![]() Learn more about hierarchical condition categories and how they can help predict the cost of high-risk patients. Kelly Long is a clinical development analyst with 3M Health Information Systems. For example: If there is a history of breast cancer (Z85.3) and the patient is ordered a mammogram, be sure to include this information under the A/P.įollowing these standard practices will ensure accurate documentation, quality patient care and an improvement in data integrity. There are multiple instances where these conditions are addressed and treated, but do not make it to the Assessment and Plan. It is acceptable to include “history of” conditions if it affects the current treatment plan. However, not only should providers show evaluation and treatment for all conditions assessed at the time of the encounter, but they should also ensure that this information is documented. If the diagnosis on the claim is not accurate or complete, this would indicate that the provider did much less work (medical decision making, evaluation, and management) than actually performed, leading to much lower reimbursement. Hypertension (I10) remains stable, will continue with Losartan 100 mg daily.ĭepression recurrent moderate (F33.1) patient has not noticed improvement on current medication, will increase Zoloft from 50mg to 100mg.ĬMS focuses on these diagnoses to demonstrate the need for higher reimbursement rates for patients who have more serious conditions or problems to manage. An acceptable problem list must show evaluation and treatment for each condition that relates to an ICD code. Simply listing every diagnosis in the medical record does not support a reported HCC code* and is unacceptable according to CMS. These four factors help providers establish the presence of a diagnosis during an encounter and ensure proper documentation. T: Treat-medications, therapies, other modalities M: Monitor-signs, symptoms, disease progression, disease regressionĮ: Evaluate-test results, medication effectiveness, response to treatmentĪ: Assess/Address-ordering tests, discussion, review records, counseling Each diagnosis must be documented in an assessment and care plan and each diagnosis must show that the provider is Monitoring, Evaluating, Assessing/addressing or Treating the condition: This simply means that diagnoses cannot be wholly determined from test results and a patient’s past medical history.Ī well-documented progress note would include the HPI, ROS, physical exam and show the medical decision-making process. ![]() Physicians must accurately document each patient diagnosis and the diagnosis MUST be based on clinical medical record documentation from a face-to-face encounter. ![]() The Official ICD Coding Guidelines state that a condition must be present at the time of the encounter, affect patient care or management and be clearly documented in order to be coded as a diagnosis. 21, 2018 / By Kelly Long, BS, CPC, CPCO, CAPM
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![]() ![]() While it might be tempting to place a fire pit on a deck, or under a pergola, do so only with caution, as these structures, too, are flammable.Īnd be mindful of plant life when you’re choosing a site for your fire pit. Build your fire pit 15-20 feet away from your house and any outbuildings-dog house, barn, detached garage, shed, pool house-on your property. You’ll, of course, want to position your fire pit well away from anything that is flammable. DON’T construct your fire pit near potential fire hazards As a non-combustible material, the steel will ward off heat and keep the wall itself from prematurely dehydrating and crumbling this will preserve the looks and structural integrity of your fire pit longer. When building a fire pit, lining the innermost wall with a steel fire ring ( available on Amazon from brands like Sunnydaze Decor) will prevent the wall material from drying out from regular exposure to the heat of the fire. Photo: DO install a steel ring in the fire pit. RELATED: How To: Build a Basic Backyard Fire Pit No part of the fire pit should be made with flammable materials (e.g., plywood shipping pallets) or non-porous materials that hold water, such as pea gravel, river rocks, or compressed concrete blocks these materials can trap steam and eventually explode. Flagstone is an ideal material for the fire pit cap. The inner wall must be made of fireproof building materials, optimally fire brick the outer walls should still be heat-resistant but can be made of traditional brick, stone, masonry blocks (consisting of brick, concrete, granite, etc.), concrete pavers, or even heat-resistant outdoor stucco or tile. DON’T use flammable or non-porous, water-retaining building materials.