; coding; descriptive questionnaire.

The National Human Exposure Assessment...

A numerical similarity approach for using retired Current Procedural Terminology (CPT) codes for electronic phenotyping in the Scalable Collaborative Infrastructure for a Learning Health System (SCILHS).

PubMed

Klann, Jeffrey G; Phillips, Lori C; Turchin, Alexander; Weiler, Sarah; Mandl, Kenneth D; Murphy, Shawn N

2015-12-11

Interoperable phenotyping algorithms, needed to identify patient cohorts meeting eligibility criteria for observational studies or clinical trials, require medical data in a consistent structured, coded format. Data heterogeneity limits such algorithms' applicability. Existing approaches are often: not widely interoperable; or, have low sensitivity due to reliance on the lowest common denominator (ICD-9 diagnoses). In the Scalable Collaborative Infrastructure for a Learning Healthcare System (SCILHS) we endeavor to use the widely-available Current Procedural Terminology (CPT) procedure codes with ICD-9. Unfortunately, CPT changes drastically year-to-year - codes are retired/replaced. Longitudinal analysis requires grouping retired and current codes. BioPortal provides a navigable CPT hierarchy, which we imported into the Informatics for Integrating Biology and the Bedside (i2b2) data warehouse and analytics platform. However, this hierarchy does not include retired codes. We compared BioPortal's 2014AA CPT hierarchy with Partners Healthcare's SCILHS datamart, comprising three-million patients' data over 15 years. 573 CPT codes were not present in 2014AA (6.5 million occurrences). No existing terminology provided hierarchical linkages for these missing codes, so we developed a method that automatically places missing codes in the most specific "grouper" category, using the numerical similarity of CPT codes. Two informaticians reviewed the results. We incorporated the final table into our i2b2 SCILHS/PCORnet ontology, deployed it at seven sites, and performed a gap analysis and an evaluation against several phenotyping algorithms. The reviewers found the method placed the code correctly with 97 % precision when considering only miscategorizations ("correctness precision") and 52 % precision using a gold-standard of optimal placement ("optimality precision"). High correctness precision meant that codes were placed in a reasonable hierarchal position that a reviewer can quickly validate. Lower optimality precision meant that codes were not often placed in the optimal hierarchical subfolder. The seven sites encountered few occurrences of codes outside our ontology, 93 % of which comprised just four codes. Our hierarchical approach correctly grouped retired and non-retired codes in most cases and extended the temporal reach of several important phenotyping algorithms. We developed a simple, easily-validated, automated method to place retired CPT codes into the BioPortal CPT hierarchy. This complements existing hierarchical terminologies, which do not include retired codes. The approach's utility is confirmed by the high correctness precision and successful grouping of retired with non-retired codes.

Failure to Follow Written Procedures

DOT National Transportation Integrated Search

2017-12-01

Most tasks in aviation have a mandated written procedure to be followed specifically under the Code of Federal Regulations (CFR) Part 14, Section 43.13(a). However, the incidence of Failure to Follow Procedure (FFP) events continues to be a major iss...

An artificial viscosity method for the design of supercritical airfoils

NASA Technical Reports Server (NTRS)

Mcfadden, G. B.

1979-01-01

A numerical technique is presented for the design of two-dimensional supercritical wing sections with low wave drag. The method is a design mode of the analysis code H which gives excellent agreement with experimental results and is widely used in the aircraft industry. Topics covered include the partial differential equations of transonic flow, the computational procedure and results; the design procedure; a convergence theorem; and description of the code.

JPRS Report: East Asia, Southeast Asia, LPDR Criminal Code, Courts, and Criminal Procedure.

DTIC Science & Technology

1991-03-05

1941 - 1991 JPRS Repor East Asia Southeast Asia LPDR Criminal Code, Courts, and Criminal Procedure mom m £C QUALITY »ra^r...prostitution, will be impris- oned for three to five years. Article 124. Incest . Anyone who has sexual intercourse with parents, step- parents...This consists of facts which indicate whether there have been actions dangerous to society, the guilt of the per- sons who undertook the

[Orthopedic and trauma surgery in the German-DRG-System 2009].

PubMed

Franz, D; Windolf, J; Siebert, C H; Roeder, N

2009-01-01

The German DRG-System was advanced into version 2009. For orthopedic and trauma surgery significant changes concerning coding of diagnoses, medical procedures and concerning the DRG-structure were made. Analysis of relevant diagnoses, medical procedures and G-DRGs in the versions 2008 and 2009 based on the publications of the German DRG-institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes for 2009 focussed on the development of DRG-structure, DRG-validation and codes for medical procedures to be used for very complex cases. The outcome of these changes for German hospitals may vary depending in the range of activities. G-DRG-System gained complexity again. High demands are made on correct and complete coding of complex orthopedic and trauma surgery cases. Quality of case-allocation within the G-DRG-System was improved. Nevertheless, further adjustments of the G-DRG-System especially for cases with severe injuries are necessary.

Development of a thermal and structural analysis procedure for cooled radial turbines

NASA Technical Reports Server (NTRS)

Kumar, Ganesh N.; Deanna, Russell G.

1988-01-01

A procedure for computing the rotor temperature and stress distributions in a cooled radial turbine are considered. Existing codes for modeling the external mainstream flow and the internal cooling flow are used to compute boundary conditions for the heat transfer and stress analysis. The inviscid, quasi three dimensional code computes the external free stream velocity. The external velocity is then used in a boundary layer analysis to compute the external heat transfer coefficients. Coolant temperatures are computed by a viscous three dimensional internal flow cade for the momentum and energy equation. These boundary conditions are input to a three dimensional heat conduction code for the calculation of rotor temperatures. The rotor stress distribution may be determined for the given thermal, pressure and centrifugal loading. The procedure is applied to a cooled radial turbine which will be tested at the NASA Lewis Research Center. Representative results are given.

An efficient code for the simulation of nonhydrostatic stratified flow over obstacles

NASA Technical Reports Server (NTRS)

Pihos, G. G.; Wurtele, M. G.

1981-01-01

The physical model and computational procedure of the code is described in detail. The code is validated in tests against a variety of known analytical solutions from the literature and is also compared against actual mountain wave observations. The code will receive as initial input either mathematically idealized or discrete observational data. The form of the obstacle or mountain is arbitrary.

[Placement of children and adolescents following seclusion and restraint actions–a study on family-court approvals of minors in youth welfare, child and adolescent psychiatry and jail according to Para. 1631 German Civil Code].

PubMed

Kölch, Michael; Vogel, Harald

2016-01-01

According to German law (Para. 1631b German Civil Code), the placement of children and adolescents following seclusion and restraint actions must be approved by a family court. We analyzed the family court data of a court district in Berlin (Tempelhof-Kreuzberg) concerning cases of “placement of minors” between 2008 and 2011. A total of 474 such procedures were discovered. After data clearing and correction of cases (e. g., because of emergency interventions of the youth welfare system taking children into custody according to Para. 42, German Civil Code VIII), 376 cases remained. Of these 376 procedures in the years 2008 to 2011, 127 cases concerned children and adolescents according to Para. 1631b German Civil Code, and 249 procedures were settled either by dismissal, withdrawal or by repealing the initial decision to place the child with restrain or seclusion by means of an interim order or by filing an appeal against the final decision. Of the 127 procedures, 68 concerned girls, who were on average slightly younger than boys (14.5 years vs. 15.1 years). In two thirds of the procedures, the children and adolescents were German citizens. The majority of youths involved were living at home at the time of the procedure, but in 15 % of the case the youths were homeless. Most of the adolescents were treated with restraint in child and adolescent psychiatry. The most frequently quoted reasons for seclusion were substance abuse, suicide risk and running away from home/being homeless.

The procedure execution manager and its application to Advanced Photon Source operation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Borland, M.

1997-06-01

The Procedure Execution Manager (PEM) combines a complete scripting environment for coding accelerator operation procedures with a manager application for executing and monitoring the procedures. PEM is based on Tcl/Tk, a supporting widget library, and the dp-tcl extension for distributed processing. The scripting environment provides support for distributed, parallel execution of procedures along with join and abort operations. Nesting of procedures is supported, permitting the same code to run as a top-level procedure under operator control or as a subroutine under control of another procedure. The manager application allows an operator to execute one or more procedures in automatic, semi-automatic,more » or manual modes. It also provides a standard way for operators to interact with procedures. A number of successful applications of PEM to accelerator operations have been made to date. These include start-up, shutdown, and other control of the positron accumulator ring (PAR), low-energy transport (LET) lines, and the booster rf systems. The PAR/LET procedures make nested use of PEM`s ability to run parallel procedures. There are also a number of procedures to guide and assist tune-up operations, to make accelerator physics measurements, and to diagnose equipment. Because of the success of the existing procedures, expanded use of PEM is planned.« less

A Comparison of Fatigue Design Methods

DTIC Science & Technology

2001-04-05

Boiler and Pressure Vessel Code does not...Engineers, "ASME Boiler and Pressure Vessel Code ," ASME, 3 Park Ave., New York, NY 10016-5990. [4] Langer, B. F., "Design of Pressure Vessels Involving... and Pressure Vessel Code [3] presents these methods and has expanded the procedures to other pressure vessels besides nuclear pressure vessels. B.

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CODING: QUESTIONNAIRE FEEDBACK FORM (UA-D-46.0)

EPA Science Inventory

The purpose of this SOP is to describe the coding strategy for the Questionnaire Feedback form. This Questionnaire Feedback form was developed for use during the Arizona NHEXAS project and the "Border" study. Keywords: data; coding; questionnaire feedback form.

The National Hu...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CODING: DIET DIARY QUESTIONNAIRE (UA-D-43.0)

EPA Science Inventory

The purpose of this SOP is to define the coding strategy for the Diet Diary Questionnaire. This questionnaire was developed for use during the Arizona NHEXAS project and the "Border" study. Keywords: data; coding; diet diary questionnaire.

The National Human Exposure Assessme...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CODING: TECHNICIAN WALK-THROUGH QUESTIONNAIRE (UA-D-35.0)

EPA Science Inventory

The purpose of this SOP is to define the coding strategy for the Technician Walk-Through Questionnaire. This questionnaire was developed for use during the Arizona NHEXAS project and the "Border" study. Keywords: data; coding; technician walk-through questionnaire.

The Nationa...

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR CODING: DESCRIPTIVE QUESTIONNAIRE (UA-D-6.0)

EPA Science Inventory

This purpose of this SOP is to define the coding strategy for the Descriptive Questionnaire. This questionnaire was developed for use in the Arizona NHEXAS project and the Border study. Keywords: data; coding; descriptive questionnaire.

The U.S.-Mexico Border Program is sponso...

The Attorney General's Proposed Voluntary Student Code of Conduct.

ERIC Educational Resources Information Center

Texas State Attorney General's Office, Austin.

Intended as a guide for Texas school districts wishing to adopt or modify a student code of conduct, this proposed code describes a positive learning atmosphere, specifies conduct that disrupts such an environment, assures the rights and responsibilities of students, and standardizes procedures to be used in responding to disciplinary problems.…

Content Analysis Coding Schemes for Online Asynchronous Discussion

ERIC Educational Resources Information Center

Weltzer-Ward, Lisa

2011-01-01

Purpose: Researchers commonly utilize coding-based analysis of classroom asynchronous discussion contributions as part of studies of online learning and instruction. However, this analysis is inconsistent from study to study with over 50 coding schemes and procedures applied in the last eight years. The aim of this article is to provide a basis…

Continuities in Reading Acquisition, Reading Skill, and Reading Disability.

ERIC Educational Resources Information Center

Perfetti, Charles A.

1986-01-01

Learning to read depends on eventual mastery of coding procedures, and even skilled reading depends on coding processes low in cost to processing resources. Reading disability may be understood as a point on an ability continuum or a wide range of coding ability. Instructional goals of word reading skill, including rapid and fluent word…

New double-byte error-correcting codes for memory systems

NASA Technical Reports Server (NTRS)

Feng, Gui-Liang; Wu, Xinen; Rao, T. R. N.

1996-01-01

Error-correcting or error-detecting codes have been used in the computer industry to increase reliability, reduce service costs, and maintain data integrity. The single-byte error-correcting and double-byte error-detecting (SbEC-DbED) codes have been successfully used in computer memory subsystems. There are many methods to construct double-byte error-correcting (DBEC) codes. In the present paper we construct a class of double-byte error-correcting codes, which are more efficient than those known to be optimum, and a decoding procedure for our codes is also considered.

A Coded Structured Light System Based on Primary Color Stripe Projection and Monochrome Imaging

PubMed Central

Barone, Sandro; Paoli, Alessandro; Razionale, Armando Viviano

2013-01-01

Coded Structured Light techniques represent one of the most attractive research areas within the field of optical metrology. The coding procedures are typically based on projecting either a single pattern or a temporal sequence of patterns to provide 3D surface data. In this context, multi-slit or stripe colored patterns may be used with the aim of reducing the number of projected images. However, color imaging sensors require the use of calibration procedures to address crosstalk effects between different channels and to reduce the chromatic aberrations. In this paper, a Coded Structured Light system has been developed by integrating a color stripe projector and a monochrome camera. A discrete coding method, which combines spatial and temporal information, is generated by sequentially projecting and acquiring a small set of fringe patterns. The method allows the concurrent measurement of geometrical and chromatic data by exploiting the benefits of using a monochrome camera. The proposed methodology has been validated by measuring nominal primitive geometries and free-form shapes. The experimental results have been compared with those obtained by using a time-multiplexing gray code strategy. PMID:24129018

A coded structured light system based on primary color stripe projection and monochrome imaging.

PubMed

Barone, Sandro; Paoli, Alessandro; Razionale, Armando Viviano

2013-10-14

Coded Structured Light techniques represent one of the most attractive research areas within the field of optical metrology. The coding procedures are typically based on projecting either a single pattern or a temporal sequence of patterns to provide 3D surface data. In this context, multi-slit or stripe colored patterns may be used with the aim of reducing the number of projected images. However, color imaging sensors require the use of calibration procedures to address crosstalk effects between different channels and to reduce the chromatic aberrations. In this paper, a Coded Structured Light system has been developed by integrating a color stripe projector and a monochrome camera. A discrete coding method, which combines spatial and temporal information, is generated by sequentially projecting and acquiring a small set of fringe patterns. The method allows the concurrent measurement of geometrical and chromatic data by exploiting the benefits of using a monochrome camera. The proposed methodology has been validated by measuring nominal primitive geometries and free-form shapes. The experimental results have been compared with those obtained by using a time-multiplexing gray code strategy.

Galen-In-Use: using artificial intelligence terminology tools to improve the linguistic coherence of a national coding system for surgical procedures.

PubMed

Rodrigues, J M; Trombert-Paviot, B; Baud, R; Wagner, J; Meusnier-Carriot, F

1998-01-01

GALEN has developed a language independent common reference model based on a medically oriented ontology and practical tools and techniques for managing healthcare terminology including natural language processing. GALEN-IN-USE is the current phase which applied the modelling and the tools to the development or the updating of coding systems for surgical procedures in different national coding centers co-operating within the European Federation of Coding Centre (EFCC) to create a language independent knowledge repository for multicultural Europe. We used an integrated set of artificial intelligence terminology tools named CLAssification Manager workbench to process French professional medical language rubrics into intermediate dissections and to the Grail reference ontology model representation. From this language independent concept model representation we generate controlled French natural language. The French national coding centre is then able to retrieve the initial professional rubrics with different categories of concepts, to compare the professional language proposed by expert clinicians to the French generated controlled vocabulary and to finalize the linguistic labels of the coding system in relation with the meanings of the conceptual system structure.

Three-dimensional turbopump flowfield analysis

NASA Technical Reports Server (NTRS)

Sharma, O. P.; Belford, K. A.; Ni, R. H.

1992-01-01

A program was conducted to develop a flow prediction method applicable to rocket turbopumps. The complex nature of a flowfield in turbopumps is described and examples of flowfields are discussed to illustrate that physics based models and analytical calculation procedures based on computational fluid dynamics (CFD) are needed to develop reliable design procedures for turbopumps. A CFD code developed at NASA ARC was used as the base code. The turbulence model and boundary conditions in the base code were modified, respectively, to: (1) compute transitional flows and account for extra rates of strain, e.g., rotation; and (2) compute surface heat transfer coefficients and allow computation through multistage turbomachines. Benchmark quality data from two and three-dimensional cascades were used to verify the code. The predictive capabilities of the present CFD code were demonstrated by computing the flow through a radial impeller and a multistage axial flow turbine. Results of the program indicate that the present code operated in a two-dimensional mode is a cost effective alternative to full three-dimensional calculations, and that it permits realistic predictions of unsteady loadings and losses for multistage machines.

Caregiver Person-Centeredness and Behavioral Symptoms during Mealtime Interactions: Development and Feasibility of a Coding Scheme

PubMed Central

Gilmore-Bykovskyi, Andrea L.

2015-01-01

Mealtime behavioral symptoms are distressing and frequently interrupt eating for the individual experiencing them and others in the environment. In order to enable identification of potential antecedents to mealtime behavioral symptoms, a computer-assisted coding scheme was developed to measure caregiver person-centeredness and behavioral symptoms for nursing home residents with dementia during mealtime interactions. The purpose of this pilot study was to determine the acceptability and feasibility of procedures for video-capturing naturally-occurring mealtime interactions between caregivers and residents with dementia, to assess the feasibility, ease of use, and inter-observer reliability of the coding scheme, and to explore the clinical utility of the coding scheme. Trained observers coded 22 observations. Data collection procedures were feasible and acceptable to caregivers, residents and their legally authorized representatives. Overall, the coding scheme proved to be feasible, easy to execute and yielded good to very good inter-observer agreement following observer re-training. The coding scheme captured clinically relevant, modifiable antecedents to mealtime behavioral symptoms, but would be enhanced by the inclusion of measures for resident engagement and consolidation of items for measuring caregiver person-centeredness that co-occurred and were difficult for observers to distinguish. PMID:25784080

Improving accuracy of clinical coding in surgery: collaboration is key.

PubMed

Heywood, Nick A; Gill, Michael D; Charlwood, Natasha; Brindle, Rachel; Kirwan, Cliona C

2016-08-01

Clinical coding data provide the basis for Hospital Episode Statistics and Healthcare Resource Group codes. High accuracy of this information is required for payment by results, allocation of health and research resources, and public health data and planning. We sought to identify the level of accuracy of clinical coding in general surgical admissions across hospitals in the Northwest of England. Clinical coding departments identified a total of 208 emergency general surgical patients discharged between 1st March and 15th August 2013 from seven hospital trusts (median = 20, range = 16-60). Blinded re-coding was performed by a senior clinical coder and clinician, with results compared with the original coding outcome. Recorded codes were generated from OPCS-4 & ICD-10. Of all cases, 194 of 208 (93.3%) had at least one coding error and 9 of 208 (4.3%) had errors in both primary diagnosis and primary procedure. Errors were found in 64 of 208 (30.8%) of primary diagnoses and 30 of 137 (21.9%) of primary procedure codes. Median tariff using original codes was £1411.50 (range, £409-9138). Re-calculation using updated clinical codes showed a median tariff of £1387.50, P = 0.997 (range, £406-10,102). The most frequent reasons for incorrect coding were "coder error" and a requirement for "clinical interpretation of notes". Errors in clinical coding are multifactorial and have significant impact on primary diagnosis, potentially affecting the accuracy of Hospital Episode Statistics data and in turn the allocation of health care resources and public health planning. As we move toward surgeon specific outcomes, surgeons should increase collaboration with coding departments to ensure the system is robust. Copyright © 2016 Elsevier Inc. All rights reserved.

An interactive method for digitizing zone maps

NASA Technical Reports Server (NTRS)

Giddings, L. E.; Thompson, E. J.

1975-01-01

A method is presented for digitizing maps that consist of zones, such as contour or climatic zone maps. A color-coded map is prepared by any convenient process. The map is then read into memory of an Image 100 computer by means of its table scanner, using colored filters. Zones are separated and stored in themes, using standard classification procedures. Thematic data are written on magnetic tape and these data, appropriately coded, are combined to make a digitized image on tape. Step-by-step procedures are given for digitization of crop moisture index maps with this procedure. In addition, a complete example of the digitization of a climatic zone map is given.

25 CFR 11.503 - Applicable civil procedure.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Applicable civil procedure. 11.503 Section 11.503 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER COURTS OF INDIAN OFFENSES AND LAW AND ORDER CODE Civil Actions § 11.503 Applicable civil procedure. The procedure to be followed in civil...

25 CFR 11.503 - Applicable civil procedure.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false Applicable civil procedure. 11.503 Section 11.503 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER COURTS OF INDIAN OFFENSES AND LAW AND ORDER CODE Civil Actions § 11.503 Applicable civil procedure. The procedure to be followed in civil...

25 CFR 11.503 - Applicable civil procedure.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false Applicable civil procedure. 11.503 Section 11.503 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER COURTS OF INDIAN OFFENSES AND LAW AND ORDER CODE Civil Actions § 11.503 Applicable civil procedure. The procedure to be followed in civil...

25 CFR 11.503 - Applicable civil procedure.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Applicable civil procedure. 11.503 Section 11.503 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER COURTS OF INDIAN OFFENSES AND LAW AND ORDER CODE Civil Actions § 11.503 Applicable civil procedure. The procedure to be followed in civil...

25 CFR 11.503 - Applicable civil procedure.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 1 2012-04-01 2011-04-01 true Applicable civil procedure. 11.503 Section 11.503 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER COURTS OF INDIAN OFFENSES AND LAW AND ORDER CODE Civil Actions § 11.503 Applicable civil procedure. The procedure to be followed in civil...

Racial/ethnic disparities in provision of dental procedures to children enrolled in Delta Dental insurance in Milwaukee, Wisconsin.

PubMed

Bhagavatula, Pradeep; Xiang, Qun; Eichmiller, Fredrick; Szabo, Aniko; Okunseri, Christopher

2014-01-01

Most studies on the provision of dental procedures have focused on Medicaid enrollees known to have inadequate access to dental care. Little information on private insurance enrollees exists. This study documents the rates of preventive, restorative, endodontic, and surgical dental procedures provided to children enrolled in Delta Dental of Wisconsin (DDWI) in Milwaukee. We analyzed DDWI claims data for Milwaukee children aged 0-18 years between 2002 and 2008. We linked the ZIP codes of enrollees to the 2000 U.S. Census information to derive racial/ethnic estimates in the different ZIP codes. We estimated the rates of preventive, restorative, endodontic, and surgical procedures provided to children in different racial/ethnic groups based on the population estimates derived from the U.S. Census data. Descriptive and multivariable analysis was done using Poisson regression modeling on dental procedures per year. In 7 years, a total of 266,380 enrollees were covered in 46 ZIP codes in the database. Approximately, 64 percent, 44 percent, and 49 percent of White, African American, and Hispanic children had at least one dental visit during the study period, respectively. The rates of preventive procedures increased up to the age of 9 years and decreased thereafter among children in all three racial groups included in the analysis. African American and Hispanic children received half as many preventive procedures as White children. Our study shows that substantial racial disparities may exist in the types of dental procedures that were received by children. © 2012 American Association of Public Health Dentistry.

Evaluation of three coding schemes designed for improved data communication

NASA Technical Reports Server (NTRS)

Snelsire, R. W.

1974-01-01

Three coding schemes designed for improved data communication are evaluated. Four block codes are evaluated relative to a quality function, which is a function of both the amount of data rejected and the error rate. The Viterbi maximum likelihood decoding algorithm as a decoding procedure is reviewed. This evaluation is obtained by simulating the system on a digital computer. Short constraint length rate 1/2 quick-look codes are studied, and their performance is compared to general nonsystematic codes.

General phase spaces: from discrete variables to rotor and continuum limits

NASA Astrophysics Data System (ADS)

Albert, Victor V.; Pascazio, Saverio; Devoret, Michel H.

2017-12-01

We provide a basic introduction to discrete-variable, rotor, and continuous-variable quantum phase spaces, explaining how the latter two can be understood as limiting cases of the first. We extend the limit-taking procedures used to travel between phase spaces to a general class of Hamiltonians (including many local stabilizer codes) and provide six examples: the Harper equation, the Baxter parafermionic spin chain, the Rabi model, the Kitaev toric code, the Haah cubic code (which we generalize to qudits), and the Kitaev honeycomb model. We obtain continuous-variable generalizations of all models, some of which are novel. The Baxter model is mapped to a chain of coupled oscillators and the Rabi model to the optomechanical radiation pressure Hamiltonian. The procedures also yield rotor versions of all models, five of which are novel many-body extensions of the almost Mathieu equation. The toric and cubic codes are mapped to lattice models of rotors, with the toric code case related to U(1) lattice gauge theory.

TAS: A Transonic Aircraft/Store flow field prediction code

NASA Technical Reports Server (NTRS)

Thompson, D. S.

1983-01-01

A numerical procedure has been developed that has the capability to predict the transonic flow field around an aircraft with an arbitrarily located, separated store. The TAS code, the product of a joint General Dynamics/NASA ARC/AFWAL research and development program, will serve as the basis for a comprehensive predictive method for aircraft with arbitrary store loadings. This report described the numerical procedures employed to simulate the flow field around a configuration of this type. The validity of TAS code predictions is established by comparison with existing experimental data. In addition, future areas of development of the code are outlined. A brief description of code utilization is also given in the Appendix. The aircraft/store configuration is simulated using a mesh embedding approach. The computational domain is discretized by three meshes: (1) a planform-oriented wing/body fine mesh, (2) a cylindrical store mesh, and (3) a global Cartesian crude mesh. This embedded mesh scheme enables simulation of stores with fins of arbitrary angular orientation.

Exposure calculation code module for reactor core analysis: BURNER

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vondy, D.R.; Cunningham, G.W.

