Was ist das eigentlich? Cyberrisiken verständlich erklärt

Es wird viel über Cyberrisiken gesprochen. Oftmals fehlt aber das grundsätzliche Verständnis, was Cyberrisiken überhaupt sind. Ohne diese zu verstehen, lässt sich aber auch kein Versicherungsschutz gestalten.

Beinahe alle Aktivitäten des täglichen Lebens können heute über das Internet abgewickelt werden. Online-Shopping und Online-Banking sind im Alltag angekommen. Diese Entwicklung trifft längst nicht nur auf Privatleute, sondern auch auf Firmen zu. Das Schlagwort Industrie 4.0 verheißt bereits eine zunehmende Vernetzung diverser geschäftlicher Vorgänge über das Internet.

Anbieter von Cyberversicherungen für kleinere und mittelständische Unternehmen (KMU) haben Versicherungen die Erfahrung gemacht, dass trotz dieser eindeutigen Entwicklung Cyberrisiken immer noch unterschätzt werden, da sie als etwas Abstraktes wahrgenommen werden. Für KMU kann dies ein gefährlicher Trugschluss sein, da gerade hier Cyberattacken existenzbedrohende Ausmaße annehmen können. So wird noch häufig gefragt, was Cyberrisiken eigentlich sind. Diese Frage ist mehr als verständlich, denn ohne (Cyber-)Risiken bestünde auch kein Bedarf für eine (Cyber-)Versicherung.

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Medical OCS : Ophthalmic Coding Specialist exam Dumps

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Exam Number : OCS
Exam Name : Ophthalmic Coding Specialist
Vendor Name : Medical
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OCS exam Format | OCS Course Contents | OCS Course Outline | OCS exam Syllabus | OCS exam Objectives


Test Detail:
The OCS (Ophthalmic Coding Specialist) exam is conducted to certify individuals who possess the knowledge and skills required to accurately assign medical codes for ophthalmic procedures and services. The exam evaluates the candidate's understanding of coding guidelines, reimbursement policies, and ophthalmic terminology.

Course Outline:
The course for the OCS certification covers various courses related to ophthalmic coding. The following is a general outline of the key areas covered:

1. Introduction to Ophthalmic Coding:
- Overview of the role of an Ophthalmic Coding Specialist.
- Understanding the purpose and importance of accurate medical coding.
- Familiarization with coding systems and guidelines specific to ophthalmology, such as CPT, ICD-10, and HCPCS.

2. Ophthalmic Terminology and Anatomy:
- Understanding ophthalmic anatomy and physiology.
- Learning common ophthalmic conditions and diseases.
- Familiarization with ophthalmic terminology and abbreviations.

3. Coding Guidelines and Documentation:
- Understanding coding guidelines and conventions.
- Reviewing documentation requirements for ophthalmic procedures and services.
- Identifying key elements necessary for accurate coding and reimbursement.

4. Ophthalmic Coding Systems:
- Understanding the Current Procedural Terminology (CPT) coding system.
- Familiarization with the International Classification of Diseases (ICD) coding system.
- Learning the Healthcare Common Procedure Coding System (HCPCS).

5. Evaluation and Management (E/M) Services:
- Understanding the E/M coding guidelines specific to ophthalmology.
- Identifying the key components of E/M services and assigning appropriate codes.
- Reviewing documentation requirements for E/M services.

6. Surgical Procedures and Services:
- Coding for common ophthalmic surgical procedures, such as cataract surgery, corneal transplant, and glaucoma procedures.
- Understanding modifiers and their application in ophthalmic coding.
- Familiarization with surgical documentation requirements.

7. Diagnostic Testing and Imaging:
- Coding for ophthalmic diagnostic tests and imaging procedures, including visual field tests, optical coherence tomography (OCT), and fundus photography.
- Familiarization with coding guidelines and documentation requirements for diagnostic testing.

