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Icd 10 Diabetic Retinopathy

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Eyes with macular edema caused by retinal branch vein occlusion underwent masked evaluation of fluorescein angiography to determine complete macular perfusion vs incomplete macular perfusion (capillary dropout, ischemia). Cases evaluated as incomplete macular perfusion showed a greater frequency of improvement (91%) in visual acuity than did perfused cases (29%) (P = .003) after a mean follow-up of 39 months. Ischemic edema is often transient, and is associated with a good outcome in visual acuity (median final visual acuity was 20/30). Perfused macular edema has a poorer prognosis for visual acuity (median final visual acuity was 20/80). Macular ischemia is usually associated with a broken foveal capillary ring. Previous animal research on ischemic brain edema has shown that following brain ischemia, an intracellular and an extracellular hypertonic environment lead to intracellular and extracellular edema (cytotoxic edema), which is often followed by vascular protein leakage (vasogenic edema). A similar occurrence in ischemic retina could explain the transient edema reported herein, with good outcome in visual acuity following the spontaneous resolution of edema.

Type 2 Diabetes Mellitus With Unspecified Diabetic Retinopathy With Macular Edema

E11.311 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Short description: Type 2 diabetes w unsp diabetic retinopathy w macular edema This is the American ICD-10-CM version of E11.311 - other international versions of ICD-10 E11.311 may differ. A disease in which the body does not control the amount of glucose (a type of sugar) in the blood and the kidneys make a large amount of urine. This disease occurs when the body does not make enough insulin or does not use it the way it should. A heterogeneous group of disorders characterized by hyperglycemia and glucose intolerance. A metabolic disorder characterized by abnormally high blood sugar levels due to diminished production of insulin or insulin resistance/desensitization. A subclass of diabetes mellitus that is not insulin-responsive or dependent (niddm). It is characterized initially by insulin resistance and hyperinsulinemia; and eventually by glucose intolerance; hyperglycemia; and overt diabetes. Type ii diabetes mellitus is no longer considered a disease exclusively found in adults. Patients seldom develop ketosis but often exhibit obesity. A type of diabetes mellitu Continue reading >>

