J-26 Treatment Qtr Rpt.pdf

World Trade Center - Treatment Program Participants Version LT-13 Quarterly Report for: 10/01/2009 to 12/31/2009 25-Jan-2010

Clinical Center:

Enter data in colored boxes

01/01/2009 to 03/31/2009

04/01/2009 to 06/30/2009

07/01/2009 to 09/30/2009

10/01/2009 to 12/31/2009

Past 4 Quarters ICD9 Codes

Health Conditions (unique patients in each row) Total Patients Patients with any Physical Health Condition

Upper Airway Rhinosinusitis 472.0, 473.0, Throat disorders (RUDS, vocal cord issues, phryngitis, laryngitis, etc) and obstructive sleep apnea

474.00, 474.0

Lower Airway Asthma/RADS 493.00, 493.0 COPD (chronic bronchitis, emphysema, etc), interstitial lung diseases, alveolar diseases, pleural diseases

491.0, 491.1, Gastrointestinal Gastroesphageal reflux disesase and related disorders (ulcers, barretts, etc.)

530.0, 787.20

Musculoskeletal Spine disorders 722.10, 723.1 Extremity disorders (upper and lower limbs) 354, 354.2, 7

Patients with any Mental Health Condition Post traumatic stress disorder (PTSD) 309.81 Anxiety Disorders other than PTSD (panic, anxiety, etc.) Mood disorders (depression, bipolar, dysthymic, etc) Psychosocial disorders (v-codes, etc) Substance Abuse (ETOH)

296.20, 296.2

Patients with both Physical and Mental Conditions

Participants

Comorbidities (unique patients in each row) Cardiac Musculoskeletal Endocrine/Renal/GI Cancer Other Patients with any comorbidity

Employment Status @ time of visit Currently Employed Unemployed/Laid off Extended Sick Leave/Disabled Retired Other No Answer Provided

TOTAL 0 0 0 0 0

Occupation @ time of visit Construction Law Enforcement Civilian Public Sector Technical and Utilities Transportation Cleaning/Maintenance

Tx Qtr Rpt Example 20100518.xlsx Page 1 of 6

01/01/2009 to 03/31/2009

04/01/2009 to 06/30/2009

07/01/2009 to 09/30/2009

10/01/2009 to 12/31/2009

Past 4 Quarters ICD9 Codes

Volunteer Firefighter (not FDNY) Healthcare News Agency Office/Administrative/Professional Federal Employee Other Occupation Not Currently Employed No Answer Provided

TOTAL 0 0 0 0 0

Insurance Status @ time of visit Yes No No Answer Provided

TOTAL 0 0 0 0 0

Insurance Category @ time of visit Aetna Blue Cross/Blue Shield

GHI

HIP

Other Managed Care/PPO Other Managed Care/HMO Other Private

Tx Qtr Rpt Example 20100518.xlsx Page 2 of 6

04/01/2009 to 06/30/2009

07/01/2009 to 09/30/2009

10/01/2009 to 12/31/2009

Past 4 Quarters ICD9 Codes

Medicaid Medicare No Answer Provided

TOTAL 0 0 0 0 0

Workers' Compensation WC Claim filed for WTC-related condition 0 Medical care for WTC-related conditions through WC claim 0

Line of Duty LODI Claim filed for WTC-related condition 0 Medical care for WTC-relted condition through LODI claim 0

Prescriptions (number filled) Upper Airway 0 Lower Airway 0 Gastrointestinal 0 Musculoskeletal 0 Mental Health 0

TOTAL 0 0 0 0 0

Hospitalizations (Inpatient) Physical Health 0 Mental Health 0

TOTAL 0 0 0 0 0

Number of Visits (includes multiple visits per patient) Physical Health (PH) 0 Mental Health (MH) 0Mental Health (MH) 0 Subtotal 0 0 0 0 0 Social Work (SW) * 0 Total 0 0 0 0 0

* These SW visits are not part of PH or MH treatment, which may have their own SW visits.