Exam Objectives:
The OCS exam focuses on evaluating the candidate's knowledge and understanding of the following key areas:

1. Ophthalmic Coding Guidelines and Conventions
2. Ophthalmic Terminology and Anatomy
3. Evaluation and Management (E/M) Services Coding
4. Surgical Procedures and Services Coding
5. Diagnostic Testing and Imaging Coding
6. Reimbursement Policies and Regulations

Exam Syllabus:
The exam syllabus for the OCS certification provides a detailed breakdown of the courses covered in each exam objective. It includes sub-topics, coding scenarios, and specific coding guidelines that candidates should be familiar with. The syllabus may cover the following areas:

- Ophthalmic surgical procedures and coding
- Ophthalmic diagnostic testing and imaging procedures
- Evaluation and management (E/M) coding in ophthalmology
- Coding guidelines and conventions specific to ophthalmology
- Reimbursement policies and regulations for ophthalmic coding



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Medical Ophthalmic questions

 

Medical Ophthalmic Lens Implants Market Overview by Rising Demands and Scope 2023 to 2031

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The Medical Ophthalmic Lens Implants Market is expected at value of US$ million in 2022 and grow at approximately % CAGR during 2022 and 2028. The United States Market is expected at value of US$ million in 2022 and grow at approximately % CAGR during 2022 and 2028. The Europe Market is expected at value of US$ million in 2022 and grow at approximately % CAGR during 2022 and 2028. The China market is expected at value of US$ million in 2022 and grow at approximately % CAGR during 2022 and 2028.

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Segmentation by typeSoft Crystals Hard Crystals

Segmentation by applicationHospital Clinic

Segmentation by regionAmericas United States Canada Mexico Brazil APAC China Japan Korea Southeast Asia India Australia Europe Germany France UK Italy Russia Middle East & Africa Egypt South Africa Israel Turkey GCC Countries

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Preservatives in Topical Ophthalmic Medications: Historical and Clinical Perspectives

Evolution of Preservatives Since Benzalkonium Chloride

Cetrimonium is a detergent-type preservative. Its ophthalmic uses have included preservation of artificial tear preparations such as Civigel (Ciba Vision Ophthalmics, GA, USA) Table 1 . Cetrimonium causes keratinization and inflammatory infiltrates at the limbus and within the conjunctival stroma and epithelium.[3] Its corneo–conjunctival cell toxicity has been deemed similar to BAK. Owing to its antiseptic and cationic surfactant qualities, cetrimonium is used mostly as a softening agent in hair treatments. It is also used as a fermentation aid, a dispersant and in preservation of antifungal creams.

Chlorobutanol

Chlorobutanol is a detergent preservative that was formerly used as an active ingredient in hypnotic and sedative agents.[9] Chlorobutanol has been used as a preservative agent in artificial tears, where it has been documented to cause significant keratitis and irritation to the ocular surface.[15] While it damages the ocular surface cells, the toxic effects take longer to manifest in human corneas than do the effects of BAK.[16] Human corneal epithelial cells exposed to chlorobutanol display a decreased amount of mitoses and deterioration of overall cell integrity.[16] Chlorobutanol does not, however, affect the stability of the lipid component of the tear film.[17]

Although the antimicrobial activity of chlorobutanol is extensive,[18] its use has been limited due to the fact that it becomes unstable when stored at room temperature for extended periods of time. Unlike BAK, chlorobutanol does not act like a surfactant.[17] The method of action of chlorobutanol is cell lysis by way of disruption of microbial cell membrane lipid configuration.[17]

Edetate Disodium

Edetate disodium (EDTA) is a chelating agent used in a variety of nonophthalmic products, including hair conditioner, facial cleansers, aftershaves and deodorants. In the recycling industry, it has been used to recover lead from used lead-acid batteries. In the medical field, uses include the treatment of acute mercury poisoning, lead poisoning and hypercalcemia. EDTA has gained use in ophthalmic solutions owing to its ability to bind metals. Therapeutically, EDTA has been used to remove calcified plaques that occur in the superficial cornea in band keratopathy.[19] EDTA has also been used in eye washes to aid in neutralization of calcium hydroxide or lime burns to the cornea.