įire pits commonly consist of an inner wall, an outer wall, a “cap” (i.e., a flat tabletop-like surface around the opening at the top of the pit), and decorative stones, pavers or glassas the base of the pit. Would a square or rectangular fire pit fit your “style” better than a traditional round shape? Do you want an in-ground, above-ground, or tabletop DIY fire pit? Do you want to use found, recycled, or purchased materials? Concrete, bricks, pavers, stones from the yard - you’ll want to explore all your options before choosing your ultimate design. Think about how big you want your DIY fire pit to be, and what shape you’re looking for. Will you want to cook over the pit or will it be primarily for warmth and gazing? Consider where in the yard/garden you’ll place it, keeping in mind that you’ll want it well away from structure. You’ll want to spend time considering all the types and designs. Once you start researching the type of fire pit you want to build, you might be surprised at the large number of options you’ll find. Photo: DO explore different build options In addition, use the National Water and Climate Center’s Wind Rose tool to identify the prevailing wind direction in your location you want to ensure that you won’t have smoke blowing into your home through open doors or windows. Plan to install your fire pit on a patch of level ground in an open area of the yard that’s at least 15 feet from other residences and at least 10 feet from property lines, flammable structures such as wooden sheds, bushes, and trees. DON’T position fire pits in hazard-prone zones with unfavorable winds. Increase the pit height to 18 to 20 inches tall if you want to be able to comfortably sit directly on the edge of the pit. Aim for a fire pit height of 12 to 14 inches from the base of the walls to the top of the walls if you want guests to be able to prop their feet on it while seated around it on standard 18-inch-tall, dining-height patio chairs. Local ordinances permitting, your fire pit should ideally measure between 36 and 44 inches wide (including the width of the walls) to accommodate multiple people around it while maintaining an intimate setting. DO consider accessibility when choosing a fire pit size.īuilding a fire pit yourself offers room for customization of every detail, size included. Contact your municipality’s planning office and homeowner’s association, and review the deed for your house to ensure that you comply with all restrictions and obtain any permits required for fire pit installation. If your fire pit flouts these rules, you may be fined. Your local government, homeowners’ association, and house deed may impose restrictions on the size, location, material, and fuel type of home fire pits-or forbid them altogether-due to the potential for fire-related property damages. DON’T build a fire pit without approval from local authorities. You’ll learn how to legally and safely create a solidly built memory-building garden feature that you’ll treasure for years. Construct the most attractive, functional and safe fire pit possible by carefully considering the following 12 dos and don’ts of fire pit building. The benchmark will run through a set sequence of events using your current game settings, arriving at an average FPS figure for your system. To access the benchmark, launch Mafia 2, click Extras on the main menu, then select the Benchmark option. Fortunately, Mafia 2 comes with a built-in benchmark which provides a consistent measure of performance across all systems. ![]() To successfully conduct any tweaking in Mafia 2, you will need some way of objectively measuring your performance in Frames Per Second (FPS). At the very least make sure to update your graphics drivers to the latest available version. For this reason it is recommended that you download the relevant version of the TweakGuides Tweaking Companion (TGTC) and take the time to optimize your Windows installation correctly. A great many problems and performance issues can be traced directly to sub-optimal settings in Windows and out-of-date or badly configured drivers. General System OptimizationĪlmost as important as any in-game setting is the way your Windows installation is configured. The aim here is to give you enough information so that you can make an informed choice as to the settings you enable or disable to obtain the precise balance of visual quality and performance which is acceptable to you. Performance information is also provided for every setting, although bear in mind that the precise impact on your particular system depends on your specific hardware combination and your other game and system-wide settings. What follows are full descriptions for all of Mafia 2's in-game settings, including screenshot comparisons to highlight the impact on image quality of changing the various settings. We'll take a more detailed look at the PhysX/APEX enhancements later in this guide. To utilize these enhanced features at playable framerates the following is recommended as a minimum: However the game has an added PC-exclusive feature in the form of NVIDIA PhysX enhancements. This means that virtually any gaming PC can play Mafia 2. Peripherals: Keyboard & mouse or Windows compatible gamepad.Video Card: NVIDIA GeForce 8600 (or equivalent) or higher.Hard Drive: At least 8 GB of free space. ![]()
