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Credentialing

Certification for individuals

Membership

Professional development & career support

Accrediting

Certification for whole organizations (not individual persons)

ARDMS credentialing (Inteleos)

RDMS

RVT

RDCS

CCI credentialing

Cardiovascular

Alternative path to get cardiac & vascular credentials

AART credentialing

Certification for:

CT

MRI

Mammography

X ray

Sonography

Memberships for each track

SDMS (general)

ASE (cardiac)

SVU (vascular)

AIUM - multidisciplinary (doctors, scientists, engineers, sonographers)

Accrediting organizations

• ACR - American college of radiology

• JCAHO ~ 15,000 health orgs in US

• IAC - echo & vascular

• JRCDMS - reviews applications of sonography programs, sends to CAAHEP for decision

What is CAAHEP

Certified credentialing body of allied health educational programs

What is EMTALA

Emergency medical treatment & labor act

Requires hospitals to treat ER patients regardless of ability to pay for treatment

If a student/sonographer is called to testify, they must:

• Consult attorney

• Ask employer for legal coverage/attorney services

• Have professional liability coverage

• Tell whole truth but don’t self incriminate

• if unsure, it’s ok to say “I don’t remember”

• Only answer questions asked, brief & direct

Assault

Threat

Battery

Unwanted physical contact

Defamation

Harmful lies about someone

Informed consent

Knowledgeable, voluntary authorization of treatment

Sensitivity

True positive rate (true positive/false negative)

People have disease & we correctly find it

Specificity

True negative rate (true negative/false positive)

People don’t have disease & we correctly say no disease

What is in CBC?

RBC

WBC

Platelet count

Hematocrit (Hct) % of blood that is rbc

Hemoglobin

Components of blood

RBC

WBC

Platelets

Plasma

Serum

Plasma

Liquid portion of blood with clotting factors

Serum

Liquid portion of blood without clotting factors

What’s included in a urine test

Creatinine

Blood (abnormal)

Glucose (abnormal)

Nitrate (abnormal)

BUN

Blood urea nitrogen

Liver dysfunction would result in ____ BUN

Decreased

Kidney dysfunction results in ____ BUN

Increased

Quad screen test

Assess likelihood of genetic disorders

What is inhibin A?

New addition to quad screen test

Assesses Down syndrome risk

Definition of quality

Planned activities to ensure product/service is delivered & meets requirements/standards

What is correlation?

Ensures diagnostic accuracy

Compare normal & abnormal studies

If things don’t align, investigate

What image storage system is used in Ultrasound?

PACS

• store & access images

• Interface w hospital records

• Workflow management (data mining)

Shelf life of recording media/PACS

Minimum number of years required by law for maintenance of patient records

EMR

Electronic medical record

Has all patient medical history from ONE practice or provider

Health record

Has information from MANY providers

What is POCUS

Point of care ultrasound

Immediate treatment decision / emergency use

Doesn’t have to be done by doctor or sonographer

CPT codes

Currently procedural technology codes

Describes procedures & service via 5 digit code for:

• billing

• Risk assessment

• Disease trafficking

What codes does Medicare use?

HCPCS

Level 1 vs. Level 2 HCPCS

Level 1 = identical to CPT

Level 2 = costs & services like ambulance or medical equipment

What are ICD codes?

Alpha numeric codes for every disease, condition & injury

What is ICD 9, 10, 11

ICD 9 = least specific

ICD 10 = more detailed

ICD 11 = digital, has more categories/code options

Whistleblower

Person who reports violation of regulation, standards, or ethical obligation

Illegal to submit false claim for govt payout

Are whistleblowers protected from retaliation?

Yes, and they get some of the money

Hospital work environment

• Largest, most common imaging locations

• More support/assistance from staff sonographers

• On call, weekends, shifts

• Ex: inpatient, outpatient, surgical, emergency

Clinic work environment

Small hospital

No emergency or 24/7 service

Has imaging dept

Private office work environment

• More independent work, requires more experience & knowledge

• Pts require minimum care

• Monday to Friday (sometimes Saturday, no call)

Mobile company work environment

• Travel between facilities

• Very experienced & independent

• Portable ultrasound

• Bill clients, time, mileage

• May have scheduling coordinator

Staffing agency work environment

• Adapt to various departments, machines & protocols

• Travel between locations via agencies

• Independent, good pay away from family

• Can be temp, permanent or full time

ICD 9 codes are

less specific, older diagnostic code system

ICD 10 codes are

for billing, justifies medical necessity for services

ICD-10 CM

Clinical modification

For diagnosis coding in ALL healthcare settings

ICD-10 PCS

Procedure coding system

procedure coding in U.S. hospital inpatient setting

Difference between ICD 9 and ICD 10 codes

ICD-9 codes show location but not depth (stage of disease) whereas ICD-10 codes are more detailed

Advantage of ICD 11 codes

• it’s digital

• spans thousands of categories/terms which allows for specific, detailed recording