1979-02-01

The code module BURNER for nuclear reactor exposure calculations is presented. The computer requirements are shown, as are the reference data and interface data file requirements, and the programmed equations and procedure of calculation are described. The operating history of a reactor is followed over the period between solutions of the space, energy neutronics problem. The end-of-period nuclide concentrations are determined given the necessary information. A steady state, continuous fueling model is treated in addition to the usual fixed fuel model. The control options provide flexibility to select among an unusually wide variety of programmed procedures. The code also providesmore » user option to make a number of auxiliary calculations and print such information as the local gamma source, cumulative exposure, and a fine scale power density distribution in a selected zone. The code is used locally in a system for computation which contains the VENTURE diffusion theory neutronics code and other modules.« less

Probability of coding of a DNA sequence: an algorithm to predict translated reading frames from their thermodynamic characteristics.

PubMed Central

Tramontano, A; Macchiato, M F

1986-01-01

An algorithm to determine the probability that a reading frame codifies for a protein is presented. It is based on the results of our previous studies on the thermodynamic characteristics of a translated reading frame. We also develop a prediction procedure to distinguish between coding and non-coding reading frames. The procedure is based on the characteristics of the putative product of the DNA sequence and not on periodicity characteristics of the sequence, so the prediction is not biased by the presence of overlapping translated reading frames or by the presence of translated reading frames on the complementary DNA strand. PMID:3753761

Exploring Hill Ciphers with Graphing Calculators.

ERIC Educational Resources Information Center

St. John, Dennis

1998-01-01

Explains how to code and decode messages using Hill ciphers which combine matrix multiplication and modular arithmetic. Discusses how a graphing calculator can facilitate the matrix and modular arithmetic used in the coding and decoding procedures. (ASK)

48 CFR 1503.500-71 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... for: (1) A written code of business ethics and conduct and an ethics training program for all employees; (2) Periodic reviews of company business practices, procedures, policies and internal controls...

Results from the Veterans Health Administration ICD-10-CM/PCS Coding Pilot Study.

PubMed

Weems, Shelley; Heller, Pamela; Fenton, Susan H

2015-01-01

The Veterans Health Administration (VHA) of the US Department of Veterans Affairs has been preparing for the October 1, 2015, conversion to the International Classification of Diseases, Tenth Revision, Clinical Modification and Procedural Coding System (ICD-10-CM/PCS) for more than four years. The VHA's Office of Informatics and Analytics ICD-10 Program Management Office established an ICD-10 Learning Lab to explore expected operational challenges. This study was conducted to determine the effects of the classification system conversion on coding productivity. ICD codes are integral to VHA business processes and are used for purposes such as clinical studies, performance measurement, workload capture, cost determination, Veterans Equitable Resource Allocation (VERA) determination, morbidity and mortality classification, indexing of hospital records by disease and operations, data storage and retrieval, research purposes, and reimbursement. The data collection for this study occurred in multiple VHA sites across several months using standardized methods. It is commonly accepted that coding productivity will decrease with the implementation of ICD-10-CM/PCS. The findings of this study suggest that the decrease will be more significant for inpatient coding productivity (64.5 percent productivity decrease) than for ambulatory care coding productivity (6.7 percent productivity decrease). This study reveals the following important points regarding ICD-10-CM/PCS coding productivity: 1. Ambulatory care ICD-10-CM coding productivity is not expected to decrease as significantly as inpatient ICD-10-CM/PCS coding productivity. 2. Coder training and type of record (inpatient versus outpatient) affect coding productivity. 3. Inpatient coding productivity is decreased when a procedure requiring ICD-10-PCS coding is present. It is highly recommended that organizations perform their own analyses to determine the effects of ICD-10-CM/PCS implementation on coding productivity.

Results from the Veterans Health Administration ICD-10-CM/PCS Coding Pilot Study

PubMed Central

Weems, Shelley; Heller, Pamela; Fenton, Susan H.

2015-01-01

The Veterans Health Administration (VHA) of the US Department of Veterans Affairs has been preparing for the October 1, 2015, conversion to the International Classification of Diseases, Tenth Revision, Clinical Modification and Procedural Coding System (ICD-10-CM/PCS) for more than four years. The VHA's Office of Informatics and Analytics ICD-10 Program Management Office established an ICD-10 Learning Lab to explore expected operational challenges. This study was conducted to determine the effects of the classification system conversion on coding productivity. ICD codes are integral to VHA business processes and are used for purposes such as clinical studies, performance measurement, workload capture, cost determination, Veterans Equitable Resource Allocation (VERA) determination, morbidity and mortality classification, indexing of hospital records by disease and operations, data storage and retrieval, research purposes, and reimbursement. The data collection for this study occurred in multiple VHA sites across several months using standardized methods. It is commonly accepted that coding productivity will decrease with the implementation of ICD-10-CM/PCS. The findings of this study suggest that the decrease will be more significant for inpatient coding productivity (64.5 percent productivity decrease) than for ambulatory care coding productivity (6.7 percent productivity decrease). This study reveals the following important points regarding ICD-10-CM/PCS coding productivity: Ambulatory care ICD-10-CM coding productivity is not expected to decrease as significantly as inpatient ICD-10-CM/PCS coding productivity.Coder training and type of record (inpatient versus outpatient) affect coding productivity.Inpatient coding productivity is decreased when a procedure requiring ICD-10-PCS coding is present. It is highly recommended that organizations perform their own analyses to determine the effects of ICD-10-CM/PCS implementation on coding productivity. PMID:26396553

Practice patterns of academic general thoracic and adult cardiac surgeons.

PubMed

Ingram, Michael T; Wisner, David H; Cooke, David T

2014-10-01

We hypothesized that academic adult cardiac surgeons (CSs) and general thoracic surgeons (GTSs) would have distinct practice patterns of, not just case-mix, but also time devoted to outpatient care, involvement in critical care, and work relative value unit (wRVU) generation for the procedures they perform. We queried the University Health System Consortium-Association of American Medical Colleges Faculty Practice Solution Center database for fiscal years 2007-2008, 2008-2009, and 2009-2010 for the frequency of inpatient and outpatient current procedural terminology coding and wRVU data of academic GTSs and CSs. The Faculty Practice Solution Center database is a compilation of productivity and payer data from 86 academic institutions. The greatest wRVU generating current procedural terminology codes for CSs were, in order, coronary artery bypass grafting, aortic valve replacement, and mitral valve replacement. In contrast, open lobectomy, video-assisted thoracic surgery wedge, and video-assisted thoracic surgery lobectomy were greatest for GTSs. The 10 greatest wRVU-generating procedures for CSs generated more wRVUs than those for GTSs (P<.001). Although CSs generated significantly more hospital inpatient evaluation and management (E & M) wRVUs than did GTSs (P<.001), only 2.5% of the total wRVUs generated by CSs were from E & M codes versus 18.8% for GTSs. Critical care codes were 1.5% of total evaluation and management billing for both CSs and GTSs. Academic CSs and GTSs have distinct practice patterns. CSs receive greater reimbursement for services because of the greater wRVUs of the procedures performed compared with GTSs, and evaluation and management coding is a more important wRVU generator for GTSs. The results of our study could guide academic CS and GTS practice structure and time prioritization. Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

75 FR 33992 - Interest and Penalty Suspension Provisions Under Section 6404(g) of the Internal Revenue Code

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-16

... Interest and Penalty Suspension Provisions Under Section 6404(g) of the Internal Revenue Code AGENCY.... SUMMARY: This document contains final regulations under section 6404(g)(2)(E) of the Internal Revenue Code... Procedure and Administration Regulations (26 CFR part 301) by adding rules under section 6404(g) relating to...

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR CODING: TECHNICIAN WALK-THROUGH QUESTIONNAIRE (UA-D-35.0)

EPA Science Inventory

The purpose of this SOP is to define the coding strategy for the Technician Walk-Through Questionnaire. This questionnaire was developed for use during the Arizona NHEXAS project and the Border study. Keywords: data; coding; technician walk-through questionnaire.

The U.S.-Mexi...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CODING: FOOD DIARY FOLLOW UP (UA-D-10.0)

EPA Science Inventory

The purpose of this SOP is to define the coding strategy for the Food Diary Follow Up Questionnaire. This questionnaire was developed for use in the Arizona NHEXAS project and the "Border" study. Keywords: data; coding; food diary follow up questionnaire.

The National Human Ex...

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR CODING: DIET DIARY QUESTIONNAIRE (UA-D-43.0)

EPA Science Inventory

The purpose of this SOP is to define the coding strategy for the Diet Diary Questionnaire. This questionnaire was developed for use during the Arizona NHEXAS project and the Border study. Keywords: data; coding; diet diary questionnaire.

The U.S.-Mexico Border Program is spon...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CODING: TIME DIARY AND ACTIVITY QUESTIONNAIRE (UA-D-9.0)

EPA Science Inventory

The purpose of this SOP is to define the coding strategy for the Time Diary and Activity Questionnaire. This questionnaire was developed for use in the Arizona NHEXAS project and the "Border" study. Keywords: Data; Coding; Time Diary and Activity Questionnaire.

The National Hu...

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR CODING: QUESTIONNAIRE FEEDBACK FORM (UA-D-46.0)

EPA Science Inventory

The purpose of this SOP is to describe the coding strategy for the Questionnaire Feedback form. This Questionnaire Feedback form was developed for use during the Arizona NHEXAS project and the Border study. Keywords: data; coding; questionnaire feedback form.

The U.S.-Mexico B...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CODING: ARIZONA LAB DATA (UA-D-13.0)

EPA Science Inventory

The purpose of this SOP is to define the coding strategy for Arizona Lab Data. This strategy was developed for use in the Arizona NHEXAS project and the "Border" study. Keywords: data; coding; lab data forms.

The National Human Exposure Assessment Survey (NHEXAS) is a federal ...

Coding Manual for Continuous Observation of Interactions by Single Subjects in an Academic Setting.

ERIC Educational Resources Information Center

Cobb, Joseph A.; Hops, Hyman

The manual, designed particularly for work with acting-out or behavior problem students, describes coding procedures used in the observation of continuous classroom interactions between the student and his peers and teacher. Peer and/or teacher behaviors antecedent and consequent to the subject's behavior are identified in the coding process,…

CFD analysis of turbopump volutes

NASA Technical Reports Server (NTRS)

Ascoli, Edward P.; Chan, Daniel C.; Darian, Armen; Hsu, Wayne W.; Tran, Ken

1993-01-01

An effort is underway to develop a procedure for the regular use of CFD analysis in the design of turbopump volutes. Airflow data to be taken at NASA Marshall will be used to validate the CFD code and overall procedure. Initial focus has been on preprocessing (geometry creation, translation, and grid generation). Volute geometries have been acquired electronically and imported into the CATIA CAD system and RAGGS (Rockwell Automated Grid Generation System) via the IGES standard. An initial grid topology has been identified and grids have been constructed for turbine inlet and discharge volutes. For CFD analysis of volutes to be used regularly, a procedure must be defined to meet engineering design needs in a timely manner. Thus, a compromise must be established between making geometric approximations, the selection of grid topologies, and possible CFD code enhancements. While the initial grid developed approximated the volute tongue with a zero thickness, final computations should more accurately account for the geometry in this region. Additionally, grid topologies will be explored to minimize skewness and high aspect ratio cells that can affect solution accuracy and slow code convergence. Finally, as appropriate, code modifications will be made to allow for new grid topologies in an effort to expedite the overall CFD analysis process.

Agile deployment and code coverage testing metrics of the boot software on-board Solar Orbiter's Energetic Particle Detector

NASA Astrophysics Data System (ADS)

Parra, Pablo; da Silva, Antonio; Polo, Óscar R.; Sánchez, Sebastián

2018-02-01

In this day and age, successful embedded critical software needs agile and continuous development and testing procedures. This paper presents the overall testing and code coverage metrics obtained during the unit testing procedure carried out to verify the correctness of the boot software that will run in the Instrument Control Unit (ICU) of the Energetic Particle Detector (EPD) on-board Solar Orbiter. The ICU boot software is a critical part of the project so its verification should be addressed at an early development stage, so any test case missed in this process may affect the quality of the overall on-board software. According to the European Cooperation for Space Standardization ESA standards, testing this kind of critical software must cover 100% of the source code statement and decision paths. This leads to the complete testing of fault tolerance and recovery mechanisms that have to resolve every possible memory corruption or communication error brought about by the space environment. The introduced procedure enables fault injection from the beginning of the development process and enables to fulfill the exigent code coverage demands on the boot software.

Find a Gastroenterologist

MedlinePlus

... Province Select Country Zip/Postal Code Sort By GI Health Centers Colorectal Cancer Hepatitis C Inflammatory Bowel ... GI Symptoms Gastroparesis See All Topics (A-Z) GI Procedures Colonoscopy Colorectal Cancer Screening See All Procedures ( ...

XSECT: A computer code for generating fuselage cross sections - user's manual

NASA Technical Reports Server (NTRS)

Ames, K. R.

1982-01-01

A computer code, XSECT, has been developed to generate fuselage cross sections from a given area distribution and wing definition. The cross sections are generated to match the wing definition while conforming to the area requirement. An iterative procedure is used to generate each cross section. Fuselage area balancing may be included in this procedure if desired. The code is intended as an aid for engineers who must first design a wing under certain aerodynamic constraints and then design a fuselage for the wing such that the contraints remain satisfied. This report contains the information necessary for accessing and executing the code, which is written in FORTRAN to execute on the Cyber 170 series computers (NOS operating system) and produces graphical output for a Tektronix 4014 CRT. The LRC graphics software is used in combination with the interface between this software and the PLOT 10 software.

Qualitative assessment of cause-of-injury coding in U.S. military hospitals: NATO standardization agreement (STANAG) 2050.

PubMed

Amoroso, P J; Smith, G S; Bell, N S

2000-04-01

Accurate injury cause data are essential for injury prevention research. U.S. military hospitals, unlike civilian hospitals, use the NATO STANAG system for cause-of-injury coding. Reported deficiencies in civilian injury cause data suggested a need to specifically evaluate the STANAG. The Total Army Injury and Health Outcomes Database (TAIHOD) was used to evaluate worldwide Army injury hospitalizations, especially STANAG Trauma, Injury, and Place of Occurrence coding. We conducted a review of hospital procedures at Tripler Army Medical Center (TAMC) including injury cause and intent coding, potential crossover between acute injuries and musculoskeletal conditions, and data for certain hospital patients who are not true admissions. We also evaluated the use of free-text injury comment fields in three hospitals. Army-wide review of injury records coding revealed full compliance with cause coding, although nonspecific codes appeared to be overused. A small but intensive single hospital records review revealed relatively poor intent coding but good activity and cause coding. Data on specific injury history were present on most acute injury records and 75% of musculoskeletal conditions. Place of Occurrence coding, although inherently nonspecific, was over 80% accurate. Review of text fields produced additional details of the injuries in over 80% of cases. STANAG intent coding specificity was poor, while coding of cause of injury was at least comparable to civilian systems. The strengths of military hospital data systems are an exceptionally high compliance with injury cause coding, the availability of free text, and capture of all population hospital records without regard to work-relatedness. Simple changes in procedures could greatly improve data quality.

50 CFR 600.511 - Fishery closure procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 10 2011-10-01 2011-10-01 false Fishery closure procedures. 600.511 Section 600.511 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND... Fishery closure procedures. (a) Activity Codes 1 and 2 for a fishery are automatically canceled in the...

Accessing NASA Technology with the World Wide Web

NASA Technical Reports Server (NTRS)

Nelson, Michael L.; Bianco, David J.

1995-01-01

NASA Langley Research Center (LaRC) began using the World Wide Web (WWW) in the summer of 1993, becoming the first NASA installation to provide a Center-wide home page. This coincided with a reorganization of LaRC to provide a more concentrated focus on technology transfer to both aerospace and non-aerospace industry. Use of WWW and NCSA Mosaic not only provides automated information dissemination, but also allows for the implementation, evolution and integration of many technology transfer and technology awareness applications. This paper describes several of these innovative applications, including the on-line presentation of the entire Technology OPportunities Showcase (TOPS), an industrial partnering showcase that exists on the Web long after the actual 3-day event ended. The NASA Technical Report Server (NTRS) provides uniform access to many logically similar, yet physically distributed NASA report servers. WWW is also the foundation of the Langley Software Server (LSS), an experimental software distribution system which will distribute LaRC-developed software. In addition to the more formal technology distribution projects, WWW has been successful in connecting people with technologies and people with other people.

KSC-2012-5018

NASA Image and Video Library

2012-09-06

CAPE CANAVERAL, Fla. – An eight-member Kick-Start selection panel listens during a presentation by a Kennedy Space Center employee. Seated in the front row, left to right, are Bob Cabana, center director, Joyce Riquelme, director of Center Planning and Development, Susan Kroskey, center chief financial officer, and Josephine Burnett, director of International Space Station Ground Processing and Research. Back row, left to right are Tracy Anania Wetrich, director of Human Resources, Russell Romanella, director of Safety and Mission Assurance, Nancy Bray, deputy director of Center Operations, and Kelvin Manning, center associate director. As Kennedy continues developing programs and infrastructure to become a 21st century spaceport, many employees are devising ways to do their jobs better and more efficiently. On Sept. 6, 2012, 16 Kennedy employees pitched their innovative ideas for improving the center at the Kennedy Kick-Start event. The competition was part of a center-wide effort designed to increase exposure for innovative ideas and encourage their implementation. For more information, visit http://www.nasa.gov/centers/kennedy/news/kick-start_competition.html Photo credit: NASA/Gianni Woods

User's guide for ALEX: uncertainty propagation from raw data to final results for ORELA transmission measurements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Larson, N.M.

1984-02-01

This report describes a computer code (ALEX) developed to assist in AnaLysis of EXperimental data at the Oak Ridge Electron Linear Accelerator (ORELA). Reduction of data from raw numbers (counts per channel) to physically meaningful quantities (such as cross sections) is in itself a complicated procedure; propagation of experimental uncertainties through that reduction procedure has in the past been viewed as even more difficult - if not impossible. The purpose of the code ALEX is to correctly propagate all experimental uncertainties through the entire reduction procedure, yielding the complete covariance matrix for the reduced data, while requiring little additional inputmore » from the eperimentalist beyond that which is required for the data reduction itself. This report describes ALEX in detail, with special attention given to the case of transmission measurements (the code itself is applicable, with few changes, to any type of data). Application to the natural iron measurements of D.C. Larson et al. is described in some detail.« less

Ink-constrained halftoning with application to QR codes

NASA Astrophysics Data System (ADS)

Bayeh, Marzieh; Compaan, Erin; Lindsey, Theodore; Orlow, Nathan; Melczer, Stephen; Voller, Zachary

2014-01-01

This paper examines adding visually significant, human recognizable data into QR codes without affecting their machine readability by utilizing known methods in image processing. Each module of a given QR code is broken down into pixels, which are halftoned in such a way as to keep the QR code structure while revealing aspects of the secondary image to the human eye. The loss of information associated to this procedure is discussed, and entropy values are calculated for examples given in the paper. Numerous examples of QR codes with embedded images are included.

A high temperature fatigue life prediction computer code based on the total strain version of StrainRange Partitioning (SRP)

NASA Technical Reports Server (NTRS)

Mcgaw, Michael A.; Saltsman, James F.

1993-01-01

A recently developed high-temperature fatigue life prediction computer code is presented and an example of its usage given. The code discussed is based on the Total Strain version of Strainrange Partitioning (TS-SRP). Included in this code are procedures for characterizing the creep-fatigue durability behavior of an alloy according to TS-SRP guidelines and predicting cyclic life for complex cycle types for both isothermal and thermomechanical conditions. A reasonably extensive materials properties database is included with the code.

42 CFR 447.520 - FFP: Conditions relating to physician-administered drugs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... using Healthcare Common Procedure Coding System codes or NDC numbers in order to secure rebates. (2) As... Medicaid Program using NDC numbers in order to secure rebates. (b) As of January 1, 2007, a State must...

42 CFR 447.520 - FFP: Conditions relating to physician-administered drugs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... using Healthcare Common Procedure Coding System codes or NDC numbers in order to secure rebates. (2) As... Medicaid Program using NDC numbers in order to secure rebates. (b) As of January 1, 2007, a State must...

42 CFR 447.520 - FFP: Conditions relating to physician-administered drugs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... using Healthcare Common Procedure Coding System codes or NDC numbers in order to secure rebates. (2) As... Medicaid Program using NDC numbers in order to secure rebates. (b) As of January 1, 2007, a State must...

42 CFR 447.520 - FFP: Conditions relating to physician-administered drugs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... using Healthcare Common Procedure Coding System codes or NDC numbers in order to secure rebates. (2) As... Medicaid Program using NDC numbers in order to secure rebates. (b) As of January 1, 2007, a State must...

42 CFR 447.520 - FFP: Conditions relating to physician-administered drugs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... using Healthcare Common Procedure Coding System codes or NDC numbers in order to secure rebates. (2) As... Medicaid Program using NDC numbers in order to secure rebates. (b) As of January 1, 2007, a State must...

Finite-difference solution of the compressible stability eigenvalue problem

NASA Technical Reports Server (NTRS)

Malik, M. R.

1982-01-01

A compressible stability analysis computer code is developed. The code uses a matrix finite difference method for local eigenvalue solution when a good guess for the eigenvalue is available and is significantly more computationally efficient than the commonly used initial value approach. The local eigenvalue search procedure also results in eigenfunctions and, at little extra work, group velocities. A globally convergent eigenvalue procedure is also developed which may be used when no guess for the eigenvalue is available. The global problem is formulated in such a way that no unstable spurious modes appear so that the method is suitable for use in a black box stability code. Sample stability calculations are presented for the boundary layer profiles of a Laminar Flow Control (LFC) swept wing.

Joint Source-Channel Coding by Means of an Oversampled Filter Bank Code

NASA Astrophysics Data System (ADS)

Marinkovic, Slavica; Guillemot, Christine

2006-12-01

Quantized frame expansions based on block transforms and oversampled filter banks (OFBs) have been considered recently as joint source-channel codes (JSCCs) for erasure and error-resilient signal transmission over noisy channels. In this paper, we consider a coding chain involving an OFB-based signal decomposition followed by scalar quantization and a variable-length code (VLC) or a fixed-length code (FLC). This paper first examines the problem of channel error localization and correction in quantized OFB signal expansions. The error localization problem is treated as an[InlineEquation not available: see fulltext.]-ary hypothesis testing problem. The likelihood values are derived from the joint pdf of the syndrome vectors under various hypotheses of impulse noise positions, and in a number of consecutive windows of the received samples. The error amplitudes are then estimated by solving the syndrome equations in the least-square sense. The message signal is reconstructed from the corrected received signal by a pseudoinverse receiver. We then improve the error localization procedure by introducing a per-symbol reliability information in the hypothesis testing procedure of the OFB syndrome decoder. The per-symbol reliability information is produced by the soft-input soft-output (SISO) VLC/FLC decoders. This leads to the design of an iterative algorithm for joint decoding of an FLC and an OFB code. The performance of the algorithms developed is evaluated in a wavelet-based image coding system.

Encoded physics knowledge in checking codes for nuclear cross section libraries at Los Alamos

NASA Astrophysics Data System (ADS)

Parsons, D. Kent

2017-09-01

Checking procedures for processed nuclear data at Los Alamos are described. Both continuous energy and multi-group nuclear data are verified by locally developed checking codes which use basic physics knowledge and common-sense rules. A list of nuclear data problems which have been identified with help of these checking codes is also given.

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CODING: 24-HOUR FOOD DIARY (HAND ENTRY) (UA-D-39.0)

EPA Science Inventory

The purpose of this SOP is to define the coding strategy for the 24-Hour Food Diary. This diary was developed for use during the Arizona NHEXAS project and the "Border" study. Keywords: data; coding; 24-hour food diary.

The National Human Exposure Assessment Survey (NHEXAS) i...

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR CODING: ARIZONA LAB DATA (UA-D-13.0)

EPA Science Inventory

The purpose of this SOP is to define the coding strategy for Arizona Lab Data. This strategy was developed for use in the Arizona NHEXAS project and the Border study. Keywords: data; coding; lab data forms.

The U.S.-Mexico Border Program is sponsored by the Environmental Healt...

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR CODING: FOOD DIARY FOLLOW UP (UA-D-10.0)

EPA Science Inventory

The purpose of this SOP is to define the coding strategy for the Food Diary Follow Up Questionnaire. This questionnaire was developed for use in the Arizona NHEXAS project and the Border study. Keywords: data; coding; food diary follow up questionnaire.

The U.S.-Mexico Border ...

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR CODING: TIME DIARY AND ACTIVITY QUESTIONNAIRE (UA-D-9.0)

EPA Science Inventory

The purpose of this SOP is to define the coding strategy for the Time Diary and Activity Questionnaire. This questionnaire was developed for use in the Arizona NHEXAS project and the Border study. Keywords: Data; Coding; Time Diary and Activity Questionnaire.

The U.S.-Mexico B...

26 CFR 301.7701-17T - Collective-bargaining plans and agreements (temporary).

Code of Federal Regulations, 2010 CFR

2010-04-01

... TREASURY (CONTINUED) PROCEDURE AND ADMINISTRATION PROCEDURE AND ADMINISTRATION Definitions § 301.7701-17T... of 1984, the Internal Revenue Code provided no clear definition of an employee representative or...

47 CFR 25.403 - Bidding application and certification procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CARRIER SERVICES SATELLITE COMMUNICATIONS Competitive Bidding Procedures for DARS § 25.403 Bidding...'s name; (b) Mailing Address (no Post Office boxes); (c) City; (d) State; (e) ZIP Code; (f) Auction...

47 CFR 25.403 - Bidding application and certification procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CARRIER SERVICES SATELLITE COMMUNICATIONS Competitive Bidding Procedures for DARS § 25.403 Bidding...'s name; (b) Mailing Address (no Post Office boxes); (c) City; (d) State; (e) ZIP Code; (f) Auction...