![]() Some restrictions apply, see our full Returns Policy. For In-Store Purchases: Products purchased in our stores cannot be returned or exchanged online or over the phone.For oversized items and quick-ship furniture, please call (866) 472-4001 for more details. For Online Purchases: Visit our returns page to create a UPS shipping label or visit your local store to make a free return.Shipping charges may be applied to your refund amount. We will issue a refund in the form of the original payment or with a gift card. An original receipt or gift receipt is required, our stores will not accept returns or exchanges without a receipt or proof of purchase. item 2 Lego Alarm Clock Yellow Brick Block Lighted Display Works Great Lego Alarm Clock Yellow Brick Block Lighted Display Works Great. Toy: Lego Year 2011 Ninjago 'Masters of Spinjitzu' Animated Series 9 Inch Tall Figure Alarm Clock Set 9003097 - KAI with Backlight Display. Watch: LEGO Kids 9006784 Ninjago Kai ZX Minifigure Clock - LEGO. If you’re not 100% satisfied with your purchase, we’re here to help.Įligible items can be exchanged for a refund of the merchandise value within 30 days of receiving an order or seven days for Quick Ship upholstery items. LEGO Kids 9002144 Yellow Plastic Alarm Brick Clock. Jewelry: LEGO Ninjago Jungle Kai Minifigure Alarm Clock - LEGO. See our shipping details page for more pricing, delivery and pick-up information. Orders up to $399 can cost as low as $19.99 Exact shipping and processing charges will appear during the checkout process. The box has minor and minimal shelf wear. Make sure your vehicle is large enough to fit items packaged in larger boxes. 39.99 FAST N FREE Get it by Wed, May 24 - Fri, May 26 from Murfreesboro, Tennessee New condition 30 day returns - Buyer pays return shipping Lego Star Wars Darth Vader Kids Alarm Clock, Model 9002113, UPC 830659002113. You have 7 days from when you placed your order to pick up these items. You will be charged a competitive flat-rate shipping fee for most eligible orders. Eligible items will show “Buy Online, Ship to Store” on the product page. With Ship to Store Delivery, items can be shipped to and picked up from your local store for a reduced shipping price. ![]() For more details on shipping, visit our Shipping Information page. Select oversized items have an additional delivery and processing surcharge this charge is listed below the item price. Orders must be placed by 6PM PT Monday through Thursday to arrive by the next business day.Available within the contiguous 48 states.UPS Front Door Delivery: Next Day Delivery Next day delivery restrictions: ![]() With Front Door Delivery, UPS can deliver most in-stock items including select furniture and lighting within 3-5 business days. SHIPPING UPS Front Door Delivery: 3-5 Business Days YONGLIANGgychaji Timers for Cooking Mechanical Timer Kitchen Timer Reminder Baking Alarm Clock Countdown time Manager-White Cooking Accessories Alarm Clocks. 0:00 / 9:22 Intro Alarm clock YEETS LEGO in your face Brick Science 736K subscribers Join Subscribe 9.4K 549K views 9 months ago Go to to sign up for. LEGO 9002151 Blue Brick Kids Light Up Alarm Clock blue plastic 9.5 inches tall LCD display boy girl official Visit the LEGO Store 4.3 4. Tips and tricks for using hitch mounted bike racksĪ couple of tips and tricks for using a bike hitch rack or electric bike hitch carrier. It didn’t take much effort at all to put this electric bike rack together. The electric bike slotted right in – it makes a perfect fit with the electric bikes that have fat tires. ![]() This electric bike rack is very easy to install.
Pharmacogenomics-enriched comprehensive medication management has the power to catch these potential serious interactions and provide alternatives. Between 19, the proportion of adult patients at risk for severe drug-drug interactions was more than 13% 12. Studies indicate that implementing a pharmacogenomics-enriched comprehensive medication management program can save a patient $4,000 annually, simply by optimizing medication regimens 9,10.Īnother area where pharmacogenomics is distinctively advantageous is for patients that take multiple medications simultaneously which has increased in recent years with aging populations 11. More than half of patients fail to achieve remission with the first pharmacologic therapy 8. The pharmacologic treatment of mental health conditions is complex because front-line drugs like SSRIs take significant time to produce effects. In 2020, nearly 17% of adults took pills to treat mental health conditions. Mental health is a field in which the value of pharmacogenomics has significant potential. And the total healthcare cost resulting from non-adherence can range anywhere from $949 to $44,190 per person 7. In fact, they were estimated to be the fourth leading cause of death in the United States before the COVID-19 pandemic 6. And since a medication adherence of at least 80% is generally necessary for therapeutic efficacy 4, adverse drug reactions are a significant contributor to morbidity and mortality. In addition, experiencing adverse side effects is one of the most common reasons that on average, 50% of patients are non-adherent to their medication 5. ![]() And from 2009 to 2012, approximately half of patients in the United States were exposed to one or more drugs for which pharmacogenomic guidelines are known 3.