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  1. Tsunami2k

    I read a great article in Muscle and Body mag. today and decided to take the time to type it up for ya'll. Took me a while, and there might be a spelling error or two, but enjoy the article, it is a really good read.
    The 10 Rules of BCAAs
    Rule #1 - Know your three BCAAs - The BCAAs are comprised of three essential amino acids: Leucine, Isoleucine and valine. Each of these amino acid molecules has a section that builds off of the amino acid and forms a branch structure. This is why they are referred to as "branched-chain amino acids." These three aminos alone make up about one-third of the total amino acids in muscle. The human body has about 20 amino acids, so this should give you a sense of just how important these three key BCAAs are. Essential amino acids are those that your body cannot make itself; they must be provided by the diet, and that's another reason why BCAA supplementation is so important.
    Rules #2 - Learn why the BCAAs are special aminos - The BCAAs are not just important because they are essential aminos or because they make up a good proportion of muscle protein. The reason these three are super special aminos is because of how they are handled in the body. Most amino acids go directly to the liver after being digested, where they can be broken down is the body needs them for energy. On the other hand, BCAAs tend to be spared by the liver and go directly to the muscles intact. Another thing that makes the BCAAs special is that the muscle can use BCAAs directly for fuel, unlike with other amino acids. This is crucial for helping to strengthen, build and repair muscle tissue that has been stressed by weight training.
    Rule #3 - Use BCAAs to energize your muscles - Besides boosting energy by being used as a direct fuel source for muscle fibers, BCAAs also enhance energy by reducing the amount of tryptophan that gets into the brain. Tryptophan produces a metabolite known as 5-HTP or serotonin. During exercise, sertonin notifies the brain that the body is fatigued and causes it to reduce muscle strength and endurance. The BCAAs, namely valine, compete with tryptophan for entry into the brain. Research studies confirm that taking BCAAs before workouts lowers the amount of amino acid tryptophan that gets into the brain, and therefore lowers the amount of fatigue you feel. In addiction, BCAAs can also help to boost brain function by reducing brain fatigue.
    Rule #4 - Master the ways BCAAs can boost muscle growth and strength - Of all the benefits that BCAAs offer, the most interesting is their ability to enhance muscle growth and strength. They do this by directly stimulating muscle protein synthesis, which is the buildup of muscle protein. Of the three BCAAs, leucine appears to be the most critical for stimulating muscle protein synthesis, yet all three are important for optimizing protein synthesis. BCAAs also work to enhance muscle growth and strength by altering levels of anabolic and catabolic hormones. One anabolic hormone the BCAAs boost is insulin. This is primarily caused by leucine, and it leads to further enhancement of muscle protein synthesis. BCAAs have also been found to increase levels of growth hormone. Another advantage that comes (albiet from the other direction) is the BCAAs also blunt levels of the catabolic hormone cortisol, particularly during exercise. Since cortisol normally increases muscle breakdown and inhibits testosterone's anabolic actions, blunting cortisol works to increase muscle frowth and strength gains.
    Rule #5 - Use BCAAs to help cut fat - Another benefit of BCAAs is their ability to enhance fat loss. Research on leucine alone has shown that this amino acid can increase metabolic rate, and therefore the amount of total calories and fat burned. In addition, reserach shows that leucine helps to blunt hunger. It is theorized that leucine is used by the brain as an indicator of the levels of total amino acids in the bloodstream. Having more total amino acids in the blood signals your brain that you are well-fed, which means hunger should be reduced to prevent overeating, and your metabolic rate can be set on high without the concern that energy levels will run out.
    Rule #6 - Know when to take BCAAs - When it comes to BCAAs, timing is crucial. To gain more muscle mass, strength, and energy, the most critical time for taking BCAAs is around workouts. For best results, you should take one dose within 30 minutes before your workouts along with your preworkout protein shake and carbs and another dose within 30 minutes after workouts along with your post-workout protein shake and carbs. Exercising out also increases levels of cortisol. Supplementing with BCAAs before and after workouts keep cortisol levels low, which encourages greater muscle growth. A dose of BCAAs right before workouts will provide your muscles with the energy they need to stave off fatigue throughout the workout. Additionally, research confirms that taking BCAAs around workout time will help to decrease DOMS, which results from intense training. Another critical window for taking a dose of BCAAs is as soon as you wake up in the morning. This dose gets the aminos immediately to your muscles to use as fuel and for repair, which will stop the continued breakdown of your hard-earned muscle for your night-long fasting, and help build it back up. The fourth time of day you should take a dose of BCAAs is late in the day with dinner or your last meal. This helps to keep protein synthesis and GH up, and cortisol down throughout the next day. You may also want to consider taking additional doses of BCAAs between meals to keep hunger down and metabolism up for optimal fat burning.
    Rule #7 - Learn how to stack BCAAs - To maximise their effectiveness, take BCAAs with protein and carbs, such as a whey protein shake and Gatorade (after workouts), eggs and toast (for breakfast) or steak and a sweet potato (for dinner). Taking BCAAs with protein and carbs will help to drive more of the BCAAs into your muscles thanks to the greater insulin boost. For those following a low-carb diet, you will obviously not want to eat carbs everytime you take a dose of BCAAs. That's fine, because the leucine will help boost insulin on its own. In addition, you can take BCAAs with supplements, such as alpha-lipoic acid, that enhance insulin's release and its action at muscle cells. Take 300-500mg of ALA when you take a dose of BCAAs to further enhance insulin's actions and get more BCAAs into your muscles.
    Rule #8 - Learn how to dose your BCAAs - We suggest you get a minimum of 5g and up to 10g of BCAAs per dose to allow your stomach to get used to them. Then slowly increase the doage (by about 1g per dose every three or four days) as your tolerance allows until you're up to at least the minimum dose of 5g.
    Rule #9 - Take the most effective ratio of BCAAs - Be aware that the ratio of leucine to isoleucine and valine is also critical for optimizing its benefits. You should look for BCAA supplements that provide leucine at a dose that delivers a ratio of leucine to valine and leucine to isoleucine of 2:1. For example, if you take a 5g dose of BCAAs, try to get about 2.5g from leucine, 1.25 from isoleucine, and 1.25g from valine.
    Rule #10 - Use the best form of BCAAs - BCAAs typically come in capsules or tablets that you swallow or as a powder that you mix. Both forms are similarly effective. Most capsules or tablets provide about 500-1000mg of BCAA's per pill. Since you'll be taking a minimum dose of 5g of BCAAs about four times per day, you may not want to swallow a total of 20-40 pills daily. This is where powders have an advantage. While it used to be that BCAA powders were chalky and flavorless, today they often come in a variety of flavors that should please anyone's palate. Of course you can't find a flavor you like, using a pill form of BCAAs could be your best bet. Another advantage of pill form is that they're easier to travel with, such as taking them to work, school, the gym or when you travel. Try both versions and see which works best for you.

