Cov Mob Uas Tus Kws Muab Kev Pab Tiv Thaiv Tau - Cov Lus Txhais
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Dab tsi yog qhov kev xav tau ntawm tus kws kho mob-tiv thaiv tau (PPCs)?
Lub Npe 42 ntawm Txoj Cai ntawm Tsoom Fwv Teb Chaws, ntu 447, 434 thiab 438 thiab Txoj Cai Kev Noj Qab Haus Huv thiab Cov Tsev Kawm Ntawv (WIC) ntu 14131.11 yuav tsum tau kom cov neeg muab kev pab tshaj tawm txhua PPCs uas cuam tshuam nrog kev thov rau Medicaid (Medi-Cal hauv California) kev them nyiaj lossis nrog cov chav kawm kho mob uas tau muab rau tus neeg mob Medicaid uas kev them nyiaj Medicaid yuav muaj. Cov cai lij choj hauv tsoomfwv thiab txoj cai lij choj hauv xeev kuj txwv tsis pub Medicaid them rau kev kho mob ntawm PPCs.
PPC yog dab tsi?
Muaj ob hom PPCs: Cov kev kho mob tau txais kev kho mob (HCAC), uas yuav tsum tau tshaj tawm yog tias cov no tshwm sim hauv tsev kho mob mob hnyav, thiab lwm yam kev tiv thaiv kev tiv thaiv (OPPC), uas yuav tsum tau tshaj tawm yog tias qhov no tshwm sim hauv ib qho chaw kho mob.
HCACs yog dab tsi?
HCACs yog tib yam mob li cov mob uas tau los ntawm tsev kho mob (HACs) uas yuav tsum tau tshaj tawm rau Medicare, tsuas yog Medi-Cal tsis xav kom cov kws kho mob tshaj tawm txog kev mob ntshav hauv cov hlab ntsha tob/pulmonary embolism rau cov poj niam cev xeeb tub thiab cov menyuam yaus hnub nyoog qis dua 21 xyoos, raws li tau hais
qab
.Cov lej ICD-10-CM rau HCACs muaj nyob rau ntawm lub vev xaib CMS rau "ICD-10 HAC List."
Cov kws kho mob yuav tsum tshaj tawm HCACs tsuas yog thaum lawv tshwm sim hauv cov tsev kho mob ceev nrooj.
HCACs:
• Kev thaiv ntshav hauv huab cua
• Kev tsis haum xeeb ntawm ntshav
• Kab mob hauv txoj kev tso zis uas cuam tshuam nrog catheter
• Mob ntshav txhaws hauv hlab ntsha tob/pulmonary embolism (tsis suav poj niam cev xeeb tub thiab menyuam yaus qis dua 21 xyoos)
• Poob/kev raug mob uas ua rau muaj cov hauv qab no:
o Pob txha tawg
o Kev txav tawm
o Kev raug mob hauv taub hau
o Kev raug mob hnyav
o Kub
o Hluav taws xob dhia
• Cov khoom txawv teb chaws nyob tom qab phais
• Iatrogenic pneumothorax nrog venous catheterization
• Cov tsos mob ntawm kev tswj ntshav qab zib tsis zoo
o Kab mob ntshav qab zib ketoacidosis
o Nonketotic hyperosmolar coma
o Hypoglycemic coma
o Mob ntshav qab zib thib ob nrog ketoacidosis
o Mob ntshav qab zib thib ob nrog hyperosmolarity
• Theem III lossis IV mob qog nqaij hlav siab
• Kab mob ntawm qhov chaw phais
o Mediastinitis tom qab coronary artery bypass graft (CABG)
o Kab mob ntawm qhov chaw phais tom qab no:
• Kev phais bariatric
• Laparoscopic gastric bypass
• Gastroenterostomy
• Kev phais mob plaparoscopic gastric restrict
• Kev kho pob txha rau txha nraub qaum, caj dab, xub pwg, thiab luj tshib
o Cov txheej txheem Cardiac implantable electronic device (CIED)
• Kab mob vascular catheter
OPCs yog dab tsi?
OPPCs kuj tseem hu ua "yeej tsis muaj xwm txheej" thiab Cov Xwm Txheej Loj Tshaj Tawm raws li Medicare. Rau Medi-Cal, OPPCs raug txhais raws li nram no:
• Phais tsis raug/txheej txheem ua rau mob
• Phais/txheej txheem ua rau mob rau tus neeg mob tsis raug
• Phais/txheej txheem ua rau mob rau qhov tsis raug ntawm lub cev
Cov kws kho mob yuav tsum tshaj tawm peb qhov OPPCs no thaum cov no tshwm sim hauv txhua qhov chaw kho mob. "Kev phais mob uas cuam tshuam" yog hais txog kev phais mob.