Usefulness of Canadian Public Health Insurance Administrative Databases to Assess Breast and Ovarian Cancer Screening Imaging Technologies for BRCA1/2 Mutation Carriers.

PubMed

Larouche, Geneviève; Chiquette, Jocelyne; Plante, Marie; Pelletier, Sylvie; Simard, Jacques; Dorval, Michel

2016-11-01

In Canada, recommendations for clinical management of hereditary breast and ovarian cancer among individuals carrying a deleterious BRCA1 or BRCA2 mutation have been available since 2007. Eight years later, very little is known about the uptake of screening and risk-reduction measures in this population. Because Canada's public health care system falls under provincial jurisdictions, using provincial health care administrative databases appears a valuable option to assess management of BRCA1/2 mutation carriers. The objective was to explore the usefulness of public health insurance administrative databases in British Columbia, Ontario, and Quebec to assess management after BRCA1/2 genetic testing. Official public health insurance documents were considered potentially useful if they had specific procedure codes, and pertained to procedures performed in the public and private health care systems. All 3 administrative databases have specific procedures codes for mammography and breast ultrasounds. Only Quebec and Ontario have a specific procedure code for breast magnetic resonance imaging. It is impossible to assess, on an individual basis, the frequency of others screening exams, with the exception of CA-125 testing in British Columbia. Screenings done in private practice are excluded from the administrative databases unless covered by special agreements for reimbursement, such as all breast imaging exams in Ontario and mammograms in British Columbia and Quebec. There are no specific procedure codes for risk-reduction surgeries for breast and ovarian cancer. Population-based assessment of breast and ovarian cancer risk management strategies other than mammographic screening, using only administrative data, is currently challenging in the 3 Canadian provinces studied. Copyright © 2016 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

Certification Examination Cases of Candidates for Certification by the American Board of Plastic Surgery: Trends in Practice Profiles Spanning a Decade (2000–2009)

PubMed Central

Chung, Kevin C.; Song, Jae W.; Shauver, Melissa J.; Cullison, Terry M.; Noone, R. Barrett

2011-01-01

Background To evaluate the case mix of plastic surgeons in their early years of practice by examining candidate case-logs submitted for the Oral Examination. Methods De-identified data from 2000–2009 consisting of case-logs submitted by young plastic surgery candidates for the Oral Examination were analyzed. Data consisted of exam year, CPT (Current Procedural Terminology) Codes and the designation of each CPT code as cosmetic or reconstructive by the candidate, and patient age and gender. Subgroup analyses for comprehensive, cosmetic, craniomaxillofacial, and hand surgery modules were performed by using the CPT code list designated by the American Board of Plastic Surgery Maintenance of Certification in Plastic Surgery ( ) module framework. Results We examined case-logs from a yearly average of 261 candidates over 10 years. Wider variations in yearly percent change in median cosmetic surgery case volumes (−62.5% to 30%) were observed when compared to the reconstructive surgery case volumes (−18.0% to 25.7%). Compared to cosmetic surgery cases per candidate, which varied significantly from year-to-year (p<0.0001), reconstructive surgery cases per candidate did not vary significantly (p=0.954). Subgroup analyses of proportions of types of surgical procedures based on CPT code categories, revealed hand surgery to be the least performed procedure relative to comprehensive, craniomaxillofacial, and cosmetic surgery procedures. Conclusions Graduates of plastic surgery training programs are committed to performing a broad spectrum of reconstructive and cosmetic surgical procedures in their first year of practice. However, hand surgery continues to have a small presence in the practice profiles of young plastic surgeons. PMID:21788850

Implementation and impact of ICD-10 (Part II).

PubMed

Rahmathulla, Gazanfar; Deen, H Gordon; Dokken, Judith A; Pirris, Stephen M; Pichelmann, Mark A; Nottmeier, Eric W; Reimer, Ronald; Wharen, Robert E

2014-01-01

The transition from the International Classification of Disease-9(th) clinical modification to the new ICD-10 was all set to occur on 1 October 2015. The American Medical Association has previously been successful in delaying the transition by over 10 years and has been able to further postpone its introduction to 2015. The new system will overcome many of the limitations present in the older version, thus paving the way to more accurate capture of clinical information. The benefits of the new ICD-10 system include improved quality of care, potential cost savings, reduction of unpaid claims, and improved tracking of healthcare data. The areas where challenges will be evident include planning and implementation, the cost to transition, a shortage of qualified coders, training and education of the healthcare workforce, and a loss of productivity when this occurs. The impacts include substantial costs to the healthcare system, but the projected long-term savings and benefits will be significant. Improved fraud detection, accurate data entry, ability to analyze cost benefits with procedures, and enhanced quality outcome measures are the most significant beneficial factors with this change. The present Current Procedural Terminology and Healthcare Common Procedure Coding System code sets will be used for reporting ambulatory procedures in the same manner as they have been. ICD-10-PCS will replace ICD-9 procedure codes for inpatient hospital services. The ICD-10-CM will replace the clinical code sets. Our article will focus on the challenges to execution of an ICD change and strategies to minimize risk while transitioning to the new system. With the implementation deadline gradually approaching, spine surgery practices that include multidisciplinary health specialists have to anticipate and prepare for the ICD change in order to mitigate risk. Education and communication is the key to this process in spine practices.

The diagnosis related groups enhanced electronic medical record.

PubMed

Müller, Marcel Lucas; Bürkle, Thomas; Irps, Sebastian; Roeder, Norbert; Prokosch, Hans-Ulrich

2003-07-01

The introduction of Diagnosis Related Groups as a basis for hospital payment in Germany announced essential changes in the hospital reimbursement practice. A hospital's economical survival will depend vitally on the accuracy and completeness of the documentation of DRG relevant data like diagnosis and procedure codes. In order to enhance physicians' coding compliance, an easy-to-use interface integrating coding tasks seamlessly into clinical routine had to be developed. A generic approach should access coding and clinical guidelines from different information sources. Within the Electronic Medical Record (EMR) a user interface ('DRG Control Center') for all DRG relevant clinical and administrative data has been built. A comprehensive DRG-related web site gives online access to DRG grouping software and an electronic coding expert. Both components are linked together using an application supporting bi-directional communication. Other web based services like a guideline search engine can be integrated as well. With the proposed method, the clinician gains quick access to context sensitive clinical guidelines for appropriate treatment of his/her patient and administrative guidelines for the adequate coding of the diagnoses and procedures. This paper describes the design and current implementation and discusses our experiences.

DOSE COEFFICIENTS FOR LIVER CHEMOEMBOLISATION PROCEDURES USING MONTE CARLO CODE.

PubMed

Karavasilis, E; Dimitriadis, A; Gonis, H; Pappas, P; Georgiou, E; Yakoumakis, E

2016-12-01

The aim of the present study is the estimation of radiation burden during liver chemoembolisation procedures. Organ dose and effective dose conversion factors, normalised to dose-area product (DAP), were estimated for chemoembolisation procedures using a Monte Carlo transport code in conjunction with an adult mathematical phantom. Exposure data from 32 patients were used to determine the exposure projections for the simulations. Equivalent organ (H T ) and effective (E) doses were estimated using individual DAP values. The organs receiving the highest amount of doses during these exams were lumbar spine, liver and kidneys. The mean effective dose conversion factor was 1.4 Sv Gy -1 m -2 Dose conversion factors can be useful for patient-specific radiation burden during chemoembolisation procedures. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

77 FR 12078 - Meeting of the Judicial Conference Advisory Committee on Rules of Appellate Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-28

... Rules of Appellate Procedure. ACTION: Notice of open meeting. SUMMARY: The Advisory Committee on Rules of Appellate Procedure will hold a two-day meeting. The meeting will be open to public observation...-12; 8:45 am] BILLING CODE 2210-55-P ...

Review of knee arthroscopic practice and coding at a major metropolitan centre.

PubMed

Lisik, James P; Dowsey, Michelle M; Petterwood, Joshua; Choong, Peter F M

2017-05-01

Arthroscopic knee surgery has been a topic of significant controversy in recent orthopaedic literature. Multiple studies have used administrative (Victorian Admitted Episodes Dataset and Centre for Health Record Linkage) data to identify trends in practice. This study explored the usage and reporting of arthroscopic knee surgery by conducting a detailed audit at a major Victorian public hospital. A database of orthopaedic procedures at St Vincent's Hospital Melbourne was used to retrospectively identify cases of knee arthroscopy from 1 December 2011 to 1 April 2014. Procedures were categorized as diagnostic or interventional, and native and prosthetic joints were analysed separately. Procedure codes were reviewed by comparing a registrar, auditor and hospital coders for agreement. Of the 401 cases for analysis, 375 were conducted in native knees and 26 in prosthetic joints. Of native knees, 369 (98.4%) were considered interventional. The majority of these were conducted for meniscal pathology (n = 263, 70.1%), osteoarthritis (OA) (n = 25, 6.7%) and infection (n = 28, 7.6%). Comparison of codes assigned by different parties were found to be between 57% (k = 0.324) and 70% (k = 0.572) agreement, but not statistically significant. In this study, the most common indication for arthroscopy was meniscal pathology. Arthroscopy was rarely performed for OA in the absence of meniscal pathology. Diagnostic arthroscopy was rarely performed in the native knee, and fair to moderate agreement existed between parties in assigning Medicare Benefits Schedule procedure codes. © 2016 Royal Australasian College of Surgeons.

Validating abortion procedure coding in Canadian administrative databases.

PubMed

Samiedaluie, Saied; Peterson, Sandra; Brant, Rollin; Kaczorowski, Janusz; Norman, Wendy V

2016-07-12

The British Columbia (BC) Ministry of Health collects abortion procedure data in the Medical Services Plan (MSP) physician billings database and in the hospital information Discharge Abstracts Database (DAD). Our study seeks to validate abortion procedure coding in these databases. Two randomized controlled trials enrolled a cohort of 1031 women undergoing abortion. The researcher collected database includes both enrollment and follow up chart review data. The study cohort was linked to MSP and DAD data to identify all abortions events captured in the administrative databases. We compared clinical chart data on abortion procedures with health administrative data. We considered a match to occur if an abortion related code was found in administrative data within 30 days of the date of the same event documented in a clinical chart. Among 1158 abortion events performed during enrollment and follow-up period, 99.1 % were found in at least one of the administrative data sources. The sensitivities for the two databases, evaluated using a gold standard, were 97.7 % (95 % confidence interval (CI): 96.6-98.5) for the MSP database and 91.9 % (95 % CI: 90.0-93.4) for the DAD. Abortion events coded in the BC health administrative databases are highly accurate. Single-payer health administrative databases at the provincial level in Canada have the potential to offer valid data reflecting abortion events. ClinicalTrials.gov Identifier NCT01174225 , Current Controlled Trials ISRCTN19506752 .

Coding for effective denial management.

PubMed

Miller, Jackie; Lineberry, Joe

2004-01-01

Nearly everyone will agree that accurate and consistent coding of diagnoses and procedures is the cornerstone for operating a compliant practice. The CPT or HCPCS procedure code tells the payor what service was performed and also (in most cases) determines the amount of payment. The ICD-9-CM diagnosis code, on the other hand, tells the payor why the service was performed. If the diagnosis code does not meet the payor's criteria for medical necessity, all payment for the service will be denied. Implementation of an effective denial management program can help "stop the bleeding." Denial management is a comprehensive process that works in two ways. First, it evaluates the cause of denials and takes steps to prevent them. Second, denial management creates specific procedures for refiling or appealing claims that are initially denied. Accurate, consistent and compliant coding is key to both of these functions. The process of proactively managing claim denials also reveals a practice's administrative strengths and weaknesses, enabling radiology business managers to streamline processes, eliminate duplicated efforts and shift a larger proportion of the staff's focus from paperwork to servicing patients--all of which are sure to enhance operations and improve practice management and office morale. Accurate coding requires a program of ongoing training and education in both CPT and ICD-9-CM coding. Radiology business managers must make education a top priority for their coding staff. Front office staff, technologists and radiologists should also be familiar with the types of information needed for accurate coding. A good staff training program will also cover the proper use of Advance Beneficiary Notices (ABNs). Registration and coding staff should understand how to determine whether the patient's clinical history meets criteria for Medicare coverage, and how to administer an ABN if the exam is likely to be denied. Staff should also understand the restrictions on use of ABNs and the compliance risks associated with improper use. Finally, training programs should include routine audits to monitor coders for competence and precision. Constantly changing codes and guidelines mean that a coder's skills can quickly become obsolete if not reinforced by ongoing training and monitoring. Comprehensive reporting and routine analysis of claim denials is without a doubt one of the greatest assets to a practice that is suffering from excessive claim denials and should be considered an investment capable of providing both short and long term ROIs. Some radiologists may lack the funding or human resources needed to implement truly effective coding programs for their staff members. In these circumstances, radiology business managers should consider outsourcing their coding.

[Differentiation of coding quality in orthopaedics by special, illustration-oriented case group analysis in the G-DRG System 2005].

PubMed

Schütz, U; Reichel, H; Dreinhöfer, K

2007-01-01

We introduce a grouping system for clinical practice which allows the separation of DRG coding in specific orthopaedic groups based on anatomic regions, operative procedures, therapeutic interventions and morbidity equivalent diagnosis groups. With this, a differentiated aim-oriented analysis of illustrated internal DRG data becomes possible. The group-specific difference of the coding quality between the DRG groups following primary coding by the orthopaedic surgeon and final coding by the medical controlling is analysed. In a consecutive series of 1600 patients parallel documentation and group-specific comparison of the relevant DRG parameters were carried out in every case after primary and final coding. Analysing the group-specific share in the additional CaseMix coding, the group "spine surgery" dominated, closely followed by the groups "arthroplasty" and "surgery due to infection, tumours, diabetes". Altogether, additional cost-weight-relevant coding was necessary most frequently in the latter group (84%), followed by group "spine surgery" (65%). In DRGs representing conservative orthopaedic treatment documented procedures had nearly no influence on the cost weight. The introduced system of case group analysis in internal DRG documentation can lead to the detection of specific problems in primary coding and cost-weight relevant changes of the case mix. As an instrument for internal process control in the orthopaedic field, it can serve as a communicative interface between an economically oriented classification of the hospital performance and a specific problem solution of the medical staff involved in the department management.

77 FR 54663 - Administrative Simplification: Adoption of a Standard for a Unique Health Plan Identifier...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-05

...This final rule adopts the standard for a national unique health plan identifier (HPID) and establishes requirements for the implementation of the HPID. In addition, it adopts a data element that will serve as an other entity identifier (OEID), or an identifier for entities that are not health plans, health care providers, or individuals, but that need to be identified in standard transactions. This final rule also specifies the circumstances under which an organization covered health care provider must require certain noncovered individual health care providers who are prescribers to obtain and disclose a National Provider Identifier (NPI). Lastly, this final rule changes the compliance date for the International Classification of Diseases, 10th Revision, Clinical Modification (ICD- 10-CM) for diagnosis coding, including the Official ICD-10-CM Guidelines for Coding and Reporting, and the International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS) for inpatient hospital procedure coding, including the Official ICD-10-PCS Guidelines for Coding and Reporting, from October 1, 2013 to October 1, 2014.

Optimized and secure technique for multiplexing QR code images of single characters: application to noiseless messages retrieval

NASA Astrophysics Data System (ADS)

Trejos, Sorayda; Fredy Barrera, John; Torroba, Roberto

2015-08-01

We present for the first time an optical encrypting-decrypting protocol for recovering messages without speckle noise. This is a digital holographic technique using a 2f scheme to process QR codes entries. In the procedure, letters used to compose eventual messages are individually converted into a QR code, and then each QR code is divided into portions. Through a holographic technique, we store each processed portion. After filtering and repositioning, we add all processed data to create a single pack, thus simplifying the handling and recovery of multiple QR code images, representing the first multiplexing procedure applied to processed QR codes. All QR codes are recovered in a single step and in the same plane, showing neither cross-talk nor noise problems as in other methods. Experiments have been conducted using an interferometric configuration and comparisons between unprocessed and recovered QR codes have been performed, showing differences between them due to the involved processing. Recovered QR codes can be successfully scanned, thanks to their noise tolerance. Finally, the appropriate sequence in the scanning of the recovered QR codes brings a noiseless retrieved message. Additionally, to procure maximum security, the multiplexed pack could be multiplied by a digital diffuser as to encrypt it. The encrypted pack is easily decoded by multiplying the multiplexing with the complex conjugate of the diffuser. As it is a digital operation, no noise is added. Therefore, this technique is threefold robust, involving multiplexing, encryption, and the need of a sequence to retrieve the outcome.

Validation of Carotid Artery Revascularization Coding in Ontario Health Administrative Databases.

PubMed

Hussain, Mohamad A; Mamdani, Muhammad; Saposnik, Gustavo; Tu, Jack V; Turkel-Parrella, David; Spears, Julian; Al-Omran, Mohammed

2016-04-02

The positive predictive value (PPV) of carotid endarterectomy (CEA) and carotid artery stenting (CAS) procedure and post-operative complication coding were assessed in Ontario health administrative databases. Between 1 April 2002 and 31 March 2014, a random sample of 428 patients were identified using Canadian Classification of Health Intervention (CCI) procedure codes and Ontario Health Insurance Plan (OHIP) billing codes from administrative data. A blinded chart review was conducted at two high-volume vascular centers to assess the level of agreement between the administrative records and the corresponding patients' hospital charts. PPV was calculated with 95% confidence intervals (CIs) to estimate the validity of CEA and CAS coding, utilizing hospital charts as the gold standard. Sensitivity of CEA and CAS coding were also assessed by linking two independent databases of 540 CEA-treated patients (Ontario Stroke Registry) and 140 CAS-treated patients (single-center CAS database) to administrative records. PPV for CEA ranged from 99% to 100% and sensitivity ranged from 81.5% to 89.6% using CCI and OHIP codes. A CCI code with a PPV of 87% (95% CI, 78.8-92.9) and sensitivity of 92.9% (95% CI, 87.4-96.1) in identifying CAS was also identified. PPV for post-admission complication diagnosis coding was 71.4% (95% CI, 53.7-85.4) for stroke/transient ischemic attack, and 82.4% (95% CI, 56.6-96.2) for myocardial infarction. Our analysis demonstrated that the codes used in administrative databases accurately identify CEA and CAS-treated patients. Researchers can confidently use administrative data to conduct population-based studies of CEA and CAS.

Low Emissions Alternative Power (LEAP) Project Office Business Team of the Aeropropulsion Research Program Office (ARPO) Org. 0140

NASA Technical Reports Server (NTRS)

Buttler, Jennifer A.

2004-01-01

The program for which I am working at this summer is Propulsion and Power/Low Emissions Alternative Power (P&P/LEAP). It invests in a fundamental TRL 1-6 research and technology portfolio that will enable the future of: Alternative fuels and/or alternative propulsion systems, non-combustion (electric) propulsion systems. P&P/LEAP will identify and capitalize on the highest potential concepts generated both internal and external to the Agency. During my 2004 summer at NASA Glenn Research Center, I worked with my mentor Barbara Mader, in the Project Office with the Business Team completing various tasks for the project and personnel. The LEAP project is a highly matrixed organization. The Project Office is responsible for the goals advocacy and dollar (budget) of the LEAP project. The objectives of the LEAP Project are to discover new energy sources and develop unconventional engines and power systems directed towards greatly reduced emissions, enable new vehicle concepts for public mobility, new science missions and national security. The Propulsion and PowerLow Emissions Alternative Power directly supports the environmental, mobility, national security objectives of the Vehicle Systems Program and the Aeronautics Technology Theme. Technology deliverables include the demonstration through integrated ground tests, a constant volume combustor in an engine system, and UAV/small transport aircraft all electric power system. My mentor serves as a key member of the management team for the Aeropropulsion Research Program Office (ARPO). She has represented the office on numerous occasions, and is a member of a number of center-wide panels/teams, such as the Space management Committee and is chair to the Business Process Consolidation Team. She is responsible for the overall coordination of resources for the Propulsion and Power Project - from advocacy to implementation. The goal for my summer at NASA was to document processes and archive program documents from the past years. I used the computer and office machines, and also worked with personnel in setting up a Cost Estimation Plan. I gained office experience in Word, Excel, and Power Point, with the completion of a variety of tasks. I made spreadsheets that pertained to the budget plan for Journey to Tomorrow, to name a few I have supported the office by tracking resource information: including programmatic travel, project budget at the center level to budgets for individual research sub-projects and grants. I also assisted the Program Support Office in their duties including, representing the office on numerous occasions on center-wide team/panels, such as the Space management committee, IFMP Budget Formulation, Journey to Tomorrow Committee, and the Vehicle Systems Program Business Process Team.

Implementation of a Blowing Boundary Condition in the LAURA Code

NASA Technical Reports Server (NTRS)

Thompson, Richard a.; Gnoffo, Peter A.

2008-01-01

Preliminary steps toward modeling a coupled ablation problem using a finite-volume Navier-Stokes code (LAURA) are presented in this paper. Implementation of a surface boundary condition with mass transfer (blowing) is described followed by verification and validation through comparisons with analytic results and experimental data. Application of the code to a carbon-nosetip ablation problem is demonstrated and the results are compared with previously published data. It is concluded that the code and coupled procedure are suitable to support further ablation analyses and studies.

Development and application of structural dynamics analysis capabilities

NASA Technical Reports Server (NTRS)

Heinemann, Klaus W.; Hozaki, Shig

1994-01-01

Extensive research activities were performed in the area of multidisciplinary modeling and simulation of aerospace vehicles that are relevant to NASA Dryden Flight Research Facility. The efforts involved theoretical development, computer coding, and debugging of the STARS code. New solution procedures were developed in such areas as structures, CFD, and graphics, among others. Furthermore, systems-oriented codes were developed for rendering the code truly multidisciplinary and rather automated in nature. Also, work was performed in pre- and post-processing of engineering analysis data.

New test techniques and analytical procedures for understanding the behavior of advanced propellers

NASA Technical Reports Server (NTRS)

Stefko, G. L.; Bober, L. J.; Neumann, H. E.

1983-01-01

Analytical procedures and experimental techniques were developed to improve the capability to design advanced high speed propellers. Some results from the propeller lifting line and lifting surface aerodynamic analysis codes are compared with propeller force data, probe data and laser velocimeter data. In general, the code comparisons with data indicate good qualitative agreement. A rotating propeller force balance demonstrated good accuracy and reduced test time by 50 percent. Results from three propeller flow visualization techniques are shown which illustrate some of the physical phenomena occurring on these propellers.

A Comparison of the Incidence of Cricothyrotomy in the Deployed Setting to the Emergency Department at a Level 1 Military Trauma Center: A Descriptive Analysis

DTIC Science & Technology

2015-03-01

the providers in the deployed setting and include the Tactical Combat Casualty Care casualty card. Data are then coded for query and analysis. All...intubate, can’t ventilate” and disruption of head/neck anatomy. Of the four procedures performed in the ED setting, three patients survived to hospital...data from SAMMC are limited by the search methods and data extraction. We searched by Current Procedural Ter- minology code , which requires that the

Proteus two-dimensional Navier-Stokes computer code, version 2.0. Volume 1: Analysis description

NASA Technical Reports Server (NTRS)

Towne, Charles E.; Schwab, John R.; Bui, Trong T.

1993-01-01

A computer code called Proteus 2D was developed to solve the two-dimensional planar or axisymmetric, Reynolds-averaged, unsteady compressible Navier-Stokes equations in strong conservation law form. The objective in this effort was to develop a code for aerospace propulsion applications that is easy to use and easy to modify. Code readability, modularity, and documentation were emphasized. The governing equations are solved in generalized nonorthogonal body-fitted coordinates, by marching in time using a fully-coupled ADI solution procedure. The boundary conditions are treated implicitly. All terms, including the diffusion terms, are linearized using second-order Taylor series expansions. Turbulence is modeled using either an algebraic or two-equation eddy viscosity model. The thin-layer or Euler equations may also be solved. The energy equation may be eliminated by the assumption of constant total enthalpy. Explicit and implicit artificial viscosity may be used. Several time step options are available for convergence acceleration. The documentation is divided into three volumes. This is the Analysis Description, and presents the equations and solution procedure. The governing equations, the turbulence model, the linearization of the equations and boundary conditions, the time and space differencing formulas, the ADI solution procedure, and the artificial viscosity models are described in detail.

Proteus three-dimensional Navier-Stokes computer code, version 1.0. Volume 1: Analysis description

NASA Technical Reports Server (NTRS)

Towne, Charles E.; Schwab, John R.; Bui, Trong T.

1993-01-01

A computer code called Proteus 3D has been developed to solve the three dimensional, Reynolds averaged, unsteady compressible Navier-Stokes equations in strong conservation law form. The objective in this effort has been to develop a code for aerospace propulsion applications that is easy to use and easy to modify. Code readability, modularity, and documentation have been emphasized. The governing equations are solved in generalized non-orthogonal body-fitted coordinates by marching in time using a fully-coupled ADI solution procedure. The boundary conditions are treated implicitly. All terms, including the diffusion terms, are linearized using second-order Taylor series expansions. Turbulence is modeled using either an algebraic or two-equation eddy viscosity model. The thin-layer or Euler equations may also be solved. The energy equation may be eliminated by the assumption of constant total enthalpy. Explicit and implicit artificial viscosity may be used. Several time step options are available for convergence acceleration. The documentation is divided into three volumes. This is the Analysis Description, and presents the equations and solution procedure. It describes in detail the governing equations, the turbulence model, the linearization of the equations and boundary conditions, the time and space differencing formulas, the ADI solution procedure, and the artificial viscosity models.

17 CFR 17.03 - Delegation of authority to the Director of the Division of Market Oversight.

Code of Federal Regulations, 2010 CFR

2010-04-01

... information using the format, coding structure or electronic data transmission procedures otherwise required...) Pursuant to § 17.00(a), the authority to approve a format and coding structure other than that set forth in...