Specialist Visits within Clinic Physical Health

Internal Medicine 0 Occupational Medicine 0 Pulmonology 0

ENT 0

GI 0

Physiatry 0 Neurology 0 Orthopedics 0 Pain Management 0 Cardiology 0 Physical Therapy 0 Occupational Therapy 0

Tx Qtr Rpt Example 20100518.xlsx Page 3 of 6

04/01/2009 to 06/30/2009

07/01/2009 to 09/30/2009

10/01/2009 to 12/31/2009

Past 4 Quarters ICD9 Codes

SW-Benefits Counseling 0 Other 0

TOTAL 0 0 0 0 0

Mental Health Psychiatry 0 Psychology 0 SW-Psycotherapy 0 SW-Benefits Counseling 0 Other 0

TOTAL 0 0 0 0 0

Specialist Visits outside of Clinic Physical Health

Internal Medicine 0 Occupational Medicine 0 Pulmonology 0

ENT 0

GI 0

Physiatry 0 Neurology 0 Orthopedics 0 Pain Management 0 Cardiology 0 Physical Therapy 0 Occupational Therapy 0 SW-Benefits Counseling 0 Other 0

TOTAL 0 0 0 0 0

Mental Health Psychiatry 0Psychiatry 0 Psychology 0 SW-Psycotherapy 0 SW-Benefits Counseling 0 Other 0

TOTAL 0 0 0 0 0

Notes:

Rows 8, 41, 59, and 65 should match.

Row 102 should equal the sum of Rows 125 and 150.

Row 103 should equal the sum of Rows 132 and 157.

Tx Qtr Rpt Example 20100518.xlsx Page 4 of 6

Instructions and Comments For rows 8 through 99, the numbers in column F (Past 4 Quarters) are derived from the data and will not equal the sum of the four quarterly numbers because responders may be seen For rows 101+ the numbers in column F (Past 4 Quarters) are calculated in the spreadsheet as the sum of the four quarterly numbers because these numbers count services provided In later quarterly reports, the past quarters' numbers may be changed to reflect updates or corrections, but changes (with reference to specific cells in the spreadsheet) should be Health Conditions (unique patients in each row) This set of health condition categories is subject to change by combining or separating ICD codes based on decisions by the WTC Consortium.

The major group (e.g. Upper Respirometry) numbers will not be the sum of the subgroup numbers because many responders have more than one health condition.

Similarly, the number of responders within the Broad groups of Physical and Mental Health Similarly, the total number of responders the sum of the broad groups.

The number of responders with both Physical and Mental Health conditions (row 38) can be used to calculate the number of responders with only physical health conditions and only All ICD codes that are identified in the healthcare of responders as WTC-related should be A claims report will be provided which gives the ICD data that are used for this table.

Comorbidities (unique patients in each row) These are health conditions that are not now covered by the WTC Program but are being tracked because of possible future coverage if a relationship with WTC exposures is This information is taken from the latest monitoring exam and any other documentation from All ICD codes for health conditions being tracked but not yet covered that are identified should be included in the appropriate category. Thus, the sum of the categories will exceed A claims report will be provided which gives the ICD data that are used for this table.A claims report will be provided which gives the ICD data that are used for this table.

Employment Status @ time of visit This information is taken from the latest MHQ and any updated information from Case Occupation @ time of visit This information is taken from the latest MHQ and any updated information from Case Insurance Status @ time of visit This information is taken from the latest MHQ and any updated information from Case Insurance Category @ time of visit This information is taken from the latest MHQ and any updated information from Case Workers' Compensation This information is taken from the latest MHQ and any updated information from Case Line of Duty This information is taken from the latest MHQ and any updated information from Case Prescriptions (number filled) This is a count of the prescriptions filled in the period, regardless of the duration of the A claims report will be provided which gives the prescription data that are used for this table.

Hospitalizations (Inpatient) This is a count of the number of hospital admissions, rather than the number of responders.

Number of Visits (includes multiple visits per patient)

This is a count of the number of visits by major category.

Social Work visits may be part of healthcare and be counted in the major categories of physical and mental health, or the visits may be made in conjunction with healthcare when Specialist Visits within Clinic This is the number of visits broken down into healthcare specialty within the NYC Clinic, so it Specialist Visits outside of Clinic This is the number of visits broken down into healthcare specialty in the UHC network.