Īpprox 1/2 of patients were exposed to one or more drugs for which pharmacogenomic guidelines are known Of these drug-gene pairs, 87% impact safety, and efficacy. Food and Drug Administration (FDA) currently lists over 300 drug-gene pairs to aid prescribers in making decisions based on genetic test results 2. ![]() Implementing a genomics program that includes access to pharmacogenomics is critical for health systems to be able to accomplish it. ![]() The Quadruple Aim-enhancing patient experience, increasing provider satisfaction, improving population health, and reducing costs of care-serves as a guide for optimal health system performance 1. ![]() ![]() His success eventually helped him to achieve fame, wealth and an incredible level of arrogance. where he, and his mustache, was ultimately promoted to the position of Deputy Director.ĭoctor Stephen Strange began his career as one of the most successful surgeons in the world. He continued his career outside the military alongside his mentor and joined him at S.H.I.E.L.D. Dugan began as a Corporal in the United States Army prior to the Korean War but was eventually promoted to First Lieutenant under Nick Fury as his second-in-command. The man has style and is renowned for it throughout the Marvel Universe.ĭugan's nickname likely came from his time as a circus strongman or as an homage to the similarly-named bullet, though it is not stated in the comics. As you can see from the picture, Dum Dum doesn't just have an impressive mustache, he also sports a bowler hat, whether he's in combat or just sitting on the john. Fury and His Howling Commandos" #1, written by Stan Lee and penciled by Jack Kirby, in 1963. and has been a core member of Nick Fury's team since its inception. He may have an odd nickname, but Timothy Aloysius Cadwallader Dugan is one of the most prominent officers in S.H.I.E.L.D. We perfer the former, but would bet on the latter. This is either a testament to how immeasurably masculine he is or an artist's attempt to distinguish him from his predecessor, General Thunderbolt Ross. Maverick is the second character to take on the mantle of the Red Hulk, but the first (and so far only one) to retain their fabulous mustache post-transformation. While Maverick is in his Red Hulk form, he possesses the same strength levels as the regular, green Hulk. and was fitted with a Hulk Plug-in, a device in his left arm that allows him to transform into a Red Hulk for one hour every 36 hours. 6, #0, written by James Robinson and penciled by Leonard Kirk. He worked to incorporate A.I.M. He made his first appearance in "Avengers" Vol. The General was working for Project Troubleshooter in an attempt to create the next line of superhuman soldiers when he was first introduced into the Marvel Universe. You know your 'stache has some staying power when it remains on your face post-Red Hulk transition, but that's exactly what happens to General Robert L. well, except for that time he shaved it to become Batman, but the less said about that, the better. Over the decades, hundreds of artists and writers have had the honor of depicting Gordon, but in each instance, his chevron-style mustache has always been a prominent feature of the Detective turned Commissioner. "Gotham" has featured Gordon as the main protagonist with Bruce Wayne acting as more of a supporting member of the cast as he develops from adolescence into maturity. Not only a supporting character, Gordon has been instrumental in the cleaning up of Gotham's criminal underworld alongside Batman and has become a main character in his own right. He has been, through much of Batman's publication, an ally of the Dark Knight, and has helped him in his crusade against evil. Gordon made his first appearance alongside the Caped Crusader in "Detective Comics" #27, written by Bill Finger and penciled by Bob Kane. Eventually, he would come around and join Mark in the rebellion to destroy the Viltrumite Empire and even become its rightful leader.