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California Medical Bill Reviewers Certification

California Medical Bill Reviewers Certification. Unit 1: Workers’ Compensation Benefit Program Module 6: ACOEM Guidelines. Overview. You have probably realized that general practitioners are governed by specific guidelines that help them diagnose and treat illness and injury.

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California Medical Bill Reviewers Certification

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  1. California Medical Bill Reviewers Certification Unit 1: Workers’ Compensation Benefit Program Module 6: ACOEM Guidelines

  2. Overview You have probably realized that general practitioners are governed by specific guidelines that help them diagnose and treat illness and injury. In this module, you will learn about the ACOEM Guidelines, what they are, and how they help physicians treat occupational illness and injury. Let’s start with what ACOEM Guidelines are... • What ACOEM Guidelines Are, and How They Are Used in California • Review the Content and Organization of the ACOEM Guidelines • Section I: Foundations of Occupational Medicine • Section II: Presenting Complaints • What ACOEM Guidelines Are, and How They Are Used in California

  3. What are ACOEM Guidelines? • The ACOEM Guidelines were developed by the Practice Guidelines Committee of the American College of Occupational and Environmental Medicine (ACOEM). ACOEM Guidelines: the primary resource for occupational medicine practitioners, which provides detailed guidelines for diagnosing, treating, and managing a variety of occupational medicine injuries.

  4. ACOEM Guidelines in California The State of California now requires that workers’ compensation utilization review follow the 2nd edition of ACOEM Guidelines.

  5. ACOEM Guidelines • The ACOEM Guidelines are broken into two general sections. Section I: Foundations of Occupational Medicine Practice Section II: Presenting Complaints

  6. Section I provides general information on a range of topics relating to occupational medicine. Foundations of Occupational Medicine Practice Section I: Foundations of Occupational Medicine Practice Section I topics include: • How to prevent work-related injuries and illnesses. • How to assess and document injuries. • How to facilitate initial treatment. • How to determine if an injury is work-related. • How to limit long-term disability and accomplish fast recovery time. • How to manage delayed recovery.

  7. Pain, Suffering, and the Restoration of Function Foundations of Occupational Medicine Practice • Additionally, Section I includes a chapter specific to pain. Section I: Foundations of Occupational Medicine Practice Chapter topics include: • How to differentiate between chronic and acute pain. • How to assess pain. • How to manage pain. • How to prevent chronic pain.

  8. Foundations of Occupational Medicine Practice • Lastly, this section includes a chapter on Independent Medical Examiners (IMEs) and Consultations. Section I: Foundations of Occupational Medicine Practice The topics include: • Roles of IMEs. • Legal requirements of IMEs. • Qualifications and skills of IMEs. • Referrals and the IME process.

  9. Presenting Complaints • Section II provides information on musculoskeletal and eye injuries. Section II: Presenting Complaints Section II includes information on the following injuries: • Neck and Back • Shoulder • Elbow • Forearm, Wrist, and Hand • Knee • Ankle and Foot • Stress-related Conditions • Eye Musculoskeletal and eye injuries account for 95% of all work-related injuries.

  10. Presenting Complaints • Section II provides detailed information relevant to specific injuries. Section II: Presenting Complaints Some of the topics include: • Identification and assessment • Diagnosis • Assessment of work-relatedness • Initial care and follow-up visits • Work activities and adaptation • Special studies, diagnostic, and treatment options • Surgical options

  11. What ACOEM Guidelines are, and how they are used. Overview of Section I: Foundations of Occupational Medicine. Overview of Section II: Presenting Complaints. Summary

  12. Module 6 Quiz Click on the link to go directly to the quiz. Feel free to review any of the material before you move on. Good Luck! Quiz: U1M6: ACOEM Guidelines

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