Managing Medical Claims

Section One: Medical Terminology
Prefixes	2
Exhibit 1.1 – Prefixes	2
Root Words	2
Exhibit 1.2 – Root Words	3
Suffixes	5
Exhibit 1.3 – Suffixes	5
Aspects or Positions on the Body	6
Exhibit 1.4 – Aspects or Positions on the Body	6
Medical Abbreviations and Emergency Room Symbols	6
Exhibit 1.5 – Symbols/Abbreviations	6
Medical Professional	8
Exhibit 1.6 – Medical Professionals	9
Abbreviations Used With/For Medical Professional	9
Exhibit 1.7 – Medical Professional Abbreviations	10
Strains and Sprains	10
Exhibit 1.8 – Sprains and Strains	11
Workshop 1.1 – What’s It Mean?	12
Section Two: Fractures and Their Treatment
Types of Fractures	16
Exhibit 2.1 – Types of Fractures	17
Exhibit 2.2 – Common Fractures	18
Symptoms of Fractures	18
Complications	19
Exhibit 2.3 – Fracture Complications	19
Treatment	20
Exhibit 2.4 – Treatment of Fractures	20
Disability Periods	21
Workshop 2.1 – Fractures and Their Treatment	23
Sections Three: Injuries to the Head
Fractures	25
Exhibit 3.1 – Head Injuries Disability Chart	26
Exhibit 3.2 – The Skull	27
Skull Injuries	27
Exhibit 3.2 – Level of Cognitive Functioning Scale	29
Workshop 3.1 – Head Injuries	31
Section Four: Injuries to the Upper Extremities
Exhibit 4.1 – The Upper Extremities	33
The Hand	33
Exhibit 4.2 – The Hand	34
Carpal Tunnel Syndrome	34
The Shoulder	36
Exhibit 4.3 – Anterior View of the Shoulder	37
Chest and Rib Injuries	37
Thoracic Outlet Syndrome	38
Workshop 4.1 – The Upper Extremities	40
Section Five: Injuries to the Spine
Terminology	42
Exhibit 5.1 – Spinal Terminology	42
The Spinal Column	43
Exhibit 5.2 – Regions of the Spine	43
Exhibit 5.3 – Lateral View of the Spine	44
The Cervical Spine	44
The Dorsal/Thoracic Spine	44
The Lumbar Spine	45
Exhibit 5.4 – Superior and Lateral Views of a Lumbar Vertabra	45
The Dermatone Chart	45
Exhibit 5.5 – Dermatone Chart	46
Other Spinal Injuries	47
Exhibit 5.6 – Spinal Fractures	47
Severe Injuries to the Spine	48
Treatment for Spinal Cord Injuries	49
Reflex Sympathetic Dystrophy Syndrome (RSDS)	50
The Nervous System	51
Workshop 5.1 – Back Injuries	52
Section Six: Injuries to the Lower Extremities
Exhibit 6.1 – The Lower Extremities	60
The Femur	60
The Ankle	60
Exhibit 6.2 – Posterior View of the Knee	62
The Knee	62
Exhibit 6.3 – Common Knee Injuries	62
Exhibit 6.4 – Treatment of Knee Injuries	63
Exhibit 6.5 – Anterior View of the Knee	64
Exhibit 6.6 – Cartilage of the Knee	64
Exhibit 6.7 – Ligaments of the Knee	65
Workshop 6.1 – Injuries to the Lower Extremities	66
Section Seven: Scarring
Anatomy of the Skin	67
Exhibit 7.1 – Cross Section of the Skin	68
Injuries that Produce Scarring	69
Exhibit 7.2 – Injuries that Produce Scarring	69
Types of Scars	70
Treatment for Scars	71
Exhibit 7.3 – Treatment for Scars	71
Treating Scars	71
Exhibit 7.4 – Scar Revision Techniques	72
Evaluation Scar Cases	72
Scars and Revision Techniques	75
Section Eight: Diagnostic Testing
Common Lab Tests and Clinical Procedures	78
Exhibit 8.1 – Common Tests and Clinical Procedures	78
Tests for Head Injuries	79
Exhibit 8.2 – Tests for Head Injuries	79
Other Tests/Procedures	80
Exhibit 8.3 – MRI and CAT Scan Comparison	82
Workshop 8.1 – Performance Tests	85
Section Nine: Temporomandibular Joint Injuries
Exhibit 9.1 – The Jaw Joint	91
What Is TMJ?	91
What Causes TMJ?	92
Symptoms of TMJ	92
Treatment	93
Reviewing TMJ Claims	94
Length and Cost of Treatment	95
Workshop 9.1 – TMJ	97
Section Ten: The Teeth
Deciduous and Permanent Teeth	98
Exhibit 10.1 – Anatomy of a Tooth	99
Exhibit 10.2 – Deciduous Teeth	99
Workshop 10.1 – The Teeth	102
Section Eleven: Independent Medical Exams
What Is An IME?	103
How Are IME’s Used?	104
Before You Consider an IME: Some Considerations	104
Timing	105
Suggested Guidelines for Ordering an IME	105
Workshop 11.1 – IME’s	107
Workshop 11.2 – Critical Review of an IME	109
Section Twelve: Rehabilitation
A Three Component Process	112