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McGarr imagesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Rob McGarr images (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - November 12, 2009 Category: Geriatrics Source Type: journals

Medicare Q & A: If after surgery, during post-op, a surgeon asks me to see my patient because of abnormal lab results can I bill a consultation for that hospital day?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
If a surgeon is asking for your opinion, post-op, on a patient because of abnormal lab results, you can charge a consultation. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - October 13, 2009 Category: Geriatrics Source Type: journals

Health-related quality of life little affected by menopausal transitionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The menopausal transition has relatively little effect on quality of life, after adjusting for age and other covariates including symptoms, medical condition, sociodemographic variables, physical activity, and psychological factors. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - October 13, 2009 Category: Geriatrics Source Type: journals

Testosterone improves functions for older men with heart failureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Testosterone supplementation may improve functional capacity, muscle strength, and glucose metabolism in older men with chronic heart failure. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - October 13, 2009 Category: Geriatrics Source Type: journals

Practical strategies for management of hypertension in the elderlyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Key strategies for hypertension treatment in elderly include lifestyle changes and hypertension treatment until target BP goal is reached with mono or combination therapy. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - October 13, 2009 Category: Geriatrics Source Type: journals

Case: Gradually enlarging plaque on handEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Consider porokeratosis if there is an annular plaque with a thin, thready, scaly border. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - October 13, 2009 Category: Geriatrics Source Type: journals

Opinion: Treat hypertension in the elderlyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Despite reams of data documenting the benefits of treatment of hypertension well into late life, many of our elderly patients never achieve their goal blood pressures because we fail to treat them adequately. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - October 13, 2009 Category: Geriatrics Source Type: journals

Acute inflammation may speed mental decline in Alzheimer'sEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Acute systemic inflammation linked to episodes of illness or injury may speed the rate of cognitive decline in persons with Alzheimer's disease. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - October 13, 2009 Category: Geriatrics Source Type: journals

Medicare Q & A: Can an emergency department visit be billed if a Medicare patient is triaged by a nurse but leaves before seeing a physician?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In a physician clinic, billing is fee-for-service, but rural health clinics are paid from Medicare Part A on an encounter basis and the encounter has to be performed by a physician, physician assistant, or nurse practitioner. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - October 13, 2009 Category: Geriatrics Source Type: journals

Waist-hip ratio more accurate predictor of seniors' mortalityEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In high-functioning older adults, waist-hip ratio is a more accurate predictor of all-cause mortality than either body mass index or waist circumference. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - October 13, 2009 Category: Geriatrics Source Type: journals

Medicare Q & A: Because Medicare pays less for a B-12 service than the B-12 costs me, can I have a patient sign an Advanced Beneficiary Notice and then bill the patient separately?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
You are not allowed to bill a patient for a covered service that is bundled into another service even if the patient signs an Advanced Beneficiary Notice. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - October 13, 2009 Category: Geriatrics Source Type: journals

Medicare Q & A: If an EKG is taken at the hospital on a patient, but I don't read the results and do my interpretation until the next day, what date should be put on the interpretationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Use the actual date of any service. If interpretation and technical portion are done on separate dates, you would charge on the separate dates. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - October 13, 2009 Category: Geriatrics Source Type: journals

Medicare Q & A: If I perform a diagnostic test on a patient in my office and then send the test to a physician in another country for interpretation, can I still be paid for the technical portion of the test?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
You can be paid for the technical portion of a diagnostic test being sent to another country, but Medicare cannot pay for an interpretation provided outside the United States. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - October 13, 2009 Category: Geriatrics Source Type: journals

Osteoarthritis: A review of treatment optionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Osteoarthritis is the leading cause of disability in the United States, especially among older adults. Treatment options primarily focus on alleviating the pain associated with the condition, but safety concerns over some of the traditional pharmacotherapeutic agents used in the management of osteoarthritis have led health care professionals to seek other options. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - October 13, 2009 Category: Geriatrics Source Type: journals

Higher bone lead concentration is linked to higher mortalityEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Lead concentration in the bones accumulated in prior decades of environmental exposure is associated with all-cause and cardiovascular mortality. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - October 12, 2009 Category: Geriatrics Source Type: journals

Geriatrics Digital Edition October 2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Practical strategies for management of hypertension in the elderly Osteoarthritis: A review of treatment options Opinion: Treat hypertension in the elderly Plus regular columns and departments (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - October 1, 2009 Category: Geriatrics Source Type: journals

Intellectually stimulating activity delays onset of dementiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Older adults who frequently engage in reading and other intellectually stimulating leisure activities may experience a significant delay in the onset of memory decline. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - September 3, 2009 Category: Geriatrics Source Type: journals

Elder self-neglect, abuse linked to higher risk of deathEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In a study of 9,318 elderly persons, mortality risk was significantly higher among those who were reported to social service agencies for self-neglect or elder abuse. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - September 3, 2009 Category: Geriatrics Source Type: journals

IV immunoglobulin treatment may reduce Alzheimer's riskEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Treatment with intravenous immunoglobulin may lower the risk for developing Alzheimer's disease and Alzheimer's disease-related disorders. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - September 3, 2009 Category: Geriatrics Source Type: journals