Ĭommissioner James Gordon probably has one of the most iconic mustaches in comics, but for some reason, they have yet to let his live-action counterpart, played by Ben McKenzie on "Gotham," let his whiskers grow. He became a villain despised by the people of Earth, though he still harbored love for his son and wife. Soon after Mark showed a maturation of his own superpowers, Omni-Man killed the members of the Guardians and attacked his son, beating him within an inch of his life and killing thousands of people in the process. He even helped to form a group of superheroes called the Guardians of the Globe. When he first arrived on Earth, in order to determine the planet's viability as an entrant into the Viltrumite Empire, he donned the guise of a superhero and became something of a Superman to the people of Earth. He made his first appearance in "Invincible" #1, written by Robert Kirkman and penciled by Cory Walker. He is an alien who is a member of the race of people known as the Viltrumites and like all other males of his species, he sports a large, luscious, walrus-like mustache. Omni-Man is the father of Mark Grayson, otherwise known as Invincible. ![]() “She has gotten serious with her lifting and nutrition and gets up super early to knock out two-hour workouts and she prepares all her “clean” meals. As an 8th grader, Katie crushed the grip strength record of all my students including college kids!” Her exceptional strength was evidenced to me when she could pound out perfect one-armed push-ups as a 10-year-old. She leads most all of my skill measurements in her grade as well as for my entire stable of pitchers. “Since 2015, Katie has shown intense dedication to mastering her pitching skills. “And I had the privilege to teach Lacey Waldrop from the very beginning and she earned 2014 National Player of the Year pitching for Florida State.” “Katie has proved to be one of the best athletes to ever come through my pitching school in my 34 years of teaching,” the instructor begins. Katie with pitching instructor Rita Lynn Gilman.Ĭoach Gilman is another longtime influence in Katie’s life and can’t say enough about her promising pupil. Last night for her prep team she played first base and went 3-for-4 with six RBIs with a triple. Her varsity high school career got off to a great start on Saturday (after her freshman campaign was eliminated because of COVID) as Katie was one batter away from a perfect game. She’s already hit the impressive benchmark of 70 mph in her pitching work with Coach Gilman and has had the opportunity to pitch a significant number of innings against some of the top 18U teams in the country, including the Birmingham Thunderbolts Premier – Rocky, Impact Gold – Jackson, and Athletics – Mercado/Smith (ranked #1 by Extra Innings 18U). Katie was a USA Elite Direct Select All-American at 10U in 2016 and 12U in 2018 and compiled an impressive Allister Index score of 89 in June 2019. Katie is a top Power 5 recruit who will make an impact wherever she goes.” ![]() She is a special athlete plus Katie is just plain fun to be with and a great teammate! She has definitely earned all of the good stuff coming her way. “I’ve known Katie since she was 8-years-old,” says Coach Willemsen, who also leads a team in the Glory fastpitch organization, “and her work ethic and attention to detail is unmatched. ![]() The right-hander is a student of noted pitching instructor Rita Lynn Gilman and plays for Patrick Lewis’ powerhouse Georgia Impact Premier 18U travel team and Bishop O’Connell High in Arlington, Virginia coached by Suzy Willemssen and a contender for a conference championship and Virginia state private school title. The talented 2023 with longtime hitting, and now high school, coach Suzy Willemsen. We will be kicking off the updated 2023 Extra Elite 100 rankings on Monday, and one player you can expect to be ranked pretty highly is pitcher Katie Kutz, a 5-foot-8 talented pitcher/infielder who was in the Top 10 when the list was published last summer. Katie Kutz, a 2023 Extra Elite 100 pitcher, is a member of the the 70 mph club… but that’s not all that defines her as a pitcher and person. ![]() She has served as VP of R&D at ZioPharm (Alaunos) and President and CTO at Accurome Health. She was a Professor of Pathology at Harvard Medical School (17 years) and is an Emeritus Pathologist at Beth Israel Deaconess Medical Center and Harvard Medical School. She has a graduate certificate from Harvard Business School on Program in Leadership Development. in Genetics and Molecular Biology from University of North Carolina, Chapel Hill and carried out her Postdoctoral Fellowship at Massachusetts Institute of Technology in Cancer Immunology. She is an experienced entrepreneur and has led successful translational programs in research and development over the last 30 years in both academia and industry. Roya Khosravi-Far, Ph.D., PLD, InnoTech, co-founder, President and Chief Executive Officer is passionate about translating bench-side discoveries to bed-side realities. He also was involved with another startup diagnostic company with Dr. Roya Khosravi-Far that was sold to GT Advanced Technologies in 2015. He cofounded an equipment company that was sold to Veeco Corporation in 2005 and was a founder of another technology company with Dr. ![]() He has 5 patents on unique equipment and device designs. He has worked on and lead projects that range from developing optical coatings to