Rhexifolia versus Rhexiifolia: Plant Nomenclature Run Amok?

Treesearch

R. Kasten Dumroese; Mark W. Skinner

2005-01-01

The International Botanical Congress governs plant nomenclature worldwide through the International Code of Botanical Nomenclature. In the current code are very specific procedures for naming plants with novel compound epithets, and correcting compound epithets, like rhexifolia, that were incorrectly combined.We discuss why rhexiifolia...

78 FR 2694 - Meeting of the ACRS Subcommittee on Planning and Procedures; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-14

... NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Planning and Procedures; Notice of Meeting The ACRS Subcommittee on Planning and Procedures..., Advisory Committee on Reactor Safeguards. [FR Doc. 2013-00543 Filed 1-11-13; 8:45 am] BILLING CODE 7590-01...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR TREATMENT OF CENSORED DATA (IIT-A-4.0)

EPA Science Inventory

The purpose of this SOP is to describe the procedures undertaken to treat censored data which are below detection limits. This SOP uses data that have been properly coded and certified with appropriate QA/QC procedures by the University of Arizona NHEXAS and Battelle Laboratorie...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR SAMPLING WEIGHT CALCULATION (IIT-A-9.0)

EPA Science Inventory

The purpose of this SOP is to describe the procedures undertaken to calculate sampling weights. The sampling weights are needed to obtain weighted statistics of the NHEXAS data. This SOP uses data that have been properly coded and certified with appropriate QA/QC procedures by t...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR DERMAL EXPOSURE CALCULATION (IIT-A-11.0)

EPA Science Inventory

The purpose of this SOP is to describe the procedures undertaken to calculate the dermal exposure to chlorpyrifos and diazinon. This SOP uses data that have been properly coded and certified with appropriate QA/QC procedures by the University of Arizona NHEXAS and Battelle Labora...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR TIME ACTIVITY CALCULATION (IIT-A-12.0)

EPA Science Inventory

The purpose of this SOP is to describe the procedures undertaken to calculate the time activity pattern of the NHEXAS samples. This SOP uses data that have been properly coded and certified with appropriate QA/QC procedures by the University of Arizona NHEXAS and Battelle Laborat...

Contingency interaction analysis in psychotherapy.

PubMed

Canfield, M L; Walker, W R; Brown, L G

1991-02-01

This article introduces (a) a computerized coding procedure that rates words and utterances in terms of emotion, cognition, and contract and (b) a contingency method of analyzing verbal interactions. Using transcripts of sessions conducted by 3 master therapists with 1 client, the rating procedure and contingency correlation analyses supported the study's hypotheses. Therapists' utterances were characterized by significantly different amounts of emotion, cognition, and contracts, indicating that communication styles varied in the relative emphasis placed on these attributes. Differences suggest that the therapists responded differently to emotional, cognitive, and contract utterances and that the client's responses were different across the 3 therapist interviews. Split halves of the interviews within therapists and within client sessions were not different, providing further evidence of reliability of the coding and contingency procedures.

A Deterministic Transport Code for Space Environment Electrons

NASA Technical Reports Server (NTRS)

Nealy, John E.; Chang, C. K.; Norman, Ryan B.; Blattnig, Steve R.; Badavi, Francis F.; Adamczyk, Anne M.

2010-01-01

A deterministic computational procedure has been developed to describe transport of space environment electrons in various shield media. This code is an upgrade and extension of an earlier electron code. Whereas the former code was formulated on the basis of parametric functions derived from limited laboratory data, the present code utilizes well established theoretical representations to describe the relevant interactions and transport processes. The shield material specification has been made more general, as have the pertinent cross sections. A combined mean free path and average trajectory approach has been used in the transport formalism. Comparisons with Monte Carlo calculations are presented.

Content Analysis of Vomit and Diarrhea Cleanup Procedures To Prevent Norovirus Infections in Retail and Food Service Operations.

PubMed

Chao, Morgan G; Dubé, Anne-Julie; Leone, Cortney M; Moore, Christina M; Fraser, Angela M

2016-11-01

Human noroviruses are the leading cause of foodborne disease in the United States, sickening 19 to 21 million Americans each year. Vomit and diarrhea are both highly concentrated sources of norovirus particles. For this reason, establishing appropriate cleanup procedures for these two substances is critical. Food service establishments in states that have adopted the 2009 or 2013 U.S. Food and Drug Administration Food Code are required to have a program detailing specific cleanup procedures. The aim of our study was to determine the alignment of existing vomit and diarrhea cleanup procedures with the 11 elements recommended in Annex 3 of the 2011 Supplement to the 2009 Food Code and to determine their readability and clarity of presentation. In July 2015, we located vomit and diarrhea cleanup procedures by asking Norovirus Collaborative for Outreach, Research, and Education stakeholders for procedures used by their constituency groups and by conducting a Google Advanced Search of the World Wide Web. We performed content analysis to determine alignment with the recommendations in Annex 3. Readability and clarity of presentation were also assessed. A total of 38 artifacts were analyzed. The mean alignment score was 7.0 ± 1.7 of 11 points; the mean clarity score was 6.7 ± 2.5 of 17 points. Only nine artifacts were classified as high clarity, high alignment. Vomit and diarrhea cleanup procedures should align with Annex 3 in the Food Code and should, as well, be clearly presented; yet, none of the artifacts completely met both conditions. To reduce the spread of norovirus infections in food service establishments, editable guidelines are needed that are aligned with Annex 3 and are clearly written, into which authors could insert their facility-specific information.

Surgeon leadership in the coding, billing, and contractual negotiations for fenestrated endovascular aortic aneurysm repair increases medical center contribution margin and physician reimbursement.

PubMed

Aiello, Francesco; Durgin, Jonathan; Daniel, Vijaya; Messina, Louis; Doucet, Danielle; Simons, Jessica; Jenkins, James; Schanzer, Andres

2017-10-01

Fenestrated endovascular aneurysm repair (FEVAR) allows endovascular treatment of thoracoabdominal and juxtarenal aneurysms previously outside the indications of use for standard devices. However, because of considerable device costs and increased procedure time, FEVAR is thought to result in financial losses for medical centers and physicians. We hypothesized that surgeon leadership in the coding, billing, and contractual negotiations for FEVAR procedures will increase medical center contribution margin (CM) and physician reimbursement. At the UMass Memorial Center for Complex Aortic Disease, a vascular surgeon with experience in medical finances is supported to manage the billing and coding of FEVAR procedures for medical center and physician reimbursement. A comprehensive financial analysis was performed for all FEVAR procedures (2011-2015), independent of insurance status, patient presentation, or type of device used. Medical center CM (actual reimbursement minus direct costs) was determined for each index FEVAR procedure and for all related subsequent procedures, inpatient or outpatient, 3 months before and 1 year subsequent to the index FEVAR procedure. Medical center CM for outpatient clinic visits, radiology examinations, vascular laboratory studies, and cardiology and pulmonary evaluations related to FEVAR were also determined. Surgeon reimbursement for index FEVAR procedure, related adjunct procedures, and assistant surgeon reimbursement were also calculated. All financial analyses were performed and adjudicated by the UMass Department of Finance. The index hospitalization for 63 FEVAR procedures incurred $2,776,726 of direct costs and generated $3,027,887 in reimbursement, resulting in a positive CM of $251,160. Subsequent related hospital procedures (n = 26) generated a CM of $144,473. Outpatient clinic visits, radiologic examinations, and vascular laboratory studies generated an additional CM of $96,888. Direct cost analysis revealed that grafts accounted for the largest proportion of costs (55%), followed by supplies (12%), bed (12%), and operating room (10%). Total medical center CM for all FEVAR services was $492,521. Average surgeon reimbursements per FEVAR from 2011 to 2015 increased from $1601 to $2480 while the surgeon payment denial rate declined from 50% to 0%. Surgeon-led negotiations with the Centers for Medicare & Medicaid Services during 2015 resulted in a 27% increase in physician reimbursement for the remainder of 2015 ($2480 vs $3068/case) and a 91% increase in reimbursement from 2011 ($1601 vs $3068). Assistant surgeon reimbursement also increased ($266 vs $764). Concomitant FEVAR-related procedures generated an additional $27,347 in surgeon reimbursement. Physician leadership in the coding, billing, and contractual negotiations for FEVAR results in a positive medical center CM and increased physician reimbursement. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

48 CFR 204.7202-1 - CAGE codes.

Code of Federal Regulations, 2014 CFR

2014-10-01

... issued by DLA Logistics Information Service. (Their address is: Customer Service, Federal Center, 74... Logistics Information Service assigns or records and maintains CAGE codes to identify commercial and... Volume 7 of DoD 4100.39-M, Federal Logistics Information System (FLIS) Procedures Manual, prescribe use...

48 CFR 204.7202-1 - CAGE codes.

Code of Federal Regulations, 2011 CFR

2011-10-01

... issued by DLA Logistics Information Service. (Their address is: Customer Service, Federal Center, 74... Logistics Information Service assigns or records and maintains CAGE codes to identify commercial and... Volume 7 of DoD 4100.39-M, Federal Logistics Information System (FLIS) Procedures Manual, prescribe use...

48 CFR 204.7202-1 - CAGE codes.

Code of Federal Regulations, 2013 CFR

2013-10-01

... issued by DLA Logistics Information Service. (Their address is: Customer Service, Federal Center, 74... Logistics Information Service assigns or records and maintains CAGE codes to identify commercial and... Volume 7 of DoD 4100.39-M, Federal Logistics Information System (FLIS) Procedures Manual, prescribe use...

48 CFR 204.7202-1 - CAGE codes.

Code of Federal Regulations, 2012 CFR

2012-10-01

... issued by DLA Logistics Information Service. (Their address is: Customer Service, Federal Center, 74... Logistics Information Service assigns or records and maintains CAGE codes to identify commercial and... Volume 7 of DoD 4100.39-M, Federal Logistics Information System (FLIS) Procedures Manual, prescribe use...

40 CFR 147.1450 - State-administered program.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Nevada Administrative Code [NAC], Underground Injection Control Regulations, Sections 1 through 96.1, Inclusive. July 22, 1987, revised September 3, 1987 (amending NAC Chapter 445). (5) Nevada Administrative Code [NAC], Regulations and Rules of Practice and Procedure adopted Pursuant to NRS 534A, Sections 1...

40 CFR 147.1450 - State-administered program.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Nevada Administrative Code [NAC], Underground Injection Control Regulations, Sections 1 through 96.1, Inclusive. July 22, 1987, revised September 3, 1987 (amending NAC Chapter 445). (5) Nevada Administrative Code [NAC], Regulations and Rules of Practice and Procedure adopted Pursuant to NRS 534A, Sections 1...

14 CFR 153.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... the airport security program, in which certain security measures specified in Title 49 of the Code of... procedures. Security Identification Display Area (SIDA) means a portion of an airport, specified in the airport security program, in which security measures specified in Title 49 of the Code of Federal...

14 CFR 153.3 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... the airport security program, in which certain security measures specified in Title 49 of the Code of... procedures. Security Identification Display Area (SIDA) means a portion of an airport, specified in the airport security program, in which security measures specified in Title 49 of the Code of Federal...

14 CFR 153.3 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... the airport security program, in which certain security measures specified in Title 49 of the Code of... procedures. Security Identification Display Area (SIDA) means a portion of an airport, specified in the airport security program, in which security measures specified in Title 49 of the Code of Federal...

Television News Without Pictures?

ERIC Educational Resources Information Center

Graber, Doris A.

1987-01-01

Describes "gestalt" coding procedures that concentrate on the meanings conveyed by audio-visual messages rather than on coding individual pictorial elements shown in a news story. Discusses the totality of meaning that results from the interaction of verbal and visual story elements, external settings, and the decoding proclivities of…

Parallel-vector computation for linear structural analysis and non-linear unconstrained optimization problems

NASA Technical Reports Server (NTRS)

Nguyen, D. T.; Al-Nasra, M.; Zhang, Y.; Baddourah, M. A.; Agarwal, T. K.; Storaasli, O. O.; Carmona, E. A.

1991-01-01

Several parallel-vector computational improvements to the unconstrained optimization procedure are described which speed up the structural analysis-synthesis process. A fast parallel-vector Choleski-based equation solver, pvsolve, is incorporated into the well-known SAP-4 general-purpose finite-element code. The new code, denoted PV-SAP, is tested for static structural analysis. Initial results on a four processor CRAY 2 show that using pvsolve reduces the equation solution time by a factor of 14-16 over the original SAP-4 code. In addition, parallel-vector procedures for the Golden Block Search technique and the BFGS method are developed and tested for nonlinear unconstrained optimization. A parallel version of an iterative solver and the pvsolve direct solver are incorporated into the BFGS method. Preliminary results on nonlinear unconstrained optimization test problems, using pvsolve in the analysis, show excellent parallel-vector performance indicating that these parallel-vector algorithms can be used in a new generation of finite-element based structural design/analysis-synthesis codes.

Comparison between variable and fixed dwell-time PN acquisition algorithms. [for synchronization in pseudonoise spread spectrum systems

NASA Technical Reports Server (NTRS)

Braun, W. R.

1981-01-01

Pseudo noise (PN) spread spectrum systems require a very accurate alignment between the PN code epochs at the transmitter and receiver. This synchronism is typically established through a two-step algorithm, including a coarse synchronization procedure and a fine synchronization procedure. A standard approach for the coarse synchronization is a sequential search over all code phases. The measurement of the power in the filtered signal is used to either accept or reject the code phase under test as the phase of the received PN code. This acquisition strategy, called a single dwell-time system, has been analyzed by Holmes and Chen (1977). A synopsis of the field of sequential analysis as it applies to the PN acquisition problem is provided. From this, the implementation of the variable dwell time algorithm as a sequential probability ratio test is developed. The performance of this algorithm is compared to the optimum detection algorithm and to the fixed dwell-time system.

Homosexual Cohabitees Act, 18 June 1987.

PubMed

1989-01-01

The purpose of this Act is to place homosexual cohabitees in the same legal position as heterosexual cohabitees. It provides that if 2 persons are living together in a homosexual relationship, the following legal provisions relating to cohabitation shall apply to them: 1) the Cohabitees (Joint Homes) Act (1987:232), 2) the Inheritance Code, 3) the Real Property Code, 4) Chapter 10, section 9, of the Code of Judicial Procedure, 5) Chapter 4, section 19, 1st paragraph, of the Code of Execution, 6) section 19, 1st paragraph, section 35, subsection 4, and point 2a, 7th paragraph, of the regulations relating to Section 36 of the Municipal Tax Act (1928:370), 7) the Inheritance and Gift Taxes Act (1941:416), 8) Section 6 of the Court Procedures (Miscellaneous Business) Act (1946:807), 9) the Tenant Owner Act (1971:479), 10) section 10 of the Legal Aid Act (1972:429), and 11) the Notice to Unknown Creditors Act (1981:131).

Processes involved in solving mathematical problems

NASA Astrophysics Data System (ADS)

Shahrill, Masitah; Putri, Ratu Ilma Indra; Zulkardi, Prahmana, Rully Charitas Indra

2018-04-01

This study examines one of the instructional practices features utilized within the Year 8 mathematics lessons in Brunei Darussalam. The codes from the TIMSS 1999 Video Study were applied and strictly followed, and from the 183 mathematics problems recorded, there were 95 problems with a solution presented during the public segments of the video-recorded lesson sequences of the four sampled teachers. The analyses involved firstly, identifying the processes related to mathematical problem statements, and secondly, examining the different processes used in solving the mathematical problems for each problem publicly completed during the lessons. The findings revealed that for three of the teachers, their problem statements coded as `using procedures' ranged from 64% to 83%, while the remaining teacher had 40% of his problem statements coded as `making connections.' The processes used when solving the problems were mainly `using procedures', and none of the problems were coded as `giving results only'. Furthermore, all four teachers made use of making the relevant connections in solving the problems given to their respective students.

National Trends in Surgery for Rotator Cuff Disease in Korea

PubMed Central

2017-01-01

The objective of this study was to investigate the national trends in rotator cuff surgery in Korea and analyze hospital type-specific trends. We analyzed a nationwide database acquired from the Korean Health Insurance Review and Assessment Service (HIRA) from 2007 to 2015. International Classification of Diseases, 10th revision (ICD-10) codes, procedure codes, and arthroscopic device code were used to identify patients who underwent surgical treatment for rotator cuff disease. A total of 383,719 cases of rotator cuff surgeries were performed from 2007 to 2015. The mean annual percentage change in the age-adjusted rate of rotator cuff surgery per population of 100,000 persons rapidly increased from 2007 to 2012 (53.3%, P < 0.001), while that between 2012 to 2015 remained steady (2.3%, P = 0.34). The proportion of arthroscopic surgery among all rotator cuff surgeries steadily rose from 89.9% in 2007 to 96.8% in 2015 (P < 0.001). In terms of hospital types, the rate of rotator cuff surgery increased to the greatest degree in hospitals with 30–100 inpatient beds, and isolated acromioplasty procedure accounted for a larger proportion of the rotator cuff surgeries in small hospitals and clinics compared to large hospitals. Overall, our findings indicate that cases of rotator cuff surgery have increased rapidly recently in Korea, of which arthroscopic surgeries account for the greatest proportion. While rotator cuff surgery is a popular procedure that is commonly performed even in small hospitals, there was a difference in the component ratio of the procedure code in accordance with hospital type. PMID:28049250

Identifying and acting on potentially inappropriate care? Inadequacy of current hospital coding for this task.

PubMed

Cooper, P David; Smart, David R

2017-06-01

Recent Australian attempts to facilitate disinvestment in healthcare, by identifying instances of 'inappropriate' care from large Government datasets, are subject to significant methodological flaws. Amongst other criticisms has been the fact that the Government datasets utilized for this purpose correlate poorly with datasets collected by relevant professional bodies. Government data derive from official hospital coding, collected retrospectively by clerical personnel, whilst professional body data derive from unit-specific databases, collected contemporaneously with care by clinical personnel. Assessment of accuracy of official hospital coding data for hyperbaric services in a tertiary referral hospital. All official hyperbaric-relevant coding data submitted to the relevant Australian Government agencies by the Royal Hobart Hospital, Tasmania, Australia for financial year 2010-2011 were reviewed and compared against actual hyperbaric unit activity as determined by reference to original source documents. Hospital coding data contained one or more errors in diagnoses and/or procedures in 70% of patients treated with hyperbaric oxygen that year. Multiple discrete error types were identified, including (but not limited to): missing patients; missing treatments; 'additional' treatments; 'additional' patients; incorrect procedure codes and incorrect diagnostic codes. Incidental observations of errors in surgical, anaesthetic and intensive care coding within this cohort suggest that the problems are not restricted to the specialty of hyperbaric medicine alone. Publications from other centres indicate that these problems are not unique to this institution or State. Current Government datasets are irretrievably compromised and not fit for purpose. Attempting to inform the healthcare policy debate by reference to these datasets is inappropriate. Urgent clinical engagement with hospital coding departments is warranted.

Research Prototype: Automated Analysis of Scientific and Engineering Semantics

NASA Technical Reports Server (NTRS)

Stewart, Mark E. M.; Follen, Greg (Technical Monitor)

2001-01-01

Physical and mathematical formulae and concepts are fundamental elements of scientific and engineering software. These classical equations and methods are time tested, universally accepted, and relatively unambiguous. The existence of this classical ontology suggests an ideal problem for automated comprehension. This problem is further motivated by the pervasive use of scientific code and high code development costs. To investigate code comprehension in this classical knowledge domain, a research prototype has been developed. The prototype incorporates scientific domain knowledge to recognize code properties (including units, physical, and mathematical quantity). Also, the procedure implements programming language semantics to propagate these properties through the code. This prototype's ability to elucidate code and detect errors will be demonstrated with state of the art scientific codes.

Potential loss of revenue due to errors in clinical coding during the implementation of the Malaysia diagnosis related group (MY-DRG®) Casemix system in a teaching hospital in Malaysia.

PubMed

Zafirah, S A; Nur, Amrizal Muhammad; Puteh, Sharifa Ezat Wan; Aljunid, Syed Mohamed

2018-01-25

The accuracy of clinical coding is crucial in the assignment of Diagnosis Related Groups (DRGs) codes, especially if the hospital is using Casemix System as a tool for resource allocations and efficiency monitoring. The aim of this study was to estimate the potential loss of income due to an error in clinical coding during the implementation of the Malaysia Diagnosis Related Group (MY-DRG ® ) Casemix System in a teaching hospital in Malaysia. Four hundred and sixty-four (464) coded medical records were selected, re-examined and re-coded by an independent senior coder (ISC). This ISC re-examined and re-coded the error code that was originally entered by the hospital coders. The pre- and post-coding results were compared, and if there was any disagreement, the codes by the ISC were considered the accurate codes. The cases were then re-grouped using a MY-DRG ® grouper to assess and compare the changes in the DRG assignment and the hospital tariff assignment. The outcomes were then verified by a casemix expert. Coding errors were found in 89.4% (415/424) of the selected patient medical records. Coding errors in secondary diagnoses were the highest, at 81.3% (377/464), followed by secondary procedures at 58.2% (270/464), principal procedures of 50.9% (236/464) and primary diagnoses at 49.8% (231/464), respectively. The coding errors resulted in the assignment of different MY-DRG ® codes in 74.0% (307/415) of the cases. From this result, 52.1% (160/307) of the cases had a lower assigned hospital tariff. In total, the potential loss of income due to changes in the assignment of the MY-DRG ® code was RM654,303.91. The quality of coding is a crucial aspect in implementing casemix systems. Intensive re-training and the close monitoring of coder performance in the hospital should be performed to prevent the potential loss of hospital income.

Pedestrian injury causation study (pedestrian accident typing)

DOT National Transportation Integrated Search

1982-08-01

A new computerized pedestrian accident typing procedure was tested on 1,997 cases from the Pedestrian Injury Causation Study (PICS). Two coding procedures were used to determine the effects of quantity and quality of information on accident typing ac...

The FORTRAN static source code analyzer program (SAP) system description

NASA Technical Reports Server (NTRS)

Decker, W.; Taylor, W.; Merwarth, P.; Oneill, M.; Goorevich, C.; Waligora, S.

1982-01-01

A source code analyzer program (SAP) designed to assist personnel in conducting studies of FORTRAN programs is described. The SAP scans FORTRAN source code and produces reports that present statistics and measures of statements and structures that make up a module. The processing performed by SAP and of the routines, COMMON blocks, and files used by SAP are described. The system generation procedure for SAP is also presented.

Text mining applied to electronic cardiovascular procedure reports to identify patients with trileaflet aortic stenosis and coronary artery disease.

PubMed

Small, Aeron M; Kiss, Daniel H; Zlatsin, Yevgeny; Birtwell, David L; Williams, Heather; Guerraty, Marie A; Han, Yuchi; Anwaruddin, Saif; Holmes, John H; Chirinos, Julio A; Wilensky, Robert L; Giri, Jay; Rader, Daniel J

2017-08-01

Interrogation of the electronic health record (EHR) using billing codes as a surrogate for diagnoses of interest has been widely used for clinical research. However, the accuracy of this methodology is variable, as it reflects billing codes rather than severity of disease, and depends on the disease and the accuracy of the coding practitioner. Systematic application of text mining to the EHR has had variable success for the detection of cardiovascular phenotypes. We hypothesize that the application of text mining algorithms to cardiovascular procedure reports may be a superior method to identify patients with cardiovascular conditions of interest. We adapted the Oracle product Endeca, which utilizes text mining to identify terms of interest from a NoSQL-like database, for purposes of searching cardiovascular procedure reports and termed the tool "PennSeek". We imported 282,569 echocardiography reports representing 81,164 individuals and 27,205 cardiac catheterization reports representing 14,567 individuals from non-searchable databases into PennSeek. We then applied clinical criteria to these reports in PennSeek to identify patients with trileaflet aortic stenosis (TAS) and coronary artery disease (CAD). Accuracy of patient identification by text mining through PennSeek was compared with ICD-9 billing codes. Text mining identified 7115 patients with TAS and 9247 patients with CAD. ICD-9 codes identified 8272 patients with TAS and 6913 patients with CAD. 4346 patients with AS and 6024 patients with CAD were identified by both approaches. A randomly selected sample of 200-250 patients uniquely identified by text mining was compared with 200-250 patients uniquely identified by billing codes for both diseases. We demonstrate that text mining was superior, with a positive predictive value (PPV) of 0.95 compared to 0.53 by ICD-9 for TAS, and a PPV of 0.97 compared to 0.86 for CAD. These results highlight the superiority of text mining algorithms applied to electronic cardiovascular procedure reports in the identification of phenotypes of interest for cardiovascular research. Copyright © 2017. Published by Elsevier Inc.

[ENT medicine and head and neck surgery in the G-DRG system 2008].

PubMed

Franz, D; Roeder, N; Hörmann, K; Alberty, J

2008-09-01

Further developments in the German DRG system have been incorporated into the 2008 version. For ENT medicine and head and neck surgery significant changes concerning coding of diagnoses, medical procedures and concerning the DRG-structure were made. Analysis of relevant diagnoses, medical procedures and G-DRGs in the versions 2007 and 2008 based on the publications of the German DRG institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes for 2008 focussed on the development of DRG structure, DRG validation and codes for medical procedures. The outcome of these changes for German hospitals may vary depending on the range of activities. The G-DRG system has gained in complexity again. High demands are made on correct and complete coding of complex ENT and head and neck surgery cases. Quality of case allocation within the G-DRG system has been improved. For standard cases quality of case allocation is adequate. Nevertheless, further adjustments of the G-DRG system especially for cases with complex neck surgery are necessary.

User guide for WIACX: A transonic wind-tunnel wall interference assessment and correction procedure for the NTF

NASA Technical Reports Server (NTRS)

Garriz, Javier A.; Haigler, Kara J.