Edetate disodium also has preservative effects based on its ability to chelate. When added to topical medicines in low concentrations, EDTA has been shown to inactivate trace amounts of heavy metals, which aids in the preservation of the solution.[18] Ophthalmic solutions that have employed EDTA include Acular® (ketorolac tromethamine ophthalmic solution) and Betagan® (levobunolol hydrochloride ophthalmic solution USP).

Polyquaternium-1 (Polyquad®)

Polyquad® is a detergent-type preservative derived from BAK. Polyquad was formulated in the mid 1980s by Alcon as a preservative for contact lens storage solutions. It was developed because other preservatives (e.g., BAK) were known to become concentrated in contact lenses that had been stored in conventional lens solutions. When placed in an aqueous ocular environment, the contaminated contact lens can act as a reservoir of preservative that can later be released. Polyquad does not become concentrated in contact lenses.

Although it is a detergent, Polyquad has unique properties distinguishing it from BAK. Bacterial cells attract Polyquad, yet human corneal epithelial cells tend to repel the compound.[20] Polyquad is the main ingredient in Tears Naturale II (Alcon) and Opti-Free Express MultiPurpose Disinfecting Solution (Alcon), as well as other storage solutions for contact lenses.

While Polyquad has been shown to be much less toxic to the corneo–conjunctival surface than BAK,[21] it has been shown to cause superficial epithelial damage to the cornea.[22] The main detriment associated with polyquaternium-1 is its tendency to reduce the density of conjunctival goblet cells, thereby decreasing aqueous tear film production.[21]

Polyhexamethylene Biguanide

Polyhexamethylene biguanide (PHMB) has been used in contact lens solutions such as ReNu® (Bausch & Lomb, NY, USA) and has historically been a component of pool cleaners, skin disinfectants and urinary catheter flush solutions. The benefits of PHMB against Acanthamoeba and bacteria are well known.[23] PHMB has been shown to be nonirritating to human corneal cells; however, its antifungal activity is limited.[18] PHMB employs its microbial activity by integrating into bacterial cell walls, thereby disrupting its membrane and has been shown to lethally alter the transcription of bacterial DNA.[24]

Stabilized Oxychloro Complex

Stabilized oxychloro complex (Purite, Bio-Cide International Inc., OK, USA) is an oxidative-type preservative and was introduced into ophthalmic medicines in the mid 1990s under the trade name Purite. One of its derivatives, sodium chlorite, has been used in water purification systems since the 1940s.[25] Purite has become a component of several different types of artificial tear and antiglaucoma preparations, including brimonidine tartrate ophthalmic solution (Alphagan-P®, Allergan, CA, USA) and Refresh Tears (Allergan).

Stabilized oxychloro complex has been shown to be well tolerated by the ocular surface.[25] Even at very low concentrations of SOC (0.005%), the antimicrobial activity is broad.[4] This was substantiated during a trial in which SOC was administered to patients up to eight-times daily.[25] SOC has been shown to lack cytotoxicity in vivo; however, more studies are needed to assess ocular side effects independent of active ingredients.[26] The antimicrobial effects are broad and include antibacterial, antifungal and antiviral effects. Chemically, SOC is a mixture of chlorine dioxide, chlorite and chlorate.[4] When exposed to light, SOC dissociates into water, oxygen, sodium and chlorine free radicals.[27] The chlorine free radicals are thought to inhibit microorganism protein synthesis within cells by way of glutathione oxidation, which causes microbe cell death.[101]

Sodium Perborate (GenAqua™)

GenAqua™ is a preservative composed of sodium perborate and is contained in Genteal lubricant eye drops (Novartis Ophthalmics, NJ, USA). Sodium perborate is an oxidative preservative that has been used in dental hygiene solutions since the 1950s. When it was introduced in ophthalmic solutions, it was one of the first of the oxidative-type preservatives used. Sodium perborate alters protein synthesis within bacterial cells by oxidizing cell membranes and altering membrane-bound enzymes, causing enzymatic inhibition. Upon exposure to an aqueous environment, it is catalyzed into hydrogen peroxide, water and oxygen. This is a property exclusive to this compound. The hydrogen peroxide formed by this reaction effectively kills microbes.[26] Furthermore, the efficacy of GenAqua has been demonstrated on Aspergillus niger.[26] There are few studies documenting the ocular tolerability and side-effect profile of GenAqua.