Medicare Q & A: If Medicare decides documentation from a former member of a practice doesn't support the levels that were billed, who will be responsible for paying Medicare back?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
If payment to a former member of a practice was reassigned to the group, and the documentation is found wanting, it will be up to the group practice to pay Medicare any recoupment and/or fines. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - September 3, 2009 Category: Geriatrics Source Type: journals

Divorce can have negative health effects, even years laterEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Marital disruption can have harmful effects on health, even years later, and divorced persons who later remarry may still have poorer health. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - September 3, 2009 Category: Geriatrics Source Type: journals

Medicare Q & A: In regards to a collection issue, is there a Medicare requirement that statements be sent to patients at certain intervals?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
There is no requirement by Medicare that you send a final notice or certified letter before you turn a patient over to a collection agency. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - September 3, 2009 Category: Geriatrics Source Type: journals

Medicare Q & A: Is there a billing difference between a private practice and a rural health clinic when a medical assistant or nurse performs a nurse visit and documents the blood pressure on a warfarin patient?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In a physician clinic, billing is fee-for-service, but rural health clinics are paid from Medicare Part A on an encounter basis and the encounter has to be performed by a physician, physician assistant, or nurse practitioner. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - September 3, 2009 Category: Geriatrics Source Type: journals

Hospitalists perform better for a number of conditionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Hospitals that have hospitalists provide higher-quality care for a number of conditions and dimensions of care. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - September 3, 2009 Category: Geriatrics Source Type: journals

Medicare Q & A: At a recent seminar I heard that Medicare no longer allows physician assistants or nurse practitioners to perform consultations. Is that correct?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Physician assistants and nurse practitioners can bill consultations to Medicare on new or established patients. Use the outpatient consultation codes in the office (99241-99245) or inpatient consult codes 99251-99255. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - September 3, 2009 Category: Geriatrics Source Type: journals

Case: Persistent facial eruptionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Consider factitial dermatitis if lesions are irregularly shaped and there is little or no perilesional inflammation. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - September 3, 2009 Category: Geriatrics Source Type: journals

Men with angina have worse outcomes than womenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In patients newly diagnosed with angina, 5-year outcomes are significantly worse among men than among women. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - September 3, 2009 Category: Geriatrics Source Type: journals

Stroke patients twice as likely to have hip or femur fractureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Patients who have had a stroke are twice as likely to experience a hip or femur fracture, and that risk is greatest among women, patients younger than 71 years of age, and those who recently had a stroke. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - September 2, 2009 Category: Geriatrics Source Type: journals

Opinion: Baby Boomers court metabolic syndromeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Many bulging Baby Boomers already have the "metabolic syndrome," and if clinicians don't do anything about it, their patients are 3 to 5 times more likely to develop type 2 diabetes and twice as likely to develop cardiovascular heart disease. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - September 2, 2009 Category: Geriatrics Source Type: journals

An evidence-based review of the AMA/AHA guideline for the primary prevention of ischemic strokeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This review summarizes the recently published guideline on primary prevention of ischemic stroke, focusing on recommendations applicable to the geriatric population and on assessing and treating modifiable risk factors. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - September 2, 2009 Category: Geriatrics Source Type: journals

Resistant disease or resistant patient: Problems with adherence to cardiovascular medications in the elderlyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
When faced with difficult to control cardiovascular risk factors, clinicians need to address the potential role of adherence. This includes diagnosing an adherence problem, understanding why there is an adherence problem, and then employing simple tools and clear communication to overcome the relevant barriers. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - September 2, 2009 Category: Geriatrics Source Type: journals

Geriatrics Digital Edition September 2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Resistant disease or resistant patient: Problems with adherence to cardiovascular medications An evidence-based review of the AMA/AHA guideline for the primary prevention of ischemic stroke Rheumatoid arthritis in elderly patients Opinion: Baby Boomers court metabolic syndrome Plus regular columns and departments (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - September 1, 2009 Category: Geriatrics Source Type: journals

Rheumatoid arthritis in elderly patientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Aggressive rheumatoid arthritis treatment should not be withheld in the geriatric population just because of advanced age, but rather treatment should be individualized, especially considering comorbidities and other factors that can specifically affect a patient's quality of life. Coordination of care among geriatricians and rheumatologists is the key to achieving optimal outcome. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - September 1, 2009 Category: Geriatrics Source Type: journals

Second visit of a 47-year-old woman with severe hypertriglyceridemia and type 2 diabetes (CME)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Second visit of a 47-year-old woman with severe hypertriglyceridemia and type 2 diabetes (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - August 19, 2009 Category: Geriatrics Source Type: journals

First visit of a 47-year-old woman with severe hypertriglyceridemia and type 2 diabetes (CME)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
First visit of a 47-year-old woman with severe hypertriglyceridemia and type 2 diabetes (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - August 19, 2009 Category: Geriatrics Source Type: journals