1992-01-01

A three dimensional transonic Wind-tunnel Interference Assessment and Correction (WIAC) procedure developed specifically for use in the National Transonic Facility (NTF) at NASA Langley Research Center is discussed. This report is a user manual for the codes comprising the correction procedure. It also includes listings of sample procedures and input files for running a sample case and plotting the results.

76 FR 18381 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-04

... part 51, and Sec. 97.20 of Title 14 of the Code of Federal Regulations. The large number of SIAPs... the airport and its location, the procedure and the amendment number. The Rule This amendment to 14... this amendment will not have a significant economic impact on a substantial number of small entities...

78 FR 44189 - Petition for Modification of Single Car Air Brake Test Procedures

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-23

...] Petition for Modification of Single Car Air Brake Test Procedures In accordance with Part 232 of Title 49... Administration (FRA) per 49 CFR 232.307 to modify the single car air brake test procedures located in AAR Standard S-486, Code of Air Brake System Tests for Freight Equipment-- Single Car Test, and required...

77 FR 12077 - Meeting of the Judicial Conference Advisory Committee on Rules of Bankruptcy Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-28

... Rules of Bankruptcy Procedure. ACTION: Notice of open meeting. SUMMARY: The Advisory Committee on Rules of Bankruptcy Procedure will hold a two-day meeting. The meeting will be open to public observation... Officer and Counsel. [FR Doc. 2012-4637 Filed 2-27-12; 8:45 am] BILLING CODE 2210-55-P ...

77 FR 12078 - Meeting of the Judicial Conference Advisory Committee on Rules of Criminal Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-28

... of Criminal Procedure. ACTION: Notice of open meeting. SUMMARY: The Advisory Committee on Rules of Criminal Procedure will hold a two-day meeting. The meeting will be open to public observation but not... Deputy and Counsel. [FR Doc. 2012-4654 Filed 2-27-12; 8:45 am] BILLING CODE 2210-55-P ...

77 FR 12077 - Meeting of the Judicial Conference Advisory Committee on Rules of Civil Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-28

... Civil Procedure. ACTION: Notice of open meeting. SUMMARY: The Advisory Committee on Rules of Civil Procedure will hold a two-day meeting. The meeting will be open to public observation but not participation.... [FR Doc. 2012-4671 Filed 2-27-12; 8:45 am] BILLING CODE 2210-55-P ...

77 FR 12077 - Meeting of the Judicial Conference Advisory Committee on Rules of Bankruptcy Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-28

... Rules of Bankruptcy Procedure. ACTION: Notice of open meeting. SUMMARY: The Advisory Committee on Rules of Bankruptcy Procedure will hold a two-day meeting. The meeting will be open to public observation... Committee Deputy and Counsel. [FR Doc. 2012-4668 Filed 2-27-12; 8:45 am] BILLING CODE 2210-55-P ...

76 FR 13449 - Proposed Collection; Comment Request for Revenue Procedure 2009-41 (Rev. Proc. 2002-59 Is...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-11

... Classification Elections. DATES: Written comments should be received on or before May 10, 2011 to be assured of... Classification Elections. OMB Number: 1545-1771. Revenue Procedure Number: Revenue Procedure 2009-41. (Rev. Proc... Internal Revenue Code for an eligible entity that requests relief for a late classification election filed...

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR SAMPLING WEIGHT CALCULATION (IIT-A-9.0)

EPA Science Inventory

The purpose of this SOP is to describe the procedures undertaken to calculate sampling weights. The sampling weights are needed to obtain weighted statistics of the study data. This SOP uses data that have been properly coded and certified with appropriate QA/QC procedures by th...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR PROBABILISTIC APPROACH OF EXPOSURE CALCULATION OF DERMAL EXPOSURE (IIT-A-13.0)

EPA Science Inventory

The purpose of this SOP is to describe the procedures undertaken to calculate the dermal exposure using a probabilistic approach. This SOP uses data that have been properly coded and certified with appropriate QA/QC procedures by the University of Arizona NHEXAS and Battelle Labo...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR PROBABILISTIC APPROACH FOR ESTIMATING INHALATION EXPOSURES TO CHLORPYRIFOS AND DIAZINON (IIT-A-14.0)

EPA Science Inventory

The purpose of this SOP is to describe the procedures undertaken to calculate the inhalation exposures to chlorpyrifos and diazinon using the probabilistic approach. This SOP uses data that have been properly coded and certified with appropriate QA/QC procedures by the University...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CONVERSION OF SERVINGS TO KILOGRAMS (IIT-A-8.0)

EPA Science Inventory

The purpose of this SOP is to describe the procedures undertaken to convert servings to kilograms for each food item used in the Diet Diary questionnaire. This SOP uses data that have been properly coded and certified with appropriate QA/QC procedures by the University of Arizon...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR ESTIMATING INHALATION EXPOSURES TO CHLORPYRIFOS AND DIAZINON (IIT-A-5.0)

EPA Science Inventory

The purpose of this SOP is to describe the procedures undertaken for estimating inhalation exposures to chlorpyrifos and Diazinon. This SOP uses data that have been properly coded and certified with appropriate QA/QC procedures by the University of Arizona NHEXAS and Battelle La...

Dispersion model studies for Space Shuttle environmental effects activities

NASA Technical Reports Server (NTRS)

1981-01-01

The NASA/MSFC REED computer code was developed for predicting concentrations, dosage, and deposition downwind from rocket vehicle launches. The calculation procedures and results of nine studies using the code are presented. Topics include plume expansion, hydrazine concentrations, and hazard calculations for postulated fuel spills.

Comparison of 2015 Medicare relative value units for gender-specific procedures: Gynecologic and gynecologic-oncologic versus urologic CPT coding. Has time healed gender-worth?

PubMed

Benoit, M F; Ma, J F; Upperman, B A

2017-02-01

In 1992, Congress implemented a relative value unit (RVU) payment system to set reimbursement for all procedures covered by Medicare. In 1997, data supported that a significant gender bias existed in reimbursement for gynecologic compared to urologic procedures. The present study was performed to compare work and total RVU's for gender specific procedures effective January 2015 and to evaluate if time has healed the gender-based RVU worth. Using the 2015 CPT codes, we compared work and total RVU's for 50 pairs of gender specific procedures. We also evaluated 2015 procedure related provider compensation. The groups were matched so that the procedures were anatomically similar. We also compared 2015 to 1997 RVU and fee schedules. Evaluation of work RVU's for the paired procedures revealed that in 36 cases (72%), male vs female procedures had a higher wRVU and tRVU. For total fee/reimbursement, 42 (84%) male based procedures were compensated at a higher rate than the paired female procedures. On average, male specific surgeries were reimbursed at an amount that was 27.67% higher for male procedures than for female-specific surgeries. Female procedure based work RVU's have increased minimally from 1997 to 2015. Time and effort have trended towards resolution of some gender-related procedure worth discrepancies but there are still significant RVU and compensation differences that should be further reviewed and modified as surgical time and effort highly correlate. Copyright © 2016. Published by Elsevier Inc.

Three-dimensional visualization of morphology and ventilation procedure (air flow and diffusion) of a subdivision of the acinus using synchrotron radiation microtomography of the human lung specimens

NASA Astrophysics Data System (ADS)

Shimizu, Kenji; Ikura, Hirohiko; Ikezoe, Junpei; Nagareda, Tomofumi; Yagi, Naoto; Umetani, Keiji; Imai, Yutaka

2004-04-01

We have previously reported a synchrotron radiation (SR) microtomography system constructed at the bending magnet beamline at the SPring-8. This system has been applied to the lungs obtained at autopsy and inflated and fixed by Heitzman"s method. Normal lung and lung specimens with two different types of pathologic processes (fibrosis and emphysema) were included. Serial SR microtomographic images were stacked to yield the isotropic volumetric data with high-resolution (12 μm3 in voxel size). Within the air spaces of a subdivision of the acinus, each voxel is segmented three-dimensionally using a region growing algorithm ("rolling ball algorithm"). For each voxel within the segmented air spaces, two types of voxel coding have been performed: single-seeded (SS) coding and boundary-seeded (BS) coding, in which the minimum distance from an initial point as the only seed point and all object boundary voxels as a seed set were calculated and assigned as the code values to each voxel, respectively. With these two codes, combinations of surface rendering and volume rendering techniques were applied to visualize three-dimensional morphology of a subdivision of the acinus. Furthermore, sequentially filling process of air into a subdivision of the acinus was simulated under several conditions to visualize the ventilation procedure (air flow and diffusion). A subdivision of the acinus was reconstructed three-dimensionally, demonstrating the normal architecture of the human lung. Significant differences in appearance of ventilation procedure were observed between normal and two pathologic processes due to the alteration of the lung architecture. Three-dimensional reconstruction of the microstructure of a subdivision of the acinus and visualization of the ventilation procedure (air flow and diffusion) with SR microtomography would offer a new approach to study the morphology, physiology, and pathophysiology of the human respiratory system.

Engine dynamic analysis with general nonlinear finite element codes. Part 2: Bearing element implementation overall numerical characteristics and benchmaking

NASA Technical Reports Server (NTRS)

Padovan, J.; Adams, M.; Fertis, J.; Zeid, I.; Lam, P.

1982-01-01

Finite element codes are used in modelling rotor-bearing-stator structure common to the turbine industry. Engine dynamic simulation is used by developing strategies which enable the use of available finite element codes. benchmarking the elements developed are benchmarked by incorporation into a general purpose code (ADINA); the numerical characteristics of finite element type rotor-bearing-stator simulations are evaluated through the use of various types of explicit/implicit numerical integration operators. Improving the overall numerical efficiency of the procedure is improved.

APOLLO II

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sanchez, R.; Mondot, J.; Stankovski, Z.

1988-11-01

APOLLO II is a new, multigroup transport code under development at the Commissariat a l'Energie Atomique. The code has a modular structure and uses sophisticated software for data structuralization, dynamic memory management, data storage, and user macrolanguage. This paper gives an overview of the main methods used in the code for (a) multidimensional collision probability calculations, (b) leakage calculations, and (c) homogenization procedures. Numerical examples are given to demonstrate the potential of the modular structure of the code and the novel multilevel flat-flux representation used in the calculation of the collision probabilities.

49 CFR 1503.407 - Military personnel.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION, DEPARTMENT OF HOMELAND SECURITY ADMINISTRATIVE AND PROCEDURAL RULES INVESTIGATIVE AND ENFORCEMENT PROCEDURES... the Department of Defense who is subject to the Uniform Code of Military Justice (10 U.S.C. chapter 47...

49 CFR 1503.407 - Military personnel.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION, DEPARTMENT OF HOMELAND SECURITY ADMINISTRATIVE AND PROCEDURAL RULES INVESTIGATIVE AND ENFORCEMENT PROCEDURES... the Department of Defense who is subject to the Uniform Code of Military Justice (10 U.S.C. chapter 47...

49 CFR 1503.407 - Military personnel.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION, DEPARTMENT OF HOMELAND SECURITY ADMINISTRATIVE AND PROCEDURAL RULES INVESTIGATIVE AND ENFORCEMENT PROCEDURES... the Department of Defense who is subject to the Uniform Code of Military Justice (10 U.S.C. chapter 47...

49 CFR 1503.407 - Military personnel.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION, DEPARTMENT OF HOMELAND SECURITY ADMINISTRATIVE AND PROCEDURAL RULES INVESTIGATIVE AND ENFORCEMENT PROCEDURES... the Department of Defense who is subject to the Uniform Code of Military Justice (10 U.S.C. chapter 47...

49 CFR 1503.407 - Military personnel.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION, DEPARTMENT OF HOMELAND SECURITY ADMINISTRATIVE AND PROCEDURAL RULES INVESTIGATIVE AND ENFORCEMENT PROCEDURES... the Department of Defense who is subject to the Uniform Code of Military Justice (10 U.S.C. chapter 47...

PRT Impact Study - Operational Phase : Volume 2. Data Collection Procedure and Coding Manual.

DOT National Transportation Integrated Search

1979-07-01

The report documents the procedures used by researchers at West Virginia University (WVU) in collecting data which describes transportation-related conditions in Morgantown, West Virginia following the commencement of passenger service on Phase I of ...

[Global aspects of medical ethics: conditions and possibilities].

PubMed

Neitzke, G

2001-01-01

A global or universal code of medical ethics seems paradoxical in the era of pluralism and postmodernism. A different conception of globalisation will be developed in terms of a "procedural universality". According to this philosophical concept, a code of medical ethics does not oblige physicians to accept certain specific, preset, universal values and rules. It rather obliges every culture and society to start a culture-sensitive, continuous, and active discourse on specific issues, mentioned in the codex. This procedure might result in regional, intra-cultural consensus, which should be presented to an inter-cultural dialogue. To exemplify this procedure, current topics of medical ethics (spiritual foundations of medicine, autonomy, definitions concerning life and death, physicians' duties, conduct within therapeutic teams) will be discussed from the point of view of western medicine.

DMD-based implementation of patterned optical filter arrays for compressive spectral imaging.

PubMed

Rueda, Hoover; Arguello, Henry; Arce, Gonzalo R

2015-01-01

Compressive spectral imaging (CSI) captures multispectral imagery using fewer measurements than those required by traditional Shannon-Nyquist theory-based sensing procedures. CSI systems acquire coded and dispersed random projections of the scene rather than direct measurements of the voxels. To date, the coding procedure in CSI has been realized through the use of block-unblock coded apertures (CAs), commonly implemented as chrome-on-quartz photomasks. These apertures block or permit us to pass the entire spectrum from the scene at given spatial locations, thus modulating the spatial characteristics of the scene. This paper extends the framework of CSI by replacing the traditional block-unblock photomasks by patterned optical filter arrays, referred to as colored coded apertures (CCAs). These, in turn, allow the source to be modulated not only spatially but spectrally as well, entailing more powerful coding strategies. The proposed CCAs are synthesized through linear combinations of low-pass, high-pass, and bandpass filters, paired with binary pattern ensembles realized by a digital micromirror device. The optical forward model of the proposed CSI architecture is presented along with a proof-of-concept implementation, which achieves noticeable improvements in the quality of the reconstruction.

Validation of current procedural terminology codes for rotavirus vaccination among infants in two commercially insured US populations.

PubMed

Hoffman, Veena; Everage, Nicholas J; Quinlan, Scott C; Skerry, Kathleen; Esposito, Daina; Praet, Nicolas; Rosillon, Dominique; Holick, Crystal N; Dore, David D

2016-12-01

We validated procedure codes used in health insurance claims for reimbursement of rotavirus vaccination by comparing claims for monovalent live-attenuated human rotavirus vaccine (RV1) and live, oral pentavalent rotavirus vaccine (RV5) to medical records. Using administrative data from two commercially insured United States populations, we randomly sampled vaccination claims for RV1 and RV5 from a cohort of infants aged less than 1 year from an ongoing post-licensure safety study of rotavirus vaccines. The codes for RV1 and RV5 found in claims were confirmed through medical record review. The positive predictive value (PPV) of the Current Procedural Terminology codes for RV1 and RV5 was calculated as the number of medical record-confirmed vaccinations divided by the number of medical records obtained. Medical record review confirmed 92 of 104 RV1 vaccination claims (PPV: 88.5%; 95% CI: 80.7-93.9%) and 98 of 113 RV5 vaccination claims (PPV: 86.7%; 95% CI: 79.1-92.4%). Among the 217 medical records abstracted, only three (1.4%) of vaccinations were misclassified in claims-all were RV5 misclassified as RV1. The medical records corresponding to 9 RV1 and 15 RV5 claims contained insufficient information to classify the type of rotavirus vaccine. Misclassification of rotavirus vaccines is infrequent within claims. The PPVs reported here are conservative estimates as those with insufficient information in the medical records were assumed to be incorrectly coded in the claims. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Nonlinear Transient Problems Using Structure Compatible Heat Transfer Code

NASA Technical Reports Server (NTRS)

Hou, Gene

2000-01-01

The report documents the recent effort to enhance a transient linear heat transfer code so as to solve nonlinear problems. The linear heat transfer code was originally developed by Dr. Kim Bey of NASA Largely and called the Structure-Compatible Heat Transfer (SCHT) code. The report includes four parts. The first part outlines the formulation of the heat transfer problem of concern. The second and the third parts give detailed procedures to construct the nonlinear finite element equations and the required Jacobian matrices for the nonlinear iterative method, Newton-Raphson method. The final part summarizes the results of the numerical experiments on the newly enhanced SCHT code.

The Regionalization of Lumbar Spine Procedures in New York State: A 10-Year Analysis.

PubMed

Jancuska, Jeffrey; Adrados, Murillo; Hutzler, Lorraine; Bosco, Joseph

2016-01-01

A retrospective review of an administrative database. The purpose of this study is to determine the current extent of regionalization by mapping lumbar spine procedures according to hospital and patient zip code, as well as examine the rate of growth of lumbar spine procedures performed at high-, medium-, and low-volume institutions in New York State. The association between hospital and spine surgeon volume and improved patient outcomes is well established. There is no study investigating the actual process of patient migration to high-volume hospitals. New York Statewide Planning and Research Cooperative System (SPARCS) administrative data were used to identify 228,695 lumbar spine surgery patients from 2005 to 2014. The data included the patients' zip code, hospital of operation, and year of discharge. The volume of lumbar spine surgery in New York State was mapped according to patient and hospital 3-digit zip code. New York State hospitals were categorized as low, medium, and high volume and descriptive statistics were used to determine trends in changes in hospital volume. Lumbar spine surgery recipients are widely distributed throughout the state. Procedures are regionalized on a select few metropolitan centers. The total number of procedures grew 2.5% over the entire 10-year-period. High-volume hospital caseload increased 50%, from 7253 procedures in 2005 to 10,915 procedures in 2014. The number of procedures at medium and low-volume hospitals decreased 30% and 13%, respectively. Despite any concerted effort aimed at moving orthopedic patients to high-volume hospitals, migration to high-volume centers occurred. Public interest in quality outcomes and cost, as well as financial incentives among medical centers to increase market share, potentially influence the migration of patients to high-volume centers. Further regionalization has the potential to exacerbate the current level of disparities among patient populations at low and high-volume hospitals. 3.

Temporal Trends in Gender-Affirming Surgery Among Transgender Patients in the United States.

PubMed

Canner, Joseph K; Harfouch, Omar; Kodadek, Lisa M; Pelaez, Danielle; Coon, Devin; Offodile, Anaeze C; Haider, Adil H; Lau, Brandyn D

2018-02-28

Little is known about the incidence of gender-affirming surgical procedures for transgender patients in the United States. To investigate the incidence and trends over time of gender-affirming surgical procedures and to analyze characteristics and payer status of transgender patients seeking these operations. In this descriptive observational study from 2000 to 2014, data were analyzed from the National Inpatient Sample, a representative pool of inpatient visits across the United States. The initial analyses were done from June to August 2015. Patients of interest were identified by International Classification of Diseases, Ninth Revision, diagnosis codes for transsexualism or gender identity disorder. Subanalysis focused on patients with procedure codes for surgery related to gender affirmation. Demographics, health insurance plan, and type of surgery for patients who sought gender-affirming surgery were compared between 2000-2005 and 2006-2011, as well as annually from 2012 to 2014. This study included 37 827 encounters (median [interquartile range] patient age, 38 [26-49] years) identified by a diagnosis code of transsexualism or gender identity disorder. Of all encounters, 4118 (10.9%) involved gender-affirming surgery. The incidence of genital surgery increased over time: in 2000-2005, 72.0% of patients who underwent gender-affirming procedures had genital surgery; in 2006-2011, 83.9% of patients who underwent gender-affirming procedures had genital surgery. Most patients (2319 of 4118 [56.3%]) undergoing these procedures were not covered by any health insurance plan. The number of patients seeking these procedures who were covered by Medicare or Medicaid increased by 3-fold in 2014 (to 70) compared with 2012-2013 (from 25). No patients who underwent inpatient gender-affirming surgery died in the hospital. Most transgender patients in this national sample undergoing inpatient gender-affirming surgery were classified as self-pay; however, an increasing number of transgender patients are being covered by private insurance, Medicare, or Medicaid. As coverage for these procedures increases, likely so will demand for qualified surgeons to perform them.

An evaluation of the quality of obstetric morbidity coding using an objective assessment tool, the Performance Indicators For Coding Quality (PICQ).

PubMed

Lamb, Mary K; Innes, Kerry; Saad, Patricia; Rust, Julie; Dimitropoulos, Vera; Cumerlato, Megan

The Performance Indicators for Coding Quality (PICQ) is a data quality assessment tool developed by Australia's National Centre for Classification in Health (NCCH). PICQ consists of a number of indicators covering all ICD-10-AM disease chapters, some procedure chapters from the Australian Classification of Health Intervention (ACHI) and some Australian Coding Standards (ACS). The indicators can be used to assess the coding quality of hospital morbidity data by monitoring compliance of coding conventions and ACS; this enables the identification of particular records that may be incorrectly coded, thus providing a measure of data quality. There are 31 obstetric indicators available for the ICD-10-AM Fourth Edition. Twenty of these 31 indicators were classified as Fatal, nine as Warning and two Relative. These indicators were used to examine coding quality of obstetric records in the 2004-2005 financial year Australian national hospital morbidity dataset. Records with obstetric disease or procedure codes listed anywhere in the code string were extracted and exported from the SPSS source file. Data were then imported into a Microsoft Access database table as per PICQ instructions, and run against all Fatal and Warning and Relative (N=31) obstetric PICQ 2006 Fourth Edition Indicators v.5 for the ICD-10- AM Fourth Edition. There were 689,905 gynaecological and obstetric records in the 2004-2005 financial year, of which 1.14% were found to have triggered Fatal degree errors, 3.78% Warning degree errors and 8.35% Relative degree errors. The types of errors include completeness, redundancy, specificity and sequencing problems. It was found that PICQ is a useful initial screening tool for the assessment of ICD-10-AM/ACHI coding quality. The overall quality of codes assigned to obstetric records in the 2004- 2005 Australian national morbidity dataset is of fair quality.

48 CFR 204.7202-1 - CAGE codes.

Code of Federal Regulations, 2010 CFR

2010-10-01

....39-M, Federal Logistics Information System (FLIS) Procedures Manual, prescribe use of CAGE codes. (b..., Federal Center, 74 Washington Avenue, North, Battle Creek, MI 49017-3084. Their telephone number is: toll-free 1-888-352-9333); (B) The on-line access to the CAGE file through the Defense Logistics Information...

42 CFR 414.46 - Additional rules for payment of anesthesia services.

Code of Federal Regulations, 2013 CFR

2013-10-01

.... (a) Definitions. For purposes of this section, the following definitions apply: (1) Base unit means the value for each anesthesia code that reflects all activities other than anesthesia time. These... furnishes the carrier with the base units for each anesthesia procedure code. The base units are derived...

42 CFR 414.46 - Additional rules for payment of anesthesia services.

Code of Federal Regulations, 2014 CFR

2014-10-01

.... (a) Definitions. For purposes of this section, the following definitions apply: (1) Base unit means the value for each anesthesia code that reflects all activities other than anesthesia time. These... furnishes the carrier with the base units for each anesthesia procedure code. The base units are derived...

75 FR 6769 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Order Approving...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-10

... To Amend the Hearing Location Rules of the Codes of Arbitration Procedure for Customer and Industry... expand the criteria for selecting a hearing location for an arbitration proceeding. The proposed rule..., 2010. II. Description of the Proposed Rule Change Hearing Location Selection Under the Customer Code...

Parallel Processable Cryptographic Methods with Unbounded Practical Security.

ERIC Educational Resources Information Center

Rothstein, Jerome

Addressing the problem of protecting confidential information and data stored in computer databases from access by unauthorized parties, this paper details coding schemes which present such astronomical work factors to potential code breakers that security breaches are hopeless in any practical sense. Two procedures which can be used to encode for…

32 CFR 295.3 - Definition of OIG records.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., decisions, or procedures of the OIG. Normally, computer software, including source code, object code, and... the underlying data which is processed and produced by such software and which may in some instances be stored with the software.) Exceptions to this position are outlined in § 295.4(c). (3) Anything...

32 CFR 295.3 - Definition of OIG records.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., decisions, or procedures of the OIG. Normally, computer software, including source code, object code, and... the underlying data which is processed and produced by such software and which may in some instances be stored with the software.) Exceptions to this position are outlined in § 295.4(c). (3) Anything...

32 CFR 295.3 - Definition of OIG records.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., decisions, or procedures of the OIG. Normally, computer software, including source code, object code, and... the underlying data which is processed and produced by such software and which may in some instances be stored with the software.) Exceptions to this position are outlined in § 295.4(c). (3) Anything...

32 CFR 295.3 - Definition of OIG records.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., decisions, or procedures of the OIG. Normally, computer software, including source code, object code, and... the underlying data which is processed and produced by such software and which may in some instances be stored with the software.) Exceptions to this position are outlined in § 295.4(c). (3) Anything...

32 CFR 295.3 - Definition of OIG records.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., decisions, or procedures of the OIG. Normally, computer software, including source code, object code, and... the underlying data which is processed and produced by such software and which may in some instances be stored with the software.) Exceptions to this position are outlined in § 295.4(c). (3) Anything...

15 CFR 701.4 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Subject to Offset; (iii) Names/Titles of Signatories to the Offset Agreement; (iv) Value of Export Sale.../naics.html). Paragraphs (c)(1)(iii)(A) through (c)(1)(iii)(E) of this section provide examples that illustrate how to select the appropriate NAICS code(s). (A) Example 1. Company A enters into an offset...