  2. ShyamPopat

    Great article! +Rep.
    I disagree with the 2:1 ratio, but still, it was very informative

  3. jmlstocks

    Thank you for taking the time to type all that up! Good stuff +

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Thyroid Medical Coding Profile. Alicia: Alright. This one isn't very hard once you know where to look, but I actually had to Google to get some more information because I couldn't find it. And again, Laureen probably could have done this one and done it much faster and better than I did because she's much better at CPT than I am. But the question was, Is there a thyroid profile or is it build separately? A: Actually one of the great places as I pull the screen over, Quest Diagnostic is a company that does a lot of lab work and they have really good information, that's where I got this. So, first let's break it down, there is CPT code Quest Diagnostic 4A, and I changed this, is a thyroid panel, not a profile, so that will give you some troubles if your verbiage is off just a little bit. They were telling me for a thyroid panel, these are the two codes that they use: 84436 and then 84479, and those include, and it goes in to detail what tests are included in that. I went in and found the explanation for 84436, which gives you all of these, it tells you what it does and what it doesn't do for that particular code and it tells you why this test is performed. Neonates get this test, which I thought was very, very interesting. Then, 84476 being explained, aAgain, this has your T3 and T4s. The reason they used these abbreviations is because nobody can really actually in real life pronounce this term, and so they abbreviate that stuff, and you know T-thyroid it's not as bad as you think. That wasn't the most common. I remember seeing thyroid panels and they usually have this TSA with them -- it's always with TSA. So, I thought, well there's this specific code for that that Quest Diagnostic had, so I thought I remember seeing that. Get More Medical Coding Training, Medical Coding Course, Medical Coding Tips, Medical Coding Certification and CEU Credits at http://www.cco.us/cco-monthly-newsletter

Icd-10-cm And Cpt Changes In 2017

November/ December 2016 ICD-10-CM CHANGES The proliferation of International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes for 2017 is especially relevant for retina practices, particularly the codes found in Chapter 4.1 New diagnosis codes should be in use now (started October 1), and the Centers for Medicare and Medicaid Services (CMS) has stated that they should be used from October 1 through September 30, 2017. Codes that do not change will continue to be used going forward. CMS was lenient in 2016 in allowing the use of codes with the description unspecified. In ICD-10-CM jargon, unspecified means the laterality or specificity of the diagnosis was not noted in the chart, not that it is unspecified clinically. Practices can expect claim denials if unspecified codes continue to be used. Codes that are more helpful are now in the book, but they are not necessarily where you would expect to find them. For example, codes for combined traction and rhegmatogenous retinal detachments can be found in Chapter 4 (Endocrine, Nutritional and other Metabolic Diseases) under diabetes, not in Chapter 7 (Diseases of the Eye and Adnexa). Chapter 4 also conta Continue reading >>

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  1. hide

    Has anyone had any luck finding them at a pharmacy? I went into a big Boots and the guy was trying to be helpful, but he found out that Boots don't carry them because it's their policy not to carry these types of medical accessories that you don't need a prescription for (meanwhile, loads of herbal "remedies" line the shelves). Anyway he suggested I try a small independent pharmacy, and I know you can get them from amazon, but I was wondering if anyone had any luck getting them from a pharmacy?
    Update I asked a little pharmacy tucked away next to my work, nice Irish bloke, after discussing it he said he could order some in, "about six quid", so even if it's 7 quid, it's still convenient.
    Update 2 Yep he sold them to me for six quid. I'm finding them interesting to tweak my diet, but even after eating at a nice restaurant for Valentine's day, which involved some bread, polenta, potato, and sugary pudding, I still registered ketones the next day, so I think the "if in doubt eat more butter" approach, while using MFP, is probably just fine. Still, I'll probably use them for another week or so out of curiosity.