SofZia™

SofZia™ is the most accurate advancement in the field of ophthalmic preservatives and is the preservative system contained in one preparation of travoprost (Travatan Z®, Alcon, Texas). When exposed to cations, such as those that are normally encountered in the tear film of the eye, sofZia is deemed inactive. This is thought to induce less cytotoxicity to the ocular surface compared with more conventional preservatives.

Travatan Z was introduced as the first prostaglandin analogue to be preserved with a substance other than BAK. The sofZia system effectively preserves the medicine while it is being stored; however, when the drug is introduced into the eye, it is modified into harmless elements that are gentle on the ocular surface.[6] It has been demonstrated that sofZia-preserved travoprost induces corneal and conjunctival changes similar to preservative-free artificial tears. Furthermore, travoprost with sofZia also induced reduced amounts of conjunctival inflammation and corneal changes when compared with travoprost treated with BAK.[28]


 




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Warum sind Cyberrisiken so schwer greifbar?

Als mehr oder weniger neuartiges Phänomen stellen Cyberrisiken Unternehmen und Versicherer vor besondere Herausforderungen. Nicht nur die neuen Schadenszenarien sind abstrakter oder noch nicht bekannt. Häufig sind immaterielle Werte durch Cyberrisiken in Gefahr. Diese wertvollen Vermögensgegenstände sind schwer bewertbar.

Obwohl die Gefahr durchaus wahrgenommen wird, unterschätzen viele Firmen ihr eigenes Risiko. Dies liegt unter anderem auch an den Veröffentlichungen zu Cyberrisiken. In der Presse finden sich unzählige Berichte von Cyberattacken auf namhafte und große Unternehmen. Den Weg in die Presse finden eben nur die spektakulären Fälle. Die dort genannten Schadenszenarien werden dann für das eigene Unternehmen als unrealistisch eingestuft. Die für die KMU nicht minder gefährlichen Cyber­attacken werden nur selten publiziert.

Aufgrund der fehlenden öffentlichen Meldungen von Sicherheitsvorfällen an Sicherheitsbehörden und wegen der fehlenden Presseberichte fällt es schwer, Fakten und Zahlen zur Risikolage zu erheben. Aber ohne diese Grundlage fällt es schwer, in entsprechende Sicherheitsmaßnahmen zu investieren.

Erklärungsleitfaden anhand eines Ursache-Wirkungs-Modells

Häufig nähert man sich dem Thema Cyberrisiko anlass- oder eventbezogen, also wenn sich neue Schaden­szenarien wie die weltweite WannaCry-Attacke entwickeln. Häufig wird auch akteursgebunden beleuchtet, wer Angreifer oder Opfer sein kann. Dadurch begrenzt man sich bei dem Thema häufig zu sehr nur auf die Cyberkriminalität. Um dem Thema Cyberrisiko jedoch gerecht zu werden, müssen auch weitere Ursachen hinzugezogen werden.

Mit einer Kategorisierung kann das Thema ganzheitlich und nachvollziehbar strukturiert werden. Ebenso hilft eine solche Kategorisierung dabei, eine Abgrenzung vorzunehmen, für welche Gefahren Versicherungsschutz über eine etwaige Cyberversicherung besteht und für welche nicht.

Die Ursachen sind dabei die Risiken, während finanzielle bzw. nicht finanzielle Verluste die Wirkungen sind. Cyberrisiken werden demnach in zwei Hauptursachen eingeteilt. Auf der einen Seite sind die nicht kriminellen Ursachen und auf der anderen Seite die kriminellen Ursachen zu nennen. Beide Ursachen können dabei in drei Untergruppen unterteilt werden.

Nicht kriminelle Ursachen

Höhere Gewalt

Häufig hat man bei dem Thema Cyberrisiko nur die kriminellen Ursachen vor Augen. Aber auch höhere Gewalt kann zu einem empfindlichen Datenverlust führen oder zumindest die Verfügbarkeit von Daten einschränken, indem Rechenzentren durch Naturkatastrophen wie beispielsweise Überschwemmungen oder Erdbeben zerstört werden. Ebenso sind Stromausfälle denkbar.