An Analysis of the Effect of Knowledge Management on the Execution of Simplified Acquisition Procedures

DTIC Science & Technology

2012-12-27

of Work UCC Uniform Commercial Code USD(AT&L) Under Secretary of Defense for Acquisition, Technology, and Logistics WBS Work Breakdown Structure...intensive career field. The FAR, the DFARS, and other federal agency supplements of the FAR, the Uniform Commercial Code ( UCC ), installation guidelines

47 CFR 3.22 - Number of accounting authority identification codes per applicant.

Code of Federal Regulations, 2010 CFR

2010-10-01

... AUTHORIZATION AND ADMINISTRATION OF ACCOUNTING AUTHORITIES IN MARITIME AND MARITIME MOBILE-SATELLITE RADIO SERVICES Application Procedures § 3.22 Number of accounting authority identification codes per applicant... assign U.S. AAICs for entities settling accounts of U.S. licensed vessels in the maritime mobile and...

The Therapy Process Observational Coding System for Child Psychotherapy Strategies Scale

ERIC Educational Resources Information Center

McLeod, Bryce D.; Weisz, John R.

2010-01-01

Most everyday child and adolescent psychotherapy does not follow manuals that document the procedures. Consequently, usual clinical care has remained poorly understood and rarely studied. The Therapy Process Observational Coding System for Child Psychotherapy-Strategies scale (TPOCS-S) is an observational measure of youth psychotherapy procedures…

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CODING: FIELD FORMS (UA-D-37.0)

EPA Science Inventory

The purpose of this SOP is to define the coding strategy for selected field forms. Forms addressed here will be scanned into databases; databases are created because the forms contain critical values needed to calculate pollutant concentrations. Other forms not addressed by thi...

The Library Systems Act and Rules for Administering the Library Systems Act.

ERIC Educational Resources Information Center

Texas State Library, Austin. Library Development Div.

This document contains the Texas Library Systems Act and rules for administering the Library Systems Act. Specifically, it includes the following documents: Texas Library Systems Act; Summary of Codes;Texas Administrative Code: Service Complaints and Protest Procedure; Criteria For Texas Library System Membership; and Certification Requirements…

Development of a list of high-risk operations for patients 65 years and older.

PubMed

Schwarze, Margaret L; Barnato, Amber E; Rathouz, Paul J; Zhao, Qianqian; Neuman, Heather B; Winslow, Emily R; Kennedy, Gregory D; Hu, Yue-Yung; Dodgion, Christopher M; Kwok, Alvin C; Greenberg, Caprice C

2015-04-01

No consensus exists regarding the definition of high-risk surgery in older adults. An inclusive and precise definition of high-risk surgery may be useful for surgeons, patients, researchers, and hospitals. To develop a list of high-risk operations. Retrospective cohort study and modified Delphi procedure. The setting included all Pennsylvania acute care hospitals (Pennsylvania Health Care Cost Containment Council [PHC4] April 1, 2001, to December 31, 2007) and a nationally representative sample of US acute care hospitals (Nationwide Inpatient Sample [NIS], Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality January 1, 2001, to December 31, 2006). Patients included were those 65 years and older admitted to PHC4 hospitals and those 18 years and older admitted to NIS hospitals. We identified International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure codes associated with at least 1% inpatient mortality in the PHC4. We used a modified Delphi procedure with 5 board-certified surgeons to further refine this list by excluding nonoperative procedures and operations that were unlikely to be the proximate cause of mortality and were instead a marker of critical illness (eg, tracheostomy). We then cross-validated this list of ICD-9-CM codes in the NIS. Modified Delphi procedure consensus of at least 4 of 5 panelists and proportion agreement in the NIS. Among 4,739,522 admissions of patients 65 years and older in the PHC4, a total of 2,569,589 involved a procedure, encompassing 2853 unique procedures. Of 1130 procedures associated with a crude inpatient mortality of at least 1%, 264 achieved consensus as high-risk operations by the modified Delphi procedure. The observed inpatient mortality in the NIS was at least 1% for 227 of 264 procedures (86%) in patients 65 years and older. The pooled inpatient mortality for these identified high-risk procedures performed on patients 65 years and older was double the pooled inpatient mortality for correspondingly identified high-risk operations for patients younger than 65 years (6% vs 3%). We developed a list of procedure codes to identify high-risk surgical procedures in claims data. This list of high-risk operations can be used to standardize the definition of high-risk surgery in quality and outcomes-based studies and to design targeted clinical interventions.

Progress in incompressible Navier-Stokes computations for propulsion flows and its dual-use applications

NASA Technical Reports Server (NTRS)

Kiris, Cetin

1995-01-01

Development of an incompressible Navier-Stokes solution procedure was performed for the analysis of a liquid rocket engine pump components and for the mechanical heart assist devices. The solution procedure for the propulsion systems is applicable to incompressible Navier-Stokes flows in a steadily rotating frame of reference for any general complex configurations. The computer codes were tested on different complex configurations such as liquid rocket engine inducer and impellers. As a spin-off technology from the turbopump component simulations, the flow analysis for an axial heart pump was conducted. The baseline Left Ventricular Assist Device (LVAD) design was improved by adding an inducer geometry by adapting from the liquid rocket engine pump. The time-accurate mode of the incompressible Navier-Stokes code was validated with flapping foil experiment by using different domain decomposition methods. In the flapping foil experiment, two upstream NACA 0025 foils perform high-frequency synchronized motion and generate unsteady flow conditions for a downstream larger stationary foil. Fairly good agreement was obtained between unsteady experimental data and numerical results from two different moving boundary procedures. Incompressible Navier-Stokes code (INS3D) has been extended for heat transfer applications. The temperature equation was written for both forced and natural convection phenomena. Flow in a square duct case was used for the validation of the code in both natural and forced convection.

The Proteus Navier-Stokes code

NASA Technical Reports Server (NTRS)

Towne, Charles E.; Bui, Trong T.; Cavicchi, Richard H.; Conley, Julianne M.; Molls, Frank B.; Schwab, John R.

1992-01-01

An effort is currently underway at NASA Lewis to develop two- and three-dimensional Navier-Stokes codes, called Proteus, for aerospace propulsion applications. The emphasis in the development of Proteus is not algorithm development or research on numerical methods, but rather the development of the code itself. The objective is to develop codes that are user-oriented, easily-modified, and well-documented. Well-proven, state-of-the-art solution algorithms are being used. Code readability, documentation (both internal and external), and validation are being emphasized. This paper is a status report on the Proteus development effort. The analysis and solution procedure are described briefly, and the various features in the code are summarized. The results from some of the validation cases that have been run are presented for both the two- and three-dimensional codes.

Implementation and impact of ICD-10 (Part II)

PubMed Central

Rahmathulla, Gazanfar; Deen, H. Gordon; Dokken, Judith A.; Pirris, Stephen M.; Pichelmann, Mark A.; Nottmeier, Eric W.; Reimer, Ronald; Wharen, Robert E.

2014-01-01

Background: The transition from the International Classification of Disease-9th clinical modification to the new ICD-10 was all set to occur on 1 October 2015. The American Medical Association has previously been successful in delaying the transition by over 10 years and has been able to further postpone its introduction to 2015. The new system will overcome many of the limitations present in the older version, thus paving the way to more accurate capture of clinical information. Methods: The benefits of the new ICD-10 system include improved quality of care, potential cost savings, reduction of unpaid claims, and improved tracking of healthcare data. The areas where challenges will be evident include planning and implementation, the cost to transition, a shortage of qualified coders, training and education of the healthcare workforce, and a loss of productivity when this occurs. The impacts include substantial costs to the healthcare system, but the projected long-term savings and benefits will be significant. Improved fraud detection, accurate data entry, ability to analyze cost benefits with procedures, and enhanced quality outcome measures are the most significant beneficial factors with this change. Results: The present Current Procedural Terminology and Healthcare Common Procedure Coding System code sets will be used for reporting ambulatory procedures in the same manner as they have been. ICD-10-PCS will replace ICD-9 procedure codes for inpatient hospital services. The ICD-10-CM will replace the clinical code sets. Our article will focus on the challenges to execution of an ICD change and strategies to minimize risk while transitioning to the new system. Conclusion: With the implementation deadline gradually approaching, spine surgery practices that include multidisciplinary health specialists have to anticipate and prepare for the ICD change in order to mitigate risk. Education and communication is the key to this process in spine practices. PMID:25184098

Observational Coding Systems of Parent-Child Interactions During Painful Procedures: A Systematic Review.

PubMed

Bai, Jinbing; Swanson, Kristen M; Santacroce, Sheila J

2018-01-01

Parent interactions with their child can influence the child's pain and distress during painful procedures. Reliable and valid interaction analysis systems (IASs) are valuable tools for capturing these interactions. The extent to which IASs are used in observational research of parent-child interactions is unknown in pediatric populations. To identify and evaluate studies that focus on assessing psychometric properties of initial iterations/publications of observational coding systems of parent-child interactions during painful procedures. To identify and evaluate studies that focus on assessing psychometric properties of initial iterations/publications of observational coding systems of parent-child interactions during painful procedures. Computerized databases searched included PubMed, CINAHL, PsycINFO, Health and Psychosocial Instruments, and Scopus. Timeframes covered from inception of the database to January 2017. Studies were included if they reported use or psychometrics of parent-child IASs. First assessment was whether the parent-child IASs were theory-based; next, using the Society of Pediatric Psychology Assessment Task Force criteria IASs were assigned to one of three categories: well-established, approaching well-established, or promising. A total of 795 studies were identified through computerized searches. Eighteen studies were ultimately determined to be eligible for inclusion in the review and 17 parent-child IASs were identified from these 18 studies. Among the 17 coding systems, 14 were suitable for use in children age 3 years or more; two were theory-based; and 11 included verbal and nonverbal parent behaviors that promoted either child coping or child distress. Four IASs were assessed as well-established; seven approached well-established; and six were promising. Findings indicate a need for the development of theory-based parent-child IASs that consider both verbal and nonverbal parent behaviors during painful procedures. Findings also suggest a need for further testing of those parent-child IASs deemed "approaching well-established" or "promising". © 2017 World Institute of Pain.

Guide for Developing and Evaluating an SFAR 36 Engineering Procedures Manual

DOT National Transportation Integrated Search

1997-05-22

This advisory circular (AC) sets forth an acceptable means, but not the only : means, for developing and evaluating a 14 Code of Federal Regulations (14CFR) : Special Federal Aviaton Regulation (SFAR)36 engineering procedures manual. As : such, the t...

78 FR 52785 - Meeting of the Judicial Conference Committee on Rules of Practice and Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-26

... Appellate Procedure. ACTION: Notice of Open Meeting. SUMMARY: The Advisory Committee on Rules of Appellate Procedure will hold a two-day meeting. The meeting will be open to public observation but not participation..., Secretary and Chief Rules Officer. [FR Doc. 2013-20670 Filed 8-23-13; 8:45 am] BILLING CODE 2210-55-P ...

77 FR 12078 - Meeting of the Judicial Conference Advisory Committee on Rules of Practice and Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-28

... Practice and Procedure. ACTION: Notice of open meeting. SUMMARY: The Committee on Rules of Practice and Procedure will hold a two-day meeting. The meeting will be open to public observation but not participation.... Robinson, Deputy Rules Officer and Counsel. [FR Doc. 2012-4650 Filed 2-27-12; 8:45 am] BILLING CODE 2210-55...

78 FR 53159 - Meeting of the Judicial Conference Committee on Rules of Practice and Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-28

... Criminal Procedure. ACTION: Notice of open meeting. SUMMARY: The Advisory Committee on Rules of Criminal Procedure will hold a one-day meeting. The meeting will be open to public observation but not participation.... Rose, Secretary and Chief Rules Officer . [FR Doc. 2013-20980 Filed 8-27-13; 8:45 am] BILLING CODE 2210...

77 FR 12077 - Meeting of the Judicial Conference Advisory Committee on Rules of Appellate Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-28

... Rules of Appellate Procedure. ACTION: Notice of open meeting. SUMMARY: The Advisory Committee on Rules of Appellate Procedure will hold a two-day meeting. The meeting will be open to public observation.... Robinson, Deputy Rules Officer and Counsel. [FR Doc. 2012-4636 Filed 2-27-12; 8:45 am] BILLING CODE 2210-55...

78 FR 21977 - Meeting of the Judicial Conference Committee on Rules of Practice and Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-12

... Procedure. ACTION: Notice of Open Meeting. SUMMARY: The Committee on Rules of Practice and Procedure will hold a two-day meeting. The meeting will be open to public observation but not participation. DATE.... Rose, Rules Committee Secretary. [FR Doc. 2013-08535 Filed 4-11-13; 8:45 am] BILLING CODE 2210-55-P ...

77 FR 12077 - Meeting of The Judicial Conference Advisory Committee on Rules of Civil Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-28

... Civil Procedure. ACTION: Notice of open meeting. SUMMARY: The Advisory Committee on Rules of Civil Procedure will hold a two-day meeting. The meeting will be open to public observation but not participation.... Robinson, Deputy Rules Officer and Counsel. [FR Doc. 2012-4630 Filed 2-27-12; 8:45 am] BILLING CODE 2210-55...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CALCULATING INGESTION EXPOSURE ESTIMATING INGESTION EXPOSURE, THE INDIRECT METHOD OF EXPOSURE ESTIMATION (IIT-A-7.0)

EPA Science Inventory

The purpose of this SOP is to describe the procedures undertaken for calculating ingestion exposure using the indirect method of exposure estimation. This SOP uses This SOP uses data that have been properly coded and certified with appropriate QA/QC procedures by the University ...

The Spanish national health care-associated infection surveillance network (INCLIMECC): data summary January 1997 through December 2006 adapted to the new National Healthcare Safety Network Procedure-associated module codes.

PubMed

Pérez, Cristina Díaz-Agero; Rodela, Ana Robustillo; Monge Jodrá, Vincente

2009-12-01

In 1997, a national standardized surveillance system (designated INCLIMECC [Indicadores Clínicos de Mejora Continua de la Calidad]) was established in Spain for health care-associated infection (HAI) in surgery patients, based on the National Nosocomial Infection Surveillance (NNIS) system. In 2005, in its procedure-associated module, the National Healthcare Safety Network (NHSN) inherited the NNIS program for surveillance of HAI in surgery patients and reorganized all surgical procedures. INCLIMECC actively monitors all patients referred to the surgical ward of each participating hospital. We present a summary of the data collected from January 1997 to December 2006 adapted to the new NHSN procedures. Surgical site infection (SSI) rates are provided by operative procedure and NNIS risk index category. Further quality indicators reported are surgical complications, length of stay, antimicrobial prophylaxis, mortality, readmission because of infection or other complication, and revision surgery. Because the ICD-9-CM surgery procedure code is included in each patient's record, we were able to reorganize our database avoiding the loss of extensive information, as has occurred with other systems.

New CPT codes: hospital, consultation, emergency and nursing facility services.

PubMed

Zuber, T J; Henley, D E

1992-03-01

New evaluation and management codes were created by the Current Procedural Terminology (CPT) Editorial Panel to ensure more accurate and consistent reporting of physician services. The new hospital inpatient codes describe three levels of service for both initial and subsequent care. Critical care services are reported according to the total time spent by a physician providing constant attention to a critically ill patient. Consultation codes are divided into four categories: office/outpatient, initial inpatient, follow-up inpatient and confirmatory. Emergency department services for both new and established patients are limited to five codes. In 1992, nursing facility services are described with either comprehensive-assessment codes or subsequent-care codes. Hospital discharge services may be reported in addition to the comprehensive nursing facility assessment. Since the 1992 CPT book will list only the new codes, and since all insurance carriers will not be using these codes in 1992, physicians are encouraged to keep their 1991 code books and contact their local insurance carriers to determine which codes will be used.

Performance analysis of the word synchronization properties of the outer code in a TDRSS decoder

NASA Technical Reports Server (NTRS)

Costello, D. J., Jr.; Lin, S.

1984-01-01

A self-synchronizing coding scheme for NASA's TDRSS satellite system is a concatenation of a (2,1,7) inner convolutional code with a (255,223) Reed-Solomon outer code. Both symbol and word synchronization are achieved without requiring that any additional symbols be transmitted. An important parameter which determines the performance of the word sync procedure is the ratio of the decoding failure probability to the undetected error probability. Ideally, the former should be as small as possible compared to the latter when the error correcting capability of the code is exceeded. A computer simulation of a (255,223) Reed-Solomon code as carried out. Results for decoding failure probability and for undetected error probability are tabulated and compared.

10 CFR 434.605 - Standard Calculation Procedure.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Standard Calculation Procedure. 434.605 Section 434.605 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Compliance Alternative § 434.605 Standard Calculation...

10 CFR 434.605 - Standard Calculation Procedure.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 3 2013-01-01 2013-01-01 false Standard Calculation Procedure. 434.605 Section 434.605 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Compliance Alternative § 434.605 Standard Calculation...

10 CFR 434.503 - Prototype building procedure.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 3 2011-01-01 2011-01-01 false Prototype building procedure. 434.503 Section 434.503 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Cost Compliance Alternative § 434.503 Prototype...

10 CFR 434.510 - Standard calculation procedure.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 3 2011-01-01 2011-01-01 false Standard calculation procedure. 434.510 Section 434.510 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Cost Compliance Alternative § 434.510 Standard...

10 CFR 434.605 - Standard Calculation Procedure.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 3 2014-01-01 2014-01-01 false Standard Calculation Procedure. 434.605 Section 434.605 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Compliance Alternative § 434.605 Standard Calculation...

10 CFR 434.503 - Prototype building procedure.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 3 2014-01-01 2014-01-01 false Prototype building procedure. 434.503 Section 434.503 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Cost Compliance Alternative § 434.503 Prototype...

10 CFR 434.605 - Standard Calculation Procedure.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 3 2011-01-01 2011-01-01 false Standard Calculation Procedure. 434.605 Section 434.605 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Compliance Alternative § 434.605 Standard Calculation...

10 CFR 434.510 - Standard calculation procedure.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 3 2012-01-01 2012-01-01 false Standard calculation procedure. 434.510 Section 434.510 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Cost Compliance Alternative § 434.510 Standard...

10 CFR 434.605 - Standard Calculation Procedure.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 3 2012-01-01 2012-01-01 false Standard Calculation Procedure. 434.605 Section 434.605 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Compliance Alternative § 434.605 Standard Calculation...

10 CFR 434.503 - Prototype building procedure.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 3 2012-01-01 2012-01-01 false Prototype building procedure. 434.503 Section 434.503 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Cost Compliance Alternative § 434.503 Prototype...

10 CFR 434.503 - Prototype building procedure.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 3 2013-01-01 2013-01-01 false Prototype building procedure. 434.503 Section 434.503 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Cost Compliance Alternative § 434.503 Prototype...

10 CFR 434.510 - Standard calculation procedure.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 3 2014-01-01 2014-01-01 false Standard calculation procedure. 434.510 Section 434.510 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Cost Compliance Alternative § 434.510 Standard...

Design of Instrument Approach Procedure Charts Comprehension Speed of Missed Approach Instructions Coded in Text or Icons

DOT National Transportation Integrated Search

1992-02-01

Instrument approach procedure (IAP) charts are often cluttered and confusing. The quantified effects of chart design : changes on information transfer are needed by chart manufacturers to make changes uhich will enhance information transfer : and hum...

28 CFR 2.13 - Initial hearing; procedure.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Initial hearing; procedure. 2.13 Section 2.13 Judicial Administration DEPARTMENT OF JUSTICE PAROLE, RELEASE, SUPERVISION AND RECOMMITMENT OF PRISONERS, YOUTH OFFENDERS, AND JUVENILE DELINQUENTS United States Code Prisoners and Parolees § 2.13...

28 CFR 2.13 - Initial hearing; procedure.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Initial hearing; procedure. 2.13 Section 2.13 Judicial Administration DEPARTMENT OF JUSTICE PAROLE, RELEASE, SUPERVISION AND RECOMMITMENT OF PRISONERS, YOUTH OFFENDERS, AND JUVENILE DELINQUENTS United States Code Prisoners and Parolees § 2.13...

PRT Impact Study Pre-PRT Phase : Volume 2. Data Collection Procedure and Coding Manual.

DOT National Transportation Integrated Search

1976-03-01

The report describes the procedures utilized for collection of data on transportation demand and supply prior to the revenue operation of the Personal Rapid Transit (PRT) System in Morgantown, West Virginia. Most of the report is devoted to describin...

10 CFR 434.510 - Standard calculation procedure.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Standard calculation procedure. 434.510 Section 434.510 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Cost Compliance Alternative § 434.510 Standard...

10 CFR 434.503 - Prototype building procedure.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Prototype building procedure. 434.503 Section 434.503 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Cost Compliance Alternative § 434.503 Prototype...

Recommendations for the classification of HIV associated neuromanifestations in the German DRG system.

PubMed

Evers, Stefan; Fiori, W; Brockmeyer, N; Arendt, G; Husstedt, I-W

2005-09-12

HIV associated neuromanifestations are of growing importance in the in-patient treatment of HIV infected patients. In Germany, all in-patients have to be coded according to the ICD-10 classification and the German DRG-system. We present recommendations how to code the different primary and secondary neuromanifestations of HIV infection. These recommendations are based on the commentary of the German DRG procedures and are aimed to establish uniform coding of neuromanifestations.

Nonperturbative methods in HZE ion transport

NASA Technical Reports Server (NTRS)

Wilson, John W.; Badavi, Francis F.; Costen, Robert C.; Shinn, Judy L.

1993-01-01

A nonperturbative analytic solution of the high charge and energy (HZE) Green's function is used to implement a computer code for laboratory ion beam transport. The code is established to operate on the Langley Research Center nuclear fragmentation model used in engineering applications. Computational procedures are established to generate linear energy transfer (LET) distributions for a specified ion beam and target for comparison with experimental measurements. The code is highly efficient and compares well with the perturbation approximations.

Since surgery isn't getting any easier, why is reimbursement going down? An update from the SGO taskforce on coding and reimbursement.

PubMed

Uppal, Shitanshu; Shahin, Mark S; Rathbun, Jill A; Goff, Barbara A

2017-02-01

In 2015, there was an 18% reduction in the Relative Value Units (RVUs) that the Center for Medicare and Medicaid Services (CMS) assigned to the Current Procedural Terminology (CPT) code 58571 (Laparoscopy, surgical, with total hysterectomy, for uterus 250g or less; with removal of tube(s) and/or ovary(s)→TLH+BSO). The other CPT codes for laparoscopic hysterectomy and laparoscopic supracervical hysterectomy (58541-58544 and 58570-58573) lost between 12 and 23% of their assigned RVUs. In 2016, the laparoscopic lymph node dissection codes 38570 (Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple), 38571 (Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy), and 38572 (Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), single or multiple) lost between 5.5 and 16.3% of their RVU's. The goals of this article from the Society of Gynecologic Oncology (SGO) Task force on Coding and Reimbursement are 1) to inform the SGO members on why CMS identified these codes as a part of their misvalued services screening program and then finalized a reduction in their payment levels; and 2) outline the role individual providers have in CMS' methodology used to determine the reimbursement of a surgical procedure. Copyright © 2016 Elsevier Inc. All rights reserved.

Trends in the surgical management of stress urinary incontinence among female Medicare beneficiaries, 2002-2007.

PubMed

Rogo-Gupta, Lisa; Litwin, Mark S; Saigal, Christopher S; Anger, Jennifer T

2013-07-01

To describe trends in the surgical management of female stress urinary incontinence (SUI) in the United States from 2002 to 2007. As part of the Urologic Diseases of America Project, we analyzed data from a 5% national random sample of female Medicare beneficiaries aged 65 and older. Data were obtained from the Centers for Medicare and Medicaid Services carrier and outpatient files from 2002 to 2007. Women who were diagnosed with urinary incontinence identified by the International Classification of Diseases, Ninth Edition (ICD-9) diagnosis codes and who underwent surgical management identified by Current Procedural Terminology, Fourth Edition (CPT-4) procedure codes were included in the analysis. Trends were analyzed over the 6-year period. Unweighted procedure counts were multiplied by 20 to estimate the rate among all female Medicare beneficiaries. The total number of surgical procedures remained stable during the study period, from 49,340 in 2002 to 49,900 in 2007. Slings were the most common procedure across all years, which increased from 25,840 procedures in 2002 to 33,880 procedures in 2007. Injectable bulking agents were the second most common procedure, which accounted for 14,100 procedures in 2002 but decreased to 11,320 in 2007. Procedures performed in ambulatory surgery centers and physician offices increased, although those performed in inpatient settings declined. Hospital outpatient procedures remained stable. The surgical management of women with SUI shifted toward a dominance of procedures performed in ambulatory surgery centers from 2002 to 2007, although the overall number of procedures remained stable. Slings remained the dominant surgical procedure, followed by injectable bulking agents, both of which are easily performed in outpatient settings. Copyright © 2013 Elsevier Inc. All rights reserved.

[Activities of System Studies and Simulation, Inc.

NASA Technical Reports Server (NTRS)

2004-01-01

Contents include the following: 1. Launch Vehicle Interface Work Performed: a. S3 provided to KSC the new launch inclination targets needed for the April '04 launch date. 2. Prelaunch operations work performed: a. S3 updated the staffing plan for MSFC on-console personnel\\during the Final Countdown prior to launch. 3. Software Assessment Work Performed: a. S3 evaluated and recommended approval for Program Control Board (PCB) proposed change 649 for ground software changes, as well as change 650 and 650A for Stored Program Commands. 4. Education and Public Outreach Work Performed: a. S3 continues to coordinate the effort for the design and fabrication of scale models of the GP-3 for use at the launch site, education forums, and management/technical briefings. S3 also prepared a Change Request for additional funds needed for fabrication of additional scale models. S3 drafted the planned uses of these models, including the possibility of participation in the Boston, MA showings of the traveling Einstein Exhibit. 5. Program Management Support Work Performed: a. S3 prepared the input for and closed three MSFC Centerwide Action Item Tracking Systems (CAITS) actions during this period.

