CMS 2023 changes

[johhnybgood]

If this is the idea; then they need to give us reasonable numbers for the clinical decision making pathway.

12 or less and a delta of 3 is what is on our laminated quick reference sheets.

If that were true; I'd admit so many, many more.

Even healthy young people roll a 22 on their first hsTnI.

There is very little risk in sending home pt with 2 negative trops and two unchanged ekg. If you went by hearts score then everyone should be obs d or admitted. Florida just seems to admit everyone. Not because of best practice patterns but because med mal.

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[RustedFox]

There is very little risk in sending home pt with 2 negative trops and two unchanged ekg. If you went by hearts score then everyone should be obs d or admitted. Florida just seems to admit everyone. Not because of best practice patterns but because med mal.

Yeah; so I've been thinking a lot about this (hsTnI pathways) these days.
It seems like there's a big discrepancy between the numbers that Envision wants you to use in the CDM algorithm vs. what is generally published in the literature.

If I'm wrong, I'm wrong. I've been up since 4 (just woke up) and went mountain biking (group function) from 8-1.
I'm going to pig out and pass out.

 

[SpacemanSpifff]

Yeah; so I've been thinking a lot about this (hsTnI pathways) these days.
It seems like there's a big discrepancy between the numbers that Envision wants you to use in the CDM algorithm vs. what is generally published in the literature.

If I'm wrong, I'm wrong. I've been up since 4 (just woke up) and went mountain biking (group function) from 8-1.
I'm going to pig out and pass out.

I feel like the standard of care is moving away from the HEART score in the age of high sensitivity troponin testing and a premium on inpatient beds.

May be on the path but not there yet. Med mal lawyers need To eat and will screw you sideways to get filet in lieu of a juicy in n out burger.

Since the conversation has turned a different direction from its CMS origins, I started a new thread - bring your opinions over.

 

[EctopicFetus]

If this is the idea; then they need to give us reasonable numbers for the clinical decision making pathway.

12 or less and a delta of 3 is what is on our laminated quick reference sheets.

If that were true; I'd admit so many, many more.

Even healthy young people roll a 22 on their first hsTnI.

If you can get your hospital and cardiology to write up guidelines it will offer a lot of protection. More hands on the casket.