Menschliches Versagen/Fehlverhalten

Als Cyberrisiken sind auch unbeabsichtigtes und menschliches Fehlverhalten denkbar. Hierunter könnte das versehentliche Veröffentlichen von sensiblen Informationen fallen. Möglich sind eine falsche Adressierung, Wahl einer falschen Faxnummer oder das Hochladen sensibler Daten auf einen öffentlichen Bereich der Homepage.

Technisches Versagen

Auch Hardwaredefekte können zu einem herben Datenverlust führen. Neben einem Überhitzen von Rechnern sind Kurzschlüsse in Systemtechnik oder sogenannte Headcrashes von Festplatten denkbare Szenarien.

Kriminelle Ursachen

Hackerangriffe

Hackerangriffe oder Cyberattacken sind in der Regel die Szenarien, die die Presse dominieren. Häufig wird von spektakulären Datendiebstählen auf große Firmen oder von weltweiten Angriffen mit sogenannten Kryptotrojanern berichtet. Opfer kann am Ende aber jeder werden. Ziele, Methoden und auch das Interesse sind vielfältig. Neben dem finanziellen Interesse können Hackerangriffe auch zur Spionage oder Sabotage eingesetzt werden. Mögliche Hackermethoden sind unter anderem: Social Engineering, Trojaner, DoS-Attacken oder Viren.

Physischer Angriff

Die Zielsetzung eines physischen Angriffs ist ähnlich dem eines Hacker­angriffs. Dabei wird nicht auf die Tools eines Hackerangriffs zurückgegriffen, sondern durch das physische Eindringen in Unternehmensgebäude das Ziel erreicht. Häufig sind es Mitarbeiter, die vertrauliche Informationen stehlen, da sie bereits den notwendigen Zugang zu den Daten besitzen.

Erpressung

Obwohl die Erpressung aufgrund der eingesetzten Methoden auch als Hacker­angriff gewertet werden könnte, ergibt eine Differenzierung Sinn. Erpressungsfälle durch Kryptotrojaner sind eines der häufigsten Schadenszenarien für kleinere und mittelständische Unternehmen. Außerdem sind auch Erpressungsfälle denkbar, bei denen sensible Daten gestohlen wurden und ein Lösegeld gefordert wird, damit sie nicht veröffentlicht oder weiterverkauft werden.

Ihre Cyberversicherung sollte zumindet folgende Schäden abdecken:

Cyber-Kosten:

  • Soforthilfe und Forensik-Kosten (Kosten der Ursachenermittlung, Benachrichtigungskosten und Callcenter-Leistung)
  • Krisenkommunikation / PR-Maßnahmen
  • Systemverbesserungen nach einer Cyber-Attacke
  • Aufwendungen vor Eintritt des Versicherungsfalls

Cyber-Drittschäden (Haftpflicht):

  • Befriedigung oder Abwehr von Ansprüchen Dritter
  • Rechtswidrige elektronische Kommunikation
  • Ansprüche der E-Payment-Serviceprovider
  • Vertragsstrafe wegen der Verletzung von Geheimhaltungspflichten und Datenschutzvereinbarungen
  • Vertragliche Schadenersatzansprüche
  • Vertragliche Haftpflicht bei Datenverarbeitung durch Dritte
  • Rechtsverteidigungskosten

Cyber-Eigenschäden:

  • Betriebsunterbrechung
  • Betriebsunterbrechung durch Ausfall von Dienstleister (optional)
  • Mehrkosten
  • Wiederherstellung von Daten (auch Entfernen der Schadsoftware)
  • Cyber-Diebstahl: elektronischer Zahlungsverkehr, fehlerhafter Versand von Waren, Telefon-Mehrkosten/erhöhte Nutzungsentgelte
  • Cyber-Erpressung
  • Entschädigung mit Strafcharakter/Bußgeld
  • Ersatz-IT-Hardware
  • Cyber-Betrug