Design and implementation of a pilot orientation program for new NASA engineering employees

NASA Technical Reports Server (NTRS)

Graham, Ronald E.; Furnas, Randall B.; Babula, Maria

1993-01-01

This paper describes the design and field testing of an orientation program for new employees of NASA Lewis Research Center's Engineering Directorate. A group of new employees designed the program using a series of TQM analysis techniques. The program objectives were: provide consistent treatment for new employees; assist management and clerical staff with their responsibility for orientation; introduce the employee to as many facets of the organization as possible; allow the employee to feel like a member of the organization as early as possible; maximize the use of existing services; and use up-to-date information. The major aspects of the program included: training of management and clerical staff; lab tours and briefings describing the organization; shepherding, using senior employees as shepherds; a handbook of information about the center and the directorate; a package of information about northeast Ohio; and social activities involving the new employees and shepherds. The program was tested on a pilot group of six new employees over a four month period and was considered to be highly successful by both the employees and management. Aspects of the program have subsequently been adopted for center-wide use.

A compendium of controlled diffusion blades generated by an automated inverse design procedure

NASA Technical Reports Server (NTRS)

Sanz, Jose M.

1989-01-01

A set of sample cases was produced to test an automated design procedure developed at the NASA Lewis Research Center for the design of controlled diffusion blades. The range of application of the automated design procedure is documented. The results presented include characteristic compressor and turbine blade sections produced with the automated design code as well as various other airfoils produced with the base design method prior to the incorporation of the automated procedure.

Quasi-2D Unsteady Flow Solver Module for Rocket Engine and Propulsion System Simulations

DTIC Science & Technology

2006-06-14

Conference, Sacramento, CA, 9-12 July 2006. 14. ABSTRACT A new quasi-two-dimensional procedure is presented for the transient solution of real-fluid flows...solution procedures is being developed in parallel to provide verification test cases. The solution procedure for both codes is coupled with a state-of...Davis, Davis, CA, 95616 A new quasi-two-dimensional procedure is presented for the transient solution of real- fluid flows in lines and volumes

Iraq’s Debt Relief: Procedure and Potential Implications for International Debt Relief

DTIC Science & Technology

2008-10-02

Order Code RL33376 Iraq’s Debt Relief: Procedure and Potential Implications for International Debt Relief Updated October 2, 2008 Martin A. Weiss...4. TITLE AND SUBTITLE Iraq?s Debt Relief: Procedure and Potential Implications for International Debt Relief 5a. CONTRACT NUMBER 5b. GRANT NUMBER...b. ABSTRACT unclassified c. THIS PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 Iraq’s Debt Relief: Procedure

Enhanced Multiobjective Optimization Technique for Comprehensive Aerospace Design. Part A

NASA Technical Reports Server (NTRS)

Chattopadhyay, Aditi; Rajadas, John N.

1997-01-01

A multidisciplinary design optimization procedure which couples formal multiobjectives based techniques and complex analysis procedures (such as computational fluid dynamics (CFD) codes) developed. The procedure has been demonstrated on a specific high speed flow application involving aerodynamics and acoustics (sonic boom minimization). In order to account for multiple design objectives arising from complex performance requirements, multiobjective formulation techniques are used to formulate the optimization problem. Techniques to enhance the existing Kreisselmeier-Steinhauser (K-S) function multiobjective formulation approach have been developed. The K-S function procedure used in the proposed work transforms a constrained multiple objective functions problem into an unconstrained problem which then is solved using the Broyden-Fletcher-Goldfarb-Shanno (BFGS) algorithm. Weight factors are introduced during the transformation process to each objective function. This enhanced procedure will provide the designer the capability to emphasize specific design objectives during the optimization process. The demonstration of the procedure utilizes a computational Fluid dynamics (CFD) code which solves the three-dimensional parabolized Navier-Stokes (PNS) equations for the flow field along with an appropriate sonic boom evaluation procedure thus introducing both aerodynamic performance as well as sonic boom as the design objectives to be optimized simultaneously. Sensitivity analysis is performed using a discrete differentiation approach. An approximation technique has been used within the optimizer to improve the overall computational efficiency of the procedure in order to make it suitable for design applications in an industrial setting.

Improvements to the fastex flutter analysis computer code

NASA Technical Reports Server (NTRS)

Taylor, Ronald F.

1987-01-01

Modifications to the FASTEX flutter analysis computer code (UDFASTEX) are described. The objectives were to increase the problem size capacity of FASTEX, reduce run times by modification of the modal interpolation procedure, and to add new user features. All modifications to the program are operable on the VAX 11/700 series computers under the VAX operating system. Interfaces were provided to aid in the inclusion of alternate aerodynamic and flutter eigenvalue calculations. Plots can be made of the flutter velocity, display and frequency data. A preliminary capability was also developed to plot contours of unsteady pressure amplitude and phase. The relevant equations of motion, modal interpolation procedures, and control system considerations are described and software developments are summarized. Additional information documenting input instructions, procedures, and details of the plate spline algorithm is found in the appendices.

Automation of the guiding center expansion

NASA Astrophysics Data System (ADS)

Burby, J. W.; Squire, J.; Qin, H.

2013-07-01

We report on the use of the recently developed Mathematica package VEST (Vector Einstein Summation Tools) to automatically derive the guiding center transformation. Our Mathematica code employs a recursive procedure to derive the transformation order-by-order. This procedure has several novel features. (1) It is designed to allow the user to easily explore the guiding center transformation's numerous non-unique forms or representations. (2) The procedure proceeds entirely in cartesian position and velocity coordinates, thereby producing manifestly gyrogauge invariant results; the commonly used perpendicular unit vector fields e1,e2 are never even introduced. (3) It is easy to apply in the derivation of higher-order contributions to the guiding center transformation without fear of human error. Our code therefore stands as a useful tool for exploring subtle issues related to the physics of toroidal momentum conservation in tokamaks.

Automation of The Guiding Center Expansion

DOE Office of Scientific and Technical Information (OSTI.GOV)

J. W. Burby, J. Squire and H. Qin

2013-03-19

We report on the use of the recently-developed Mathematica package VEST (Vector Einstein Summation Tools) to automatically derive the guiding center transformation. Our Mathematica code employs a recursive procedure to derive the transformation order-by-order. This procedure has several novel features. (1) It is designed to allow the user to easily explore the guiding center transformation's numerous nonunique forms or representations. (2) The procedure proceeds entirely in cartesian position and velocity coordinates, thereby producing manifestly gyrogauge invariant results; the commonly-used perpendicular unit vector fields e1, e2 are never even introduced. (3) It is easy to apply in the derivation of higher-ordermore » contributions to the guiding center transformation without fear of human error. Our code therefore stands as a useful tool for exploring subtle issues related to the physics of toroidal momentum conservation in tokamaks« less

26 CFR 51.4T - Information provided by the agencies (temporary).

Code of Federal Regulations, 2013 CFR

2013-04-01

... sales price (ASP) for each Healthcare Common Procedure Coding System (HCPCS) code for the sales year...IdentifiableDataFiles/03_PartBNationalSummaryDataFile.asp to obtain the number of allowed billing units per... respective NDCs) manufactured by a single entity, CMS will multiply the annual weighted ASP by the total...

26 CFR 51.4T - Information provided by the agencies (temporary).

Code of Federal Regulations, 2014 CFR

2014-04-01

... sales price (ASP) for each Healthcare Common Procedure Coding System (HCPCS) code for the sales year...IdentifiableDataFiles/03_PartBNationalSummaryDataFile.asp to obtain the number of allowed billing units per... respective NDCs) manufactured by a single entity, CMS will multiply the annual weighted ASP by the total...

26 CFR 51.4T - Information provided by the agencies (temporary).

Code of Federal Regulations, 2012 CFR

2012-04-01

... sales price (ASP) for each Healthcare Common Procedure Coding System (HCPCS) code for the sales year...IdentifiableDataFiles/03_PartBNationalSummaryDataFile.asp to obtain the number of allowed billing units per... respective NDCs) manufactured by a single entity, CMS will multiply the annual weighted ASP by the total...

27 CFR 53.97 - Constructive sale price; affiliated corporations.

Code of Federal Regulations, 2011 CFR

2011-04-01

...; affiliated corporations. 53.97 Section 53.97 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX...; affiliated corporations. (a) In general. Sections 4216(b) (3) and (4) of the Code establish procedures for determining a constructive sale price under section 4216(b)(1)(C) of the Code for sales between corporations...

27 CFR 53.97 - Constructive sale price; affiliated corporations.

Code of Federal Regulations, 2012 CFR

2012-04-01

...; affiliated corporations. 53.97 Section 53.97 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX...; affiliated corporations. (a) In general. Sections 4216(b) (3) and (4) of the Code establish procedures for determining a constructive sale price under section 4216(b)(1)(C) of the Code for sales between corporations...

27 CFR 53.97 - Constructive sale price; affiliated corporations.

Code of Federal Regulations, 2013 CFR

2013-04-01

...; affiliated corporations. 53.97 Section 53.97 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX...; affiliated corporations. (a) In general. Sections 4216(b) (3) and (4) of the Code establish procedures for determining a constructive sale price under section 4216(b)(1)(C) of the Code for sales between corporations...

27 CFR 53.97 - Constructive sale price; affiliated corporations.

Code of Federal Regulations, 2014 CFR

2014-04-01

...; affiliated corporations. 53.97 Section 53.97 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX...; affiliated corporations. (a) In general. Sections 4216(b) (3) and (4) of the Code establish procedures for determining a constructive sale price under section 4216(b)(1)(C) of the Code for sales between corporations...

Turbulence modeling

NASA Technical Reports Server (NTRS)

Bardina, Jorge E.

1995-01-01

The objective of this work is to develop, verify, and incorporate the baseline two-equation turbulence models which account for the effects of compressibility into the three-dimensional Reynolds averaged Navier-Stokes (RANS) code and to provide documented descriptions of the models and their numerical procedures so that they can be implemented into 3-D CFD codes for engineering applications.

A Public-Use, Full-Screen Interface for SPIRES Databases.

ERIC Educational Resources Information Center

Kriz, Harry M.

This paper describes the techniques for implementing a full-screen, custom SPIRES interface for a public-use library database. The database-independent protocol that controls the system is described in detail. Source code for an entire working application using this interface is included. The protocol, with less than 170 lines of procedural code,…

CTEPP STANDARD OPERATING PROCEDURE FOR MAINTAINING AND RECORDING ELECTRONIC CHAIN-OF-CUSTODY (SOP-4.11)

EPA Science Inventory

The method for maintaining and recording electronic Chain-of-Custody (CoC) Records for CTEPP samples is summarized in this SOP. The CoC Records that will be logged electronically include the creation of a sample's identification code, bar code labels, and hard-copy CoC document...

Coding the Composing Process: A Guide for Teachers and Researchers.

ERIC Educational Resources Information Center

Perl, Sondra

Designed for teachers and researchers interested in the study of the composing process, this guide introduces a method of analysis that can be applied to data from a range of different cases. Specifically, the guide offers a simple, direct coding scheme for describing the movements occurring during composing that involves four procedures: teaching…

Medical Surveillance Monthly Report (MSMR). Volume 18, Number 12, December 2011

DTIC Science & Technology

2011-12-01

pregnancy complications were “other specifi ed complications of preg- nancy” (code 646.8, which includes “fatigue during pregnancy” and “ herpes ...bleeding disorders 623.8, 626.5, 626.6,626.8, 626.9 Pain associated with female genital organs 625.0, 625.3, 625.5, 625.9 Inpatient procedure codes

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CODING: FOLLOW UP QUESTIONNAIRE (UA-D-11.0)

EPA Science Inventory

The purpose of this SOP is to define the coding strategy for the Follow Up Questionnaire. This questionnaire was developed for use in the Arizona NHEXAS project and the "Border" study. Household and individual follow-up data were combined in a single Follow-up Questionnaire data...

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR CODING: FIELD FORMS (UA-D-37.0)

EPA Science Inventory

The purpose of this SOP is to define the coding strategy for selected field forms. Forms addressed here will be scanned into databases. Databases are created because the forms contain critical values needed to calculate pollutant concentrations. Other forms not addressed by th...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CODING: BASELINE QUESTIONNAIRE (HOUSEHOLD) (UA-D-7.0)

EPA Science Inventory

The purpose of this SOP is to define the coding strategy for the Baseline Questionnaire. This questionnaire was developed for use in the Arizona NHEXAS project and the "Border" study. Household and individual data were combined in a single Baseline Questionnaire data file. Key...

78 FR 31560 - Medicare Program; Public Meeting in Calendar Year 2013 for New Clinical Laboratory Test Payment...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-24

... announces a public meeting to receive comments and recommendations (including accompanying data on which recommendations are based) from the public on the appropriate basis for establishing payment amounts for new or substantially revised Healthcare Common Procedure Coding System (HCPCS) codes being considered for Medicare...

78 FR 72576 - Criteria for a Catastrophically Disabled Determination for Purposes of Enrollment

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-03

... Procedural Terminology (CPT[supreg]) codes. The revisions ensure that the regulation is not out of date when... trademark of the American Medical Association. CPT codes and descriptions are copyrighted by the American Medical Association. All rights reserved.) This approach will soon be outdated; the ICD-9-CM and CPT...

75 FR 78246 - Medicare Program; Re-Chartering of the Advisory Panel on Ambulatory Payment Classification (APC...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-15

... Administrator among the fields of hospital payment systems; hospital medical care delivery systems; provider billing and accounting systems; APC groups; Current Procedural Terminology codes; HCPCS codes; the use of, and payment for, drugs, medical devices, and other services in the outpatient setting; and other forms...

76 FR 76205 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing of Proposed Rule Change Relating...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-06

... relating to codes of ethics. This Rule requires investment advisers to adopt a code of ethics that reflects... securities laws. Accordingly, procedures designed to prevent the communication and misuse of non-public... securities of large, medium and small capitalization companies across the globe including developed countries...

23 CFR 650.315 - Inventory.

Code of Federal Regulations, 2010 CFR

2010-04-01

... for collection by the FHWA as requested. A tabulation of this data is contained in the SI&A sheet distributed by the FHWA as part of the “Recording and Coding Guide for the Structure Inventory and Appraisal... version. Report the data using FHWA established procedures as outlined in the “Recording and Coding Guide...

A Partial Least Squares Based Procedure for Upstream Sequence Classification in Prokaryotes.

PubMed

Mehmood, Tahir; Bohlin, Jon; Snipen, Lars

2015-01-01

The upstream region of coding genes is important for several reasons, for instance locating transcription factor, binding sites, and start site initiation in genomic DNA. Motivated by a recently conducted study, where multivariate approach was successfully applied to coding sequence modeling, we have introduced a partial least squares (PLS) based procedure for the classification of true upstream prokaryotic sequence from background upstream sequence. The upstream sequences of conserved coding genes over genomes were considered in analysis, where conserved coding genes were found by using pan-genomics concept for each considered prokaryotic species. PLS uses position specific scoring matrix (PSSM) to study the characteristics of upstream region. Results obtained by PLS based method were compared with Gini importance of random forest (RF) and support vector machine (SVM), which is much used method for sequence classification. The upstream sequence classification performance was evaluated by using cross validation, and suggested approach identifies prokaryotic upstream region significantly better to RF (p-value < 0.01) and SVM (p-value < 0.01). Further, the proposed method also produced results that concurred with known biological characteristics of the upstream region.

Neural network decoder for quantum error correcting codes

NASA Astrophysics Data System (ADS)

Krastanov, Stefan; Jiang, Liang

Artificial neural networks form a family of extremely powerful - albeit still poorly understood - tools used in anything from image and sound recognition through text generation to, in our case, decoding. We present a straightforward Recurrent Neural Network architecture capable of deducing the correcting procedure for a quantum error-correcting code from a set of repeated stabilizer measurements. We discuss the fault-tolerance of our scheme and the cost of training the neural network for a system of a realistic size. Such decoders are especially interesting when applied to codes, like the quantum LDPC codes, that lack known efficient decoding schemes.

Secret information reconciliation based on punctured low-density parity-check codes for continuous-variable quantum key distribution

NASA Astrophysics Data System (ADS)

Jiang, Xue-Qin; Huang, Peng; Huang, Duan; Lin, Dakai; Zeng, Guihua

2017-02-01

Achieving information theoretic security with practical complexity is of great interest to continuous-variable quantum key distribution in the postprocessing procedure. In this paper, we propose a reconciliation scheme based on the punctured low-density parity-check (LDPC) codes. Compared to the well-known multidimensional reconciliation scheme, the present scheme has lower time complexity. Especially when the chosen punctured LDPC code achieves the Shannon capacity, the proposed reconciliation scheme can remove the information that has been leaked to an eavesdropper in the quantum transmission phase. Therefore, there is no information leaked to the eavesdropper after the reconciliation stage. This indicates that the privacy amplification algorithm of the postprocessing procedure is no more needed after the reconciliation process. These features lead to a higher secret key rate, optimal performance, and availability for the involved quantum key distribution scheme.

Input Files and Procedures for Analysis of SMA Hybrid Composite Beams in MSC.Nastran and ABAQUS

NASA Technical Reports Server (NTRS)

Turner, Travis L.; Patel, Hemant D.

2005-01-01

A thermoelastic constitutive model for shape memory alloys (SMAs) and SMA hybrid composites (SMAHCs) was recently implemented in the commercial codes MSC.Nastran and ABAQUS. The model is implemented and supported within the core of the commercial codes, so no user subroutines or external calculations are necessary. The model and resulting structural analysis has been previously demonstrated and experimentally verified for thermoelastic, vibration and acoustic, and structural shape control applications. The commercial implementations are described in related documents cited in the references, where various results are also shown that validate the commercial implementations relative to a research code. This paper is a companion to those documents in that it provides additional detail on the actual input files and solution procedures and serves as a repository for ASCII text versions of the input files necessary for duplication of the available results.

Computer code for the prediction of nozzle admittance

NASA Technical Reports Server (NTRS)

Nguyen, Thong V.

1988-01-01

A procedure which can accurately characterize injector designs for large thrust (0.5 to 1.5 million pounds), high pressure (500 to 3000 psia) LOX/hydrocarbon engines is currently under development. In this procedure, a rectangular cross-sectional combustion chamber is to be used to simulate the lower traverse frequency modes of the large scale chamber. The chamber will be sized so that the first width mode of the rectangular chamber corresponds to the first tangential mode of the full-scale chamber. Test data to be obtained from the rectangular chamber will be used to assess the full scale engine stability. This requires the development of combustion stability models for rectangular chambers. As part of the combustion stability model development, a computer code, NOAD based on existing theory was developed to calculate the nozzle admittances for both rectangular and axisymmetric nozzles. This code is detailed.

Performance analysis of a cascaded coding scheme with interleaved outer code

NASA Technical Reports Server (NTRS)

Lin, S.

1986-01-01

A cascaded coding scheme for a random error channel with a bit-error rate is analyzed. In this scheme, the inner code C sub 1 is an (n sub 1, m sub 1l) binary linear block code which is designed for simultaneous error correction and detection. The outer code C sub 2 is a linear block code with symbols from the Galois field GF (2 sup l) which is designed for correcting both symbol errors and erasures, and is interleaved with a degree m sub 1. A procedure for computing the probability of a correct decoding is presented and an upper bound on the probability of a decoding error is derived. The bound provides much better results than the previous bound for a cascaded coding scheme with an interleaved outer code. Example schemes with inner codes ranging from high rates to very low rates are evaluated. Several schemes provide extremely high reliability even for very high bit-error rates say 10 to the -1 to 10 to the -2 power.

Methodology for Evaluating Cost-effectiveness of Commercial Energy Code Changes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hart, Philip R.; Liu, Bing

This document lays out the U.S. Department of Energy’s (DOE’s) method for evaluating the cost-effectiveness of energy code proposals and editions. The evaluation is applied to provisions or editions of the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) Standard 90.1 and the International Energy Conservation Code (IECC). The method follows standard life-cycle cost (LCC) economic analysis procedures. Cost-effectiveness evaluation requires three steps: 1) evaluating the energy and energy cost savings of code changes, 2) evaluating the incremental and replacement costs related to the changes, and 3) determining the cost-effectiveness of energy code changes based on those costs andmore » savings over time.« less

The STAGS computer code

NASA Technical Reports Server (NTRS)

Almroth, B. O.; Brogan, F. A.

1978-01-01

Basic information about the computer code STAGS (Structural Analysis of General Shells) is presented to describe to potential users the scope of the code and the solution procedures that are incorporated. Primarily, STAGS is intended for analysis of shell structures, although it has been extended to more complex shell configurations through the inclusion of springs and beam elements. The formulation is based on a variational approach in combination with local two dimensional power series representations of the displacement components. The computer code includes options for analysis of linear or nonlinear static stress, stability, vibrations, and transient response. Material as well as geometric nonlinearities are included. A few examples of applications of the code are presented for further illustration of its scope.

Comparison of two- and three-dimensional flow computations with laser anemometer measurements in a transonic compressor rotor

NASA Technical Reports Server (NTRS)

Chima, R. V.; Strazisar, A. J.

1982-01-01

Two and three dimensional inviscid solutions for the flow in a transonic axial compressor rotor at design speed are compared with probe and laser anemometers measurements at near-stall and maximum-flow operating points. Experimental details of the laser anemometer system and computational details of the two dimensional axisymmetric code and three dimensional Euler code are described. Comparisons are made between relative Mach number and flow angle contours, shock location, and shock strength. A procedure for using an efficient axisymmetric code to generate downstream pressure input for computationally expensive Euler codes is discussed. A film supplement shows the calculations of the two operating points with the time-marching Euler code.

An integrated optimum design approach for high speed prop rotors

NASA Technical Reports Server (NTRS)

Chattopadhyay, Aditi; Mccarthy, Thomas R.

1995-01-01

The objective is to develop an optimization procedure for high-speed and civil tilt-rotors by coupling all of the necessary disciplines within a closed-loop optimization procedure. Both simplified and comprehensive analysis codes are used for the aerodynamic analyses. The structural properties are calculated using in-house developed algorithms for both isotropic and composite box beam sections. There are four major objectives of this study. (1) Aerodynamic optimization: The effects of blade aerodynamic characteristics on cruise and hover performance of prop-rotor aircraft are investigated using the classical blade element momentum approach with corrections for the high lift capability of rotors/propellers. (2) Coupled aerodynamic/structures optimization: A multilevel hybrid optimization technique is developed for the design of prop-rotor aircraft. The design problem is decomposed into a level for improved aerodynamics with continuous design variables and a level with discrete variables to investigate composite tailoring. The aerodynamic analysis is based on that developed in objective 1 and the structural analysis is performed using an in-house code which models a composite box beam. The results are compared to both a reference rotor and the optimum rotor found in the purely aerodynamic formulation. (3) Multipoint optimization: The multilevel optimization procedure of objective 2 is extended to a multipoint design problem. Hover, cruise, and take-off are the three flight conditions simultaneously maximized. (4) Coupled rotor/wing optimization: Using the comprehensive rotary wing code CAMRAD, an optimization procedure is developed for the coupled rotor/wing performance in high speed tilt-rotor aircraft. The developed procedure contains design variables which define the rotor and wing planforms.

Adaptive EAGLE dynamic solution adaptation and grid quality enhancement

NASA Technical Reports Server (NTRS)

Luong, Phu Vinh; Thompson, J. F.; Gatlin, B.; Mastin, C. W.; Kim, H. J.

1992-01-01

In the effort described here, the elliptic grid generation procedure in the EAGLE grid code was separated from the main code into a subroutine, and a new subroutine which evaluates several grid quality measures at each grid point was added. The elliptic grid routine can now be called, either by a computational fluid dynamics (CFD) code to generate a new adaptive grid based on flow variables and quality measures through multiple adaptation, or by the EAGLE main code to generate a grid based on quality measure variables through static adaptation. Arrays of flow variables can be read into the EAGLE grid code for use in static adaptation as well. These major changes in the EAGLE adaptive grid system make it easier to convert any CFD code that operates on a block-structured grid (or single-block grid) into a multiple adaptive code.

CAG12 - A CSCM based procedure for flow of an equilibrium chemically reacting gas

NASA Technical Reports Server (NTRS)

Green, M. J.; Davy, W. C.; Lombard, C. K.

1985-01-01

The Conservative Supra Characteristic Method (CSCM), an implicit upwind Navier-Stokes algorithm, is extended to the numerical simulation of flows in chemical equilibrium. The resulting computer code known as Chemistry and Gasdynamics Implicit - Version 2 (CAG12) is described. First-order accurate results are presented for inviscid and viscous Mach 20 flows of air past a hemisphere-cylinder. The solution procedure captures the bow shock in a chemically reacting gas, a technique that is needed for simulating high altitude, rarefied flows. In an initial effort to validate the code, the inviscid results are compared with published gasdynamic and chemistry solutions and satisfactorily agreement is obtained.

Evolving trends in sinus surgery: What is the impact of balloon sinus dilation?

PubMed

Svider, Peter F; Darlin, Spencer; Bobian, Michael; Sekhsaria, Vibhav; Harvey, Richard J; Gray, Stacey T; Baredes, Soly; Folbe, Adam J; Eloy, Jean Anderson

2018-06-01

Balloon dilation (BD) represents a minimally invasive alternative to endoscopic sinus surgery (ESS). Although BD was introduced in 2006, distinct Current Procedural Terminology (CPT) codes were not available until 2011, making prior analysis of population-based trends difficult. Our objectives were to evaluate these trends and compare any changes to the use of traditional ESS techniques. Geographic trends also were evaluated. Medicare Part B national datasets encompassing procedures from 2011 to 2015 were obtained. ESS CPT codes (frontal sinusotomy, maxillary antrostomy with/without tissue removal, sphenoidotomy) and BD codes were searched to determine temporal trends in their use. Additionally, state carriers were individually evaluated for geographic trends. National use of BD increased greater than five-fold (39,193 from 7,496 among Medicare patients), whereas the use of ESS increased by only 5.9%. This increase in BD was observed across all sites, including the sphenoid (7.0x), maxillary (5.1x), and frontal (4.7x) sinuses. In the most recent year for which data was available (2015), a significantly greater portion of sinus procedures in these sites utilized BD in the South (42.1%) compared to the Northeast (30.6%), West (29.5%), and Midwest (25.3%) regions (P < 0.0001). The performance of BD has increased markedly in recent years. Because the use of ESS codes remain stable, observed BD trends are unlikely to be due simply to greater familiarity with newer CPT coding. The reasons for the striking increase in BD popularity are speculative and beyond the scope of this analysis, but further study may be needed. NA. Laryngoscope, 128:1299-1303, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Accuracy of Administrative Codes for Distinguishing Positive Pressure Ventilation from High-Flow Nasal Cannula.

