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Dr. Riad  Cachecho  Md image

Dr. Riad Cachecho Md

115 Lincoln St
Framingham MA 01702
508 523-3184
Medical School: Other - 1976
Accepts Medicare: No
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: 50363
NPI: 1386781821
Taxonomy Codes:
208600000X

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Awards & Recognitions

About Us

Practice Philosophy

Conditions

Dr. Riad Cachecho is associated with these group practices

Procedure Pricing

HCPCS Code Description Average Price Average Price
Allowed By Medicare
HCPCS Code:99291 Description:Critical care first hour Average Price:$562.00 Average Price Allowed
By Medicare:
$227.79
HCPCS Code:99223 Description:Initial hospital care Average Price:$289.00 Average Price Allowed
By Medicare:
$206.57
HCPCS Code:99233 Description:Subsequent hospital care Average Price:$171.00 Average Price Allowed
By Medicare:
$105.22

HCPCS Code Definitions

99291
Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes
99233
Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed a significant complication or a significant new problem. Typically, 35 minutes are spent at the bedside and on the patient's hospital floor or unit.
99223
Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of high severity. Typically, 70 minutes are spent at the bedside and on the patient's hospital floor or unit.

Medical Malpractice Cases

None Found

Medical Board Sanctions

None Found

Referrals

NPI
Doctor Name
Specialty
Count
1902890890
Diagnostic Radiology
133
1396755575
Vascular Surgery
105
1528059144
Cardiovascular Disease (Cardiology)
104
1831183722
Diagnostic Radiology
100
1669437513
Cardiovascular Disease (Cardiology)
96
1932119005
Critical Care (Intensivists)
92
1891770913
Physical Medicine And Rehabilitation
82
1548254287
Diagnostic Radiology
81
1700806478
Diagnostic Radiology
78
1972594562
Cardiovascular Disease (Cardiology)
77
*These referrals represent the top 10 that Dr. Cachecho has made to other doctors

Publications

Prospective derivation of a clinical decision rule for thoracolumbar spine evaluation after blunt trauma: An American Association for the Surgery of Trauma Multi-Institutional Trials Group Study. - The journal of trauma and acute care surgery
Unlike the cervical spine (C-spine), where National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian C-spine Rules can be used, evidence-based thoracolumbar spine (TL-spine) clearance guidelines do not exist. The aim of this study was to develop a clinical decision rule for evaluating the TL-spine after injury.Adult (≥15 years) blunt trauma patients were prospectively enrolled at 13 US trauma centers (January 2012 to January 2014). Exclusion criteria included the following: C-spine injury with neurologic deficit, preexisting paraplegia/tetraplegia, and unevaluable examination. Remaining evaluable patients underwent TL-spine imaging and were followed up to discharge. The primary end point was a clinically significant TL-spine injury requiring TL-spine orthoses or surgical stabilization. Regression techniques were used to develop a clinical decision rule. Decision rule performance in identifying clinically significant fractures was tested.Of 12,479 patients screened, 3,065 (24.6%) met inclusion criteria (mean [SD] age, 43.5 [19.8] years [range, 15-103 years]; male sex, 66.3%; mean [SD] Injury Severity Score [ISS], 8.8 [7.5]). The majority underwent computed tomography (93.3%), 6.3% only plain films, and 0.2% magnetic resonance imaging exclusively. TL-spine injury was identified in 499 patients (16.3%), of which 264 (8.6%) were clinically significant (29.2% surgery, 70.8% TL-spine orthosis). The majority was AO Type A1 282 (56.5%), followed by 67 (13.4%) A3, 43 (8.6%) B2, and 32 (6.4%) A4 injuries. The predictive ability of clinical examination (pain, midline tenderness, deformity, neurologic deficit), age, and mechanism was examined; positive clinical examination finding resulted in a sensitivity of 78.4% and a specificity of 72.9%. Addition of age of 60 years or older and high-risk mechanism (fall, crush, motor vehicle crash with ejection/rollover, unenclosed vehicle crash, auto vs. pedestrian) increased sensitivity to 98.9% with specificity of 29.0% for clinically significant injuries and 100.0% sensitivity and 27.3% specificity for injuries requiring surgery.Clinical examination alone is insufficient for determining the need for imaging in evaluable patients at risk of TL-spine injury. Addition of age and high-risk mechanism results in a clinical decision-making rule with a sensitivity of 98.9% for clinically significant injuries.Diagnostic test, level III.
The application of human engineering interventions reduces ventilator-associated pneumonia in trauma patients. - The journal of trauma and acute care surgery
Ventilator-associated pneumonia (VAP) increases mortality and length of stay and escalates the cost of care. Our institution embarked on a project to eradicate VAP.We compared the outcome of trauma patients admitted in period 1 (P1) (January 2005 to December 2006) and period 2 (P2) (January 2006 to December 2009). Team building, culture change, and the ventilator bundle were introduced and modified during P1 and were fully implemented in P2. Outcome data were calculated for both periods. The Center for Disease Control VAP definition was used. The VAP rate was calculated as VAP/1,000 ventilator days. Chi-square and t test statistics were used as appropriate. Data were considered statistically significant if p ≤ 0.05.In total, 299 trauma patients were admitted in P1 and 655 in P2. The two groups were identical in age, Injury Severity Score, mortality, and non-VAP. There was a trend toward a shorter length of stay in P2 (p = 0.06). The days on ventilator was significantly shorter in P2 compared with P1 (p = 0.05). The VAP rate dropped significantly from 7.9/1,000 in P1 to 1.0/1,000 in P2 (p = 0.04). The Appropriate Care Measure score increased from 45% in early P1 to 91% in late P2 (p = 0.0001).The application of the VAP bundle, a checklist, and the multidisciplinary team approach resulted in significant improvement of VAP in all trauma patients admitted to the shock trauma unit and to the decrease in days on ventilator in the trauma patients. This intervention did not affect mortality or the rate of non-VAP in the trauma patients.Therapeutic study, level IV.
Pharmacist designed and nursing-driven insulin infusion protocol to achieve and maintain glycemic control in critical care patients. - Journal of trauma nursing : the official journal of the Society of Trauma Nurses
The objective of the quality assessment was to develop and evaluate a modified nurse-driven insulin infusion protocol for intensive care unit patients and compare the hours needed to achieve a targeted glycemic range and duration within a goal range (80-110 mg/dL) to that of our traditional protocol. With our modified nurse-driven protocol, the median time to reach the goal for patients with diabetes was 11.5 hours versus 21.5 hours with the traditional protocol. Patients without diabetes reached the goal in 8 hours with the modified-nurse driven protocol versus 12 hours with the traditional protocol. Percentage of time within the goal improved from 14.6% to 20.7% for patients with diabetes and from 7% to 24.3% for patients without diabetes.

Map & Directions

115 Lincoln St Framingham, MA 01702
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