  2. JenCarpeDiem

    I don't think you're going to find them -- I never have -- and if you do, they likely won't be any cheaper than they are on Amazon (£6.54). If anyone can prove me wrong though, I'd love to know! My 'stix are about to expire and I need to get some more soon. :)

  3. kersh2099

    I know its not much, but I found these on ebay for £6.30 inc postage. Arrived in 2 days with no problems for me.
    I too have found none in the shops though.

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Macular Degeneration 6 Natural Treatments for Macular Degeneration symptoms Macular Degeneration Macular Degeneration is the leading cause of vision loss, affecting more than 10 million Americans more than cataracts and glaucoma combined. At present, Macular Degeneration is considered an incurable eye disease. Macular Degeneration is caused by the deterioration of the central portion of the retina, the inside back layer of the eye that records the images we see and sends them via the optic nerve from the eye to the brain. The retinas central portion, known as the macula, is responsible for focusing central vision in the eye, and it controls our ability to read, drive a car, recognize faces or colors, and see objects in fine detail. One can compare the human eye to a camera. The macula is the central and most sensitive area of the so-called film. When it is working properly, the macula collects highly detailed images at the center of the field of vision and sends them up the optic nerve to the brain, which interprets them as sight. When the cells of the macula deteriorate, images are not received correctly. In early stages, macular degeneration does not affect vision. Later, if the disease progresses, people experience wavy or blurred vision, and, if the condition continues to worsen, central vision may be completely lost. People with very advanced macular degeneration are considered legally blind. Even so, because the rest of the retina is still working, they retain their peripheral vision, which is not as clear as central vision. Types of Macular Degeneration There are two basic types of Macular Degeneration: dry and wet. Approximately 85% to 90% of the cases of Macular Degeneration are the dry (atrophic) type, while 10-15% are the wet (exudative) type. Stargardt disease is a form of macular degeneration found in young people, caused by a recessive gene. Risk Factors The biggest risk factor for Macular Degeneration is age. Your risk increases as you age, and the disease is most likely to occur in those 55 and older. Other risk factors include: Genetics People with a family history of AMD are at a higher risk. Race Caucasians are more likely to develop the disease than African-Americans or Hispanics/Latinos. Smoking Smoking doubles the risk of AMD.

Top Icd-10-cm Changes: Diabetes, Glaucoma And Macular Degeneration

On October 1, 2016, changes to ICD-10-CM coding were implemented. While all of the code changes applicable for optometry are important, a few of the major changes are discussed in this article. Diabetic Ocular Complication Codes The first major change in ICD-10-CM codes for 2017 is for diabetic ocular complication coding. All of the DM retinopathy code choices will now specify which eye is impacted. Several new codes for proliferative diabetic retinopathy were also added. Note that a code for oral diabetic medication use (Z79.84) was added and should be used when applicable. The existing code to designate insulin use (Z79.4) was retained. Keep in mind that not all injectable diabetic medications are considered insulin. If a patient is on both oral medication and insulin, both of these medication codes should be used. The new codes for diabetic retinopathy apply to all the code categories, but only the E11.3 code section is detailed in this article so be sure to review the other categories if you are using them for any particular patient. The other categories include E08.3, E09.3, and E10.3. E11.3 Type 2 diabetes mellitus with ophthalmic complications All of the subcategories under Continue reading >>

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  1. youngm

    Exercise induced ketosis?

    Is it possible, if you haven't ingested any carb's for a whole day, to accelerate your body into a state of ketosis during an evening cardio session, whether it be steady state or HIIT?
    Just curious!

  2. skelooth

    yup. Unlikely though if you've never been in ketosis before.

  3. youngm

    I've been on an Atkins-like diet before, if that's what you mean?
    Typically, I tend to minimise my carb intake during the day to approx 40-60g and drink 1.8-2L of water, plus 3-4 cups of green tea

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