PubMed

Good, Ryan J; Leroue, Matthew K; Czaja, Angela S

2018-06-07

Noninvasive positive pressure ventilation (NIPPV) is increasingly used in critically ill pediatric patients, despite limited data on safety and efficacy. Administrative data may be a good resource for observational studies. Therefore, we sought to assess the performance of the International Classification of Diseases, Ninth Revision procedure code for NIPPV. Patients admitted to the PICU requiring NIPPV or heated high-flow nasal cannula (HHFNC) over the 11-month study period were identified from the Virtual PICU System database. The gold standard was manual review of the electronic health record to verify the use of NIPPV or HHFNC among the cohort. The presence or absence of a NIPPV procedure code was determined by using administrative data. Test characteristics with 95% confidence intervals (CIs) were generated, comparing administrative data with the gold standard. Among the cohort ( n = 562), the majority were younger than 5 years, and the most common primary diagnosis was bronchiolitis. Most (82%) required NIPPV, whereas 18% required only HHFNC. The NIPPV code had a sensitivity of 91.1% (95% CI: 88.2%-93.6%) and a specificity of 57.6% (95% CI: 47.2%-67.5%), with a positive likelihood ratio of 2.15 (95% CI: 1.70-2.71) and negative likelihood ratio of 0.15 (95% CI: 0.11-0.22). Among our critically ill pediatric cohort, NIPPV procedure codes had high sensitivity but only moderate specificity. On the basis of our study results, there is a risk of misclassification, specifically failure to identify children who require NIPPV, when using administrative data to study the use of NIPPV in this population. Copyright © 2018 by the American Academy of Pediatrics.

49 CFR 601.30 - Hearings.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 7 2014-10-01 2014-10-01 false Hearings. 601.30 Section 601.30 Transportation... TRANSPORTATION ORGANIZATION, FUNCTIONS, AND PROCEDURES Rulemaking Procedures § 601.30 Hearings. (a) Sections 556 and 557 of Title 5, United States Code, do not apply to hearings held under this part. Unless...

49 CFR 601.30 - Hearings.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 7 2012-10-01 2012-10-01 false Hearings. 601.30 Section 601.30 Transportation... TRANSPORTATION ORGANIZATION, FUNCTIONS, AND PROCEDURES Rulemaking Procedures § 601.30 Hearings. (a) Sections 556 and 557 of Title 5, United States Code, do not apply to hearings held under this part. Unless...

49 CFR 601.30 - Hearings.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 7 2013-10-01 2013-10-01 false Hearings. 601.30 Section 601.30 Transportation... TRANSPORTATION ORGANIZATION, FUNCTIONS, AND PROCEDURES Rulemaking Procedures § 601.30 Hearings. (a) Sections 556 and 557 of Title 5, United States Code, do not apply to hearings held under this part. Unless...

49 CFR 601.30 - Hearings.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Hearings. 601.30 Section 601.30 Transportation... TRANSPORTATION ORGANIZATION, FUNCTIONS, AND PROCEDURES Rulemaking Procedures § 601.30 Hearings. (a) Sections 556 and 557 of Title 5, United States Code, do not apply to hearings held under this part. Unless...

27 CFR 53.186 - Accounting procedures for like articles.

Code of Federal Regulations, 2014 CFR

2014-04-01

... like articles. 53.186 Section 53.186 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND... Accounting procedures for like articles. (a) Identification of manufacturer. In applying section 6416 of the Code and the regulations thereunder, a person who has purchased like articles from various...

27 CFR 53.186 - Accounting procedures for like articles.

Code of Federal Regulations, 2011 CFR

2011-04-01

... like articles. 53.186 Section 53.186 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND... Accounting procedures for like articles. (a) Identification of manufacturer. In applying section 6416 of the Code and the regulations thereunder, a person who has purchased like articles from various...

27 CFR 53.186 - Accounting procedures for like articles.

Code of Federal Regulations, 2013 CFR

2013-04-01

... like articles. 53.186 Section 53.186 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND... Accounting procedures for like articles. (a) Identification of manufacturer. In applying section 6416 of the Code and the regulations thereunder, a person who has purchased like articles from various...

12 CFR 313.40 - Scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE PROCEDURES FOR CORPORATE DEBT... arising under the Internal Revenue Code, the tariff laws of the United States or to any case where... any way questioning the amount or validity of a debt, in the manner specified by law or these agency...

27 CFR 53.186 - Accounting procedures for like articles.

Code of Federal Regulations, 2010 CFR

2010-04-01

... like articles. 53.186 Section 53.186 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND... Accounting procedures for like articles. (a) Identification of manufacturer. In applying section 6416 of the Code and the regulations thereunder, a person who has purchased like articles from various...

Estimating times of surgeries with two component procedures: comparison of the lognormal and normal models.

PubMed

Strum, David P; May, Jerrold H; Sampson, Allan R; Vargas, Luis G; Spangler, William E

2003-01-01

Variability inherent in the duration of surgical procedures complicates surgical scheduling. Modeling the duration and variability of surgeries might improve time estimates. Accurate time estimates are important operationally to improve utilization, reduce costs, and identify surgeries that might be considered outliers. Surgeries with multiple procedures are difficult to model because they are difficult to segment into homogenous groups and because they are performed less frequently than single-procedure surgeries. The authors studied, retrospectively, 10,740 surgeries each with exactly two CPTs and 46,322 surgical cases with only one CPT from a large teaching hospital to determine if the distribution of dual-procedure surgery times fit more closely a lognormal or a normal model. The authors tested model goodness of fit to their data using Shapiro-Wilk tests, studied factors affecting the variability of time estimates, and examined the impact of coding permutations (ordered combinations) on modeling. The Shapiro-Wilk tests indicated that the lognormal model is statistically superior to the normal model for modeling dual-procedure surgeries. Permutations of component codes did not appear to differ significantly with respect to total procedure time and surgical time. To improve individual models for infrequent dual-procedure surgeries, permutations may be reduced and estimates may be based on the longest component procedure and type of anesthesia. The authors recommend use of the lognormal model for estimating surgical times for surgeries with two component procedures. Their results help legitimize the use of log transforms to normalize surgical procedure times prior to hypothesis testing using linear statistical models. Multiple-procedure surgeries may be modeled using the longest (statistically most important) component procedure and type of anesthesia.

Endovascular repair vs open surgical repair of abdominal aortic aneurysms: comparative utilization trends from 2001 to 2006.

PubMed

Levin, David C; Rao, Vijay M; Parker, Laurence; Frangos, Andrea J; Sunshine, Jonathan H

2009-07-01

Within the past few years, endovascular aneurysm repair (EVAR) has come into use for the treatment of abdominal aortic aneurysms (AAAs). In many cases, EVAR has the potential to replace traditional open surgical repair (OSR), which is more invasive, risky, and expensive. The aim of this study was to determine to what extent EVAR is replacing OSR, whether the frequency of treatment is increasing with the advent of the less invasive approach, and which specialties are performing the procedures. The Medicare Part B data sets for 2001 through 2006 were studied. Procedure volume and utilization rates per 100,000 Medicare beneficiaries were determined for the 7 Current Procedural Terminology, fourth edition, procedure codes that describe EVAR and the 4 codes that describe OSR for AAA. Medicare's physician specialty codes were used to ascertain the specialties of the physician providers. A total of 31,965 OSRs for AAA were performed in Medicare beneficiaries in 2001, dropping to 15,665 by 2006 (-51%). In contrast, EVAR was carried out in 11,028 instances in 2001, increasing to 28,937 by 2006 (+162%). The utilization rate per 100,000 for OSR dropped from 90 to 42 (a rate decrease of 48) during the study period, while the rate for EVAR increased from 31 to 77 (a rate increase of 46). The combined utilization rate per 100,000 of the two types of interventions for AAA (EVAR and OSR) decreased from 121 in 2001 to 119 in 2006. In performing EVAR, procedure volume and market share in 2006 by specialty were 1) 22,003 procedures by surgeons, a 76% share; 2) 3,287 procedures by radiologists, an 11% share; 3) 1,915 procedures by cardiologists, a 7% share; and 4) 1,732 procedures by all other physicians, a 6% share. Treatment for AAA seems to be an example of the responsible use of new technology by physicians. The newer, less invasive, and less risky procedure (EVAR) is replacing the older and more invasive procedure (OSR) to a considerable degree. However, the overall combined utilization rate of both types of AAA treatment has remained stable in the Medicare population. There is thus no evidence to suggest that the introduction of the newer approach has led to the overtreatment of patients. Although radiologists do have a role in EVAR, surgeons strongly predominate.

Complications Following Common Inpatient Urological Procedures: Temporal Trend Analysis from 2000 to 2010.

PubMed

Meyer, Christian P; Hollis, Michael; Cole, Alexander P; Hanske, Julian; O'Leary, James; Gupta, Soham; Löppenberg, Björn; Zavaski, Mike E; Sun, Maxine; Sammon, Jesse D; Kibel, Adam S; Fisch, Margit; Chun, Felix K H; Trinh, Quoc-Dien

2016-04-01

Measuring procedure-specific complication-rate trends allows for benchmarking and improvement in quality of care but must be done in a standardized fashion. Using the Nationwide Inpatient Sample, we identified all instances of eight common inpatient urologic procedures performed in the United States between 2000 and 2010. This yielded 327218 cases including both oncologic and benign diseases. Complications were identified by International Classification of Diseases, Ninth Revision codes. Each complication was cross-referenced to the procedure code and graded according to the standardized Clavien system. The Mann-Whitney and chi-square were used to assess the statistical significance of medians and proportions, respectively. We assessed temporal variability in the rates of overall complications (Clavien grade 1-4), length of hospital stay, and in-hospital mortality using the estimated annual percent change (EAPC) linear regression methodology. We observed an overall reduction in length of stay (EAPC: -1.59; p<0.001), whereas mortality rates remained negligible and unchanged (EAPC: -0.32; p=0.83). Patient comorbidities increased significantly over the study period (EAPC: 2.09; p<0.001), as did the rates of complications. Procedure-specific trends showed a significant increase in complications for inpatient ureterorenoscopy (EAPC: 5.53; p<0.001), percutaneous nephrolithotomy (EAPC: 3.75; p<0.001), radical cystectomy (EAPC: 1.37; p<0.001), radical nephrectomy (EAPC: 1.35; p<0.001), and partial nephrectomy (EAPC: 1.22; p=0.006). Limitations include lack of postdischarge follow-up data, lack of pathologic characteristics, and inability to adjust for secular changes in administrative coding. In the context of urologic care in the United States, our findings suggest a shift toward more complex oncologic procedures in the inpatient setting, with same-day procedures most likely shifted to the outpatient setting. Consequently, complications have increased for the majority of examined procedures; however, no change in mortality was found. This report evaluated the trends of urologic procedures and their complications. A significant shift toward sicker patients and more complex procedures in the inpatient setting was found, but this did not result in higher mortality. These results are indicators of the high quality of care for urologic procedures in the inpatient setting. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Integrating advanced practice providers into medical critical care teams.

PubMed

McCarthy, Christine; O'Rourke, Nancy C; Madison, J Mark

2013-03-01

Because there is increasing demand for critical care providers in the United States, many medical ICUs for adults have begun to integrate nurse practitioners and physician assistants into their medical teams. Studies suggest that such advanced practice providers (APPs), when appropriately trained in acute care, can be highly effective in helping to deliver high-quality medical critical care and can be important elements of teams with multiple providers, including those with medical house staff. One aspect of building an integrated team is a practice model that features appropriate coding and billing of services by all providers. Therefore, it is important to understand an APP's scope of practice, when they are qualified for reimbursement, and how they may appropriately coordinate coding and billing with other team providers. In particular, understanding when and how to appropriately code for critical care services (Current Procedural Terminology [CPT] code 99291, critical care, evaluation and management of the critically ill or critically injured patient, first 30-74 min; CPT code 99292, critical care, each additional 30 min) and procedures is vital for creating a sustainable program. Because APPs will likely play a growing role in medical critical care units in the future, more studies are needed to compare different practice models and to determine the best way to deploy this talent in specific ICU settings.

[Orthopedic and trauma surgery in the German DRG System 2007].

PubMed

Franz, D; Kaufmann, M; Siebert, C H; Windolf, J; Roeder, N

2007-03-01

The German Diagnosis-Related Groups (DRG) System was further developed into its 2007 version. For orthopedic and trauma surgery, significant changes were made in terms of the coding of diagnoses and medical procedures, as well as in the DRG structure itself. The German Societies for Trauma Surgery and for Orthopedics and Orthopedic Surgery (Deutsch Gesellschaft für Unfallchirurgie, DGU; and Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie, DGOOC) once again cooperated constructively with the German DRG Institute InEK. Among other innovations, new International Classification of Diseases (ICD) codes for second-degree burns were implemented. Procedure codes for joint operations, endoprosthetic-surgery and spine surgery were restructured. Furthermore, a specific code for septic surgery was introduced in 2007. In addition, the DRG structure was improved. Case allocation of patients with more than one significant operation was established. Further DRG subdivisions were established according to the patients age and the Patient Clinical Complexity Level (PCCL). DRG developments for 2007 have improved appropriate case allocation, but once again increased the system's complexity. Clinicians need an ever growing amount of specific coding know-how. Still, further adjustments to the German DRG system are required to allow for a correct allocation of cases and funds.

Master standard data quantity food production code. Macro elements for synthesizing production labor time.

PubMed

Matthews, M E; Waldvogel, C F; Mahaffey, M J; Zemel, P C

1978-06-01

Preparation procedures of standardized quantity formulas were analyzed for similarities and differences in production activities, and three entrée classifications were developed, based on these activities. Two formulas from each classification were selected, preparation procedures were divided into elements of production, and the MSD Quantity Food Production Code was applied. Macro elements not included in the existing Code were simulated, coded, assigned associated Time Measurement Units, and added to the MSD Quantity Food Production Code. Repeated occurrence of similar elements within production methods indicated that macro elements could be synthesized for use within one or more entrée classifications. Basic elements were grouped, simulated, and macro elements were derived. Macro elements were applied in the simulated production of 100 portions of each entrée formula. Total production time for each formula and average production time for each entrée classification were calculated. Application of macro elements indicated that this method of predetermining production time was feasible and could be adapted by quantity foodservice managers as a decision technique used to evaluate menu mix, production personnel schedules, and allocation of equipment usage. These macro elements could serve as a basis for further development and refinement of other macro elements which could be applied to a variety of menu item formulas.

Committee Representation and Medicare Reimbursements-An Examination of the Resource-Based Relative Value Scale.

PubMed

Gao, Y Nina

2018-04-06

The Resource-Based Relative Value Scale Update Committee (RUC) submits recommended reimbursement values for physician work (wRVUs) under Medicare Part B. The RUC includes rotating representatives from medical specialties. To identify changes in physician reimbursements associated with RUC rotating seat representation. Relative Value Scale Update Committee members 1994-2013; Medicare Part B Relative Value Scale 1994-2013; Physician/Supplier Procedure Summary Master File 2007; Part B National Summary Data File 2000-2011. I match service and procedure codes to specialties using 2007 Medicare billing data. Subsequently, I model wRVUs as a function of RUC rotating committee representation and level of code specialization. An annual RUC rotating seat membership is associated with a statistically significant 3-5 percent increase in Medicare expenditures for codes billed to that specialty. For codes that are performed by a small number of physicians, the association between reimbursement and rotating subspecialty representation is positive, 0.177 (SE = 0.024). For codes that are performed by a large number of physicians, the association is negative, -0.183 (SE = 0.026). Rotating representation on the RUC is correlated with overall reimbursement rates. The resulting differential changes may exacerbate existing reimbursement discrepancies between generalist and specialist practitioners. © Health Research and Educational Trust.

Progressive fracture of fiber composites

NASA Technical Reports Server (NTRS)

Irvin, T. B.; Ginty, C. A.

1983-01-01

Refined models and procedures are described for determining progressive composite fracture in graphite/epoxy angleplied laminates. Lewis Research Center capabilities are utilized including the Real Time Ultrasonic C Scan (RUSCAN) experimental facility and the Composite Durability Structural Analysis (CODSTRAN) computer code. The CODSTRAN computer code is used to predict the fracture progression based on composite mechanics, finite element stress analysis, and fracture criteria modules. The RUSCAN facility, CODSTRAN computer code, and scanning electron microscope are used to determine durability and identify failure mechanisms in graphite/epoxy composites.

Dynamic Elasto-Plastic Response of Shells in an Acoustic Medium - Theoretical Development for the EPSA Code

DTIC Science & Technology

1978-07-01

TECHNOLOGY OFFICE OF NAVAL RESEARCH ARLINGTON* VA 22217 ATTN CODE 200 NAVAL. UNDERWATER SYSTEMS COMMAND NEWPORT. RI 02840 ATTN DRo AZRIEL HARARI/ 3 .b 311...ANAOST.FIT THEORETICAL DEVELOPMENT FOR THE EPSA CODE ~/ R/Atkatsh, M.P./Bieniek. -AM M.L.,/aron OFF NAVAL RESEARCH CONTRACT N/ 3 14-72-C-19~. TRACT 7_...the report, both procedures result In a marked increase in computational efficiency, parti- cularly for cases in which large systems are to be

Performance Analysis of IEEE 802.11g Waveform Transmitted Over a Fading Channel with Pulse-Noise Interference

DTIC Science & Technology

2006-06-01

called packet binary convolutional code (PBCC), was included as an option for performance at rate of either 5.5 or 11 Mpbs. The second offshoot...and the code rate is r k n= . A general convolutional encoder can be implemented with k shift-registers and n modulo-2 adders. Higher rates can be...derived from lower rate codes by employing “ puncturing .” Puncturing is a procedure for omitting some of the encoded bits in the transmitter (thus

Application of Finite Element Method to Analyze Inflatable Waveguide Structures

NASA Technical Reports Server (NTRS)

Deshpande, M. D.

1998-01-01

A Finite Element Method (FEM) is presented to determine propagation characteristics of deformed inflatable rectangular waveguide. Various deformations that might be present in an inflatable waveguide are analyzed using the FEM. The FEM procedure and the code developed here are so general that they can be used for any other deformations that are not considered in this report. The code is validated by applying the present code to rectangular waveguide without any deformations and comparing the numerical results with earlier published results.

Approximate Green's function methods for HZE transport in multilayered materials

NASA Technical Reports Server (NTRS)

Wilson, John W.; Badavi, Francis F.; Shinn, Judy L.; Costen, Robert C.

1993-01-01

A nonperturbative analytic solution of the high charge and energy (HZE) Green's function is used to implement a computer code for laboratory ion beam transport in multilayered materials. The code is established to operate on the Langley nuclear fragmentation model used in engineering applications. Computational procedures are established to generate linear energy transfer (LET) distributions for a specified ion beam and target for comparison with experimental measurements. The code was found to be highly efficient and compared well with the perturbation approximation.

Wall interference assessment and corrections

NASA Technical Reports Server (NTRS)

Newman, P. A.; Kemp, W. B., Jr.; Garriz, J. A.

1989-01-01

Wind tunnel wall interference assessment and correction (WIAC) concepts, applications, and typical results are discussed in terms of several nonlinear transonic codes and one panel method code developed for and being implemented at NASA-Langley. Contrasts between 2-D and 3-D transonic testing factors which affect WIAC procedures are illustrated using airfoil data from the 0.3 m Transonic Cryogenic Tunnel and Pathfinder 1 data from the National Transonic Facility. Initial results from the 3-D WIAC codes are encouraging; research on and implementation of WIAC concepts continue.

Dietary assessment of British police force employees: a description of diet record coding procedures and cross-sectional evaluation of dietary energy intake reporting (The Airwave Health Monitoring Study)

PubMed Central

Gibson, Rachel; Eriksen, Rebeca; Lamb, Kathryn; McMeel, Yvonne; Vergnaud, Anne-Claire; Spear, Jeanette; Aresu, Maria; Chan, Queenie; Elliott, Paul; Frost, Gary

2017-01-01

Objectives Dietary intake is a key aspect of occupational health. To capture the characteristics of dietary behaviour that is affected by occupational environment that may affect disease risk, a collection of prospective multiday dietary records is required. The aims of this paper are to: (1) collect multiday dietary data in the Airwave Health Monitoring Study, (2) describe the dietary coding procedures applied and (3) investigate the plausibility of dietary reporting in this occupational cohort. Design A dietary coding protocol for this large-scale study was developed to minimise coding error rate. Participants (n 4412) who completed 7-day food records were included for cross-sectional analyses. Energy intake (EI) misreporting was estimated using the Goldberg method. Multivariate logistic regression models were applied to determine participant characteristics associated with EI misreporting. Setting British police force employees enrolled (2007–2012) into the Airwave Health Monitoring Study. Results The mean code error rate per food diary was 3.7% (SD 3.2%). The strongest predictors of EI under-reporting were body mass index (BMI) and physical activity. Compared with participants with BMI<25 kg/m2, those with BMI>30 kg/m2 had increased odds of being classified as under-reporting EI (men OR 5.20 95% CI 3.92 to 6.89; women OR 2.66 95% CI 1.85 to 3.83). Men and women in the highest physical activity category compared with the lowest were also more likely to be classified as under-reporting (men OR 3.33 95% CI 2.46 to 4.50; women OR 4.34 95% CI 2.91 to 6.55). Conclusions A reproducible dietary record coding procedure has been developed to minimise coding error in complex 7-day diet diaries. The prevalence of EI under-reporting is comparable with existing national UK cohorts and, in agreement with previous studies, classification of under-reporting was biased towards specific subgroups of participants. PMID:28377391

Infornut® Process; improves accessibility to diagnosis and nutritional support for the malnourished hospitalized patient; impact on management indicators; two-year assessment.

PubMed

Villalobos Gámez, Juan Luis; González Pérez, Cristina; García-Almeida, José Manuel; Martínez Reina, Alfonso; Del Río Mata, José; Márquez Fernández, Efrén; Rioja Vázquez, Rosalía; Barranco Pérez, Joaquín; Enguix Armada, Alfredo; Rodríguez García, Luis Miguel; Bernal Losada, Olga; Osorio Fernández, Diego; Mínguez Mañanes, Alfredo; Lara Ramos, Carlos; Dani, Laila; Vallejo Báez, Antonio; Martínez Martín, Jesús; Fernández Ovies, José Manuel; Tinahones Madueño, Francisco Javier; Fernández-Crehuet Navajas, Joaquín

2014-06-01

The high prevalence of disease-related hospital malnutrition justifies the need for screening tools and early detection in patients at risk for malnutrition, followed by an assessment targeted towards diagnosis and treatment. At the same time there is clear undercoding of malnutrition diagnoses and the procedures to correct it Objectives: To describe the INFORNUT program/ process and its development as an information system. To quantify performance in its different phases. To cite other tools used as a coding source. To calculate the coding rates for malnutrition diagnoses and related procedures. To show the relationship to Mean Stay, Mortality Rate and Urgent Readmission; as well as to quantify its impact on the hospital Complexity Index and its effect on the justification of Hospitalization Costs. The INFORNUT® process is based on an automated screening program of systematic detection and early identification of malnourished patients on hospital admission, as well as their assessment, diagnoses, documentation and reporting. Of total readmissions with stays longer than three days incurred in 2008 and 2010, we recorded patients who underwent analytical screening with an alert for a medium or high risk of malnutrition, as well as the subgroup of patients in whom we were able to administer the complete INFORNUT® process, generating a report for each. Other documentary coding sources are cited. From the Minimum Basic Data Set, codes defined in the SEDOMSENPE consensus were analyzed. The data were processed with the Alcor-DRG program. Rates in ‰ of discharges for 2009 and 2010 of diagnoses of malnutrition, procedure and procedures-related diagnoses were calculated. These rates were compared with the mean rates in Andalusia. The contribution of these codes to the Complexity Index was estimated and, from the cost accounting data, the fraction of the hospitalization cost seen as justified by this activity was estimated. RESULTS are summarized for both study years. With respect to process performance, more than 3,600 patients per year (30% of admissions with a stay > 3 days) underwent analytical screening. Half of these patients were at medium or high risk and a nutritional assessment using INFORNUT® was completed for 55% of them, generating approximately 1,000 reports/year. Our coding rates exceeded the mean rates in Andalusia, being 3.5 times higher for diagnoses (35‰); 2.5 times higher for procedures (50‰) and five times the rate of procedurerelated diagnoses in the same patient (25‰). The Mean Stay of patients coded with malnutrition at discharge was 31.7 days, compared to 9.5 for the overall hospital stay. The Mortality Rate for the same patients (21.8%) was almost five times higher than the mean and Urgent Readmissions (5.5%) were 1.9 times higher. The impact of this coding on the hospital Complexity Index was four hundredths (from 2.08 to 2.12 in 2009 and 2.15 to 2.19 in 2010). This translates into a hospitalization cost justification of 2,000,000; five to six times the cost of artificial nutrition. The process facilitated access to the diagnosis of malnutrition and to understanding the risk of developing it, as well as to the prescription of procedures and/or supplements to correct it. The interdisciplinary team coordination, the participatory process and the tools used improved coding rates to give results far above the Andalusian mean. These results help to upwardly adjust the hospital Complexity Index or Case Mix-, as well as to explain hospitalization costs. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.