Infrared sensors and ceramic transducers. He has experiences in a vast array of micro and nanofabrication processes and device engineering. He has also served as the Director of Northeastern University’s Nano manufacturing facility for eight years with programs including biosensor development with nanomaterial. Among other recent roles that he has held are leadership roles at Draper Labs in Cambridge, MA, directing and managing the workflow and process at the biology and MEMS facilities. He has held positions as Principal Engineer at Reytheon, designing and optimizing manufacturing processes for a variety of devices including medical devices a Principal Engineer at MKS, where he was involved in managing the workflow of the processes for manufacturing of chips for EUA authorized COVID-19 tests for some of their customers. He has over 30 years of experience in nanotechnology and MEMs research and development, process and product development, manufacturing and leadership. Rich is a physicist by education and engineer by training. Richard DeVito, M.S., co-founder, and Principal Engineer, received his M.S. in Engineering Science from the University of Miami in Chemical Engineering from Columbia University, and a B.S. in Chemical/Biochemical Engineering from Rutgers University, M.S. Dr Aparicio is active in his community by participating as member of advisory committees for University of Miami Biomedical Engineering Department, Miami-Dade Community College, Cystic Fibrosis Foundation, Hialeah Technology Center, and Greater Ft Lauderdale Chamber of Commerce. In addition, he is currently a Technical Lead for the NIH/RADx-Tech program for the rapid development of diagnostic tests for Covid-19, advising diagnostic companies in their development and commercialization strategies. Prior to CLAS Automation, Dr Aparicio held C-level positions and worked in product development for ImmunoSite Technologies, Abbott, Beckman-Coulter, Warner-Lambert, and Ciba-Geigy. ![]() ![]() Prior to joining InnoTech Precision Medicine, he served as CEO & President of CLAS Automation, Inc., a world-renowned provider of laboratory automation services to Clinical Research Organizations (CROs), pharmaceutical companies, and academia. Carlos Aparicio, PhD, InnoTech, Chief Operating Officer has more than 25 years of leadership experience in the pharmaceutical and medical devices industries. ![]() ![]() Click "Back" to return to previous step.Tip: Check the "Swap L/R Image" option, you can switch left and right eye's image. Click “Next” button to return to next step.Ĭlick “Anaglyph (Red/Cyan)”, “Side by Side”, “Side by Side (Half-Width)”, “Top and Bottom” or “Top and Bottom (Half-Height)” under the preview area, select an output mode.Click "Side by Side", "Side by Side (Half-Width)", "Top and Bottom" or "Top and Bottom (Half-Height)" under the preview area, select a source mode. ![]() Click "3D to 3D" button to open settings interface.The software supports conversion between different 3D video format. Click "Finish" to return to the main window.(2) Check the “Swap L/R Image” option, you can switch left and right eye's image. (1) You can drag the “3D Depth” control slider to set the depth. Click "Anaglyph (Red/Cyan)", "Side by Side", "Side by Side (Half-Width)", "Top and Bottom" or "Top and Bottom (Half-Height)" under the preview area, select an output mode.Click "2D to 3D" button to open settings interface.You can convert 2D standard videos to 3D videos, and watch it on TV. We provide you more functions as below! 3D Video ConversionĬhoose the file you want to convert in the file list, and Click “3D Conversion” button on the toolbar to enter “3D Conversion” window. Ok, the above is the simplest function in conversion. Search for the wanted profile quickly by entering the profile keyword in “Start Searching” textbox of the profile list.Īfter selected output profile, you only need to check the files you want to convert in the file list and click “Convert Checked Item(s)” button on the toolbar to complete the task.The “Recently Used” option can record your recent usages automatically and it is convenient to use them again. Especially all-around HD video formats are supported. We provide abundant profiles compatible with various popular devices.Then click “Browse…” button to specify destination folder for saving output files. Select the files need to be converted and click “Profile” button to select the output format in the drop-down list. You can see the main interface as below.Ĭlick “Add File(s)” button on the toolbar or select “File> Add File(s)” on the main menu to load files. Getting StartedĪfter installation, run the software. How to convert video files using this video converter? The following will show you a step-by-step guide to complete conversion tasks.įirstly, download Xilisoft Video Converter Ultimate and then install and run it. Xilisoft Video Converter Ultimate Tutorial Referring FAQ |
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