A review of interventions to improve palliation of pain, dyspnea, and depressionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A review of the ACP guideline on palliative care which offers clinicians evidence-based recommendations for assessing seriously ill patients for pain, dyspnea, and depression; using therapies of proven effectiveness to manage pain, dyspnea, and depression; and ensuring that advance care planning, including completion of advance directives, occurs. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - August 14, 2009 Category: Geriatrics Source Type: journals

Case: Slightly sore, dark lesion on thighEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Consider angiokeratoma in a solitary, scaly blue-black papule on the extremity. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - August 13, 2009 Category: Geriatrics Source Type: journals

Medicare Q & A: Canl I bill for an unrelated second visit of a Medicare patient who was in earlier in the week to have some premalignant lesions destroyed?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A global fee period assigned by Medicare to each procedure determines the required times between billable visits. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - August 13, 2009 Category: Geriatrics Source Type: journals

Medicare Q & A: Can I bill for a home health discharge?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
There is no code or payment mechanism for paying a physician for discharging a patient from home health services. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - August 13, 2009 Category: Geriatrics Source Type: journals

Incorporating religion and spirituality to improve care for anxiety and depression in older adultsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Recent research suggests that religion and spirituality may be linked to improved physical and emotional health. This is a brief overview of the support for assessing and using patients' beliefs to improve anxiety and depression symptoms. The potential drawbacks of including a discussion of religion or spirituality when treating older adults are also addressed. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - August 13, 2009 Category: Geriatrics Source Type: journals

Opinion: Quick death, slow deathEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Author shares what he has learned from the quick death of his father and the slow death of his mother. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - August 13, 2009 Category: Geriatrics Source Type: journals

Medicare Q & A: Is it true that Medicare has a regulation that will require all physicians to have a certified coder on staff by 2011?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
There is no Medicare regulation, CMS regulation, or law that says a certified coder must be on staff by any date. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - August 13, 2009 Category: Geriatrics Source Type: journals

Medicare Q & A: Can I be paid by Medicare for a pulse oximetry obtained during an office visit?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Because it is bundled with a visit, Medicare will not pay for a pulse oximetry and will not allow a separate billing of the patient for it if a visit was charged on the same day. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - August 13, 2009 Category: Geriatrics Source Type: journals

Medicare Q & A: Am I required to send the referring physician my letter when I am performing a consultation in the hospital?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Current rules require sending an opinion to a referring physician unless there is a "commonality" of records, meaning the other physician has equal access to the hospital chart. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - August 13, 2009 Category: Geriatrics Source Type: journals

A review of interventions to improve palliation of pain, dyspnea, and depressionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A review of the ACP guideline on palliative care which offers clinicians evidence-based recommendations for assessing seriously ill patients for pain, dyspnea, and depression; using therapies of proven effectiveness to manage pain, dyspnea, and depression; and ensuring that advance care planning, including completion of advance directives, occurs. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - August 13, 2009 Category: Geriatrics Source Type: journals

Guided Care medical home model costs less than usual careEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Treating elderly patients with chronic conditions in a Guided Care medical home model costs less than usual care because patients spend less time in hospitals and skilled nursing facilities and have fewer ER visits and home health episodes, according to the preliminary results of a Johns Hopkins University study. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - August 12, 2009 Category: Geriatrics Source Type: journals

The case for implantable cardiac defibrillators, cardiac resynchronization therapy in older patientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Although implantable cardiac defibrillators reduce mortality through primary and secondary prevention of cardiac arrest, and cardiac resynchronization therapy improves exercise tolerance, quality of life, and decreases mortality and hospitalizations, both strategies are underutilized in older patients. Recommending device placement to patients requires a discussion of indication, risks, and benefits, as well as plans for deactivation in end-stage disease. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - August 12, 2009 Category: Geriatrics Source Type: journals

Predicting, detecting Alzheimer's earlier are key topics at ICADEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Research aiming to elucidate new and current methods to predict which patients are likely to develop Alzheimer's disease and to detect the presence of the disease in its earliest stages is increasing as the population ages, with the ultimate goal developing better treatments in mind. Several presenters discuss predictive and detection tools at the 2009 Alzheimer's Association International Conference on Alzheimer?s Disease (ICAD) in Vienna, Austria. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - July 16, 2009 Category: Geriatrics Source Type: journals

Geriatrics Digital Edition August 2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A review of interventions to improve palliation of pain, dyspnea, and depression Incorporating religion and spirituality to improve care for anxiety and depression in older adults The case for implantable cardiac defibrillators, cardiac resynchronization therapy in older adults Opinion: Learning from the deaths of parents Plus regular columns and departments (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - July 14, 2009 Category: Geriatrics Source Type: journals

Costs are soaring in the age of Alzheimer'sEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Age is the top risk factor for Alzheimer's disease (AD), so it's not surprising that the number of people with AD is expected to almost triple to 14 million by 2050, up from today's 5 million. Also not surprisingly, patients with AD and Alzheimer's disease-related dementias (ADRD) are heavy users of hospital and long-term care services, especially nursing home care, with estimated annual costs reaching tens of millions of dollars. (Source: Geriatrics Magazine)
Source: Geriatrics Magazine - July 9, 2009 Category: Geriatrics Source Type: journals