June 10, 2015 | | JFAS | Contact Us

News From ACFAS

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Surgical Coding Workshop Puts You in the Driver’s Seat
Code actual cases with your fellow attendees during ACFAS’ newly redesigned Interactive Surgical Coding Workshop. Scheduled for July 17–18 in Tysons Corner, VA (Washington DC), this hands-on course equips you and your office staff with the tools you need to streamline your practice’s surgical coding process.

Fast-paced and focused case-based sessions will cover new requirements for ICD-10, modifiers, office policies, coding for evaluation, durable medical equipment and more. This is your chance to take the inside track as you navigate the twists and turns surgical coding can present.

The fee for this two-day workshop includes 12 continuing education contact hours, a comprehensive reference guide, breakfast and lunch.

Register today at and give your practice a competitive edge.
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Grow Your Network with Facebook & Twitter
Connect with your fellow ACFAS members on Facebook and Twitter for instant access to thriving communities ready to answer your questions, offer tips and serve as your sounding board for all things foot and ankle surgery. Expand your professional circle and your knowledge while also staying current on the latest College activities and events.

Sign up to join the conversation on all of our social media sites. And be sure to encourage your patients and friends to “like”, our patient education website, on Facebook and to follow Foot Health Facts on Twitter for the latest tweets on foot and ankle conditions geared toward patients.
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Foot and Ankle Surgery

Arthroscopic Evaluation of Impingement and Osteochondral Lesions in Chronic Lateral Ankle Instability
Researchers evaluated the incidence of intra-articular synovitis, osteochondral lesions (OCLs), impingement lesions and other associated pathologies in patients with chronic lateral ankle instability undergoing modified Broström-Gould ankle ligament reconstruction. One hundred patients were reviewed over a 10-year period, of which 63 percent had intra-articular synovitis requiring arthroscopic debridement. OCLs appeared in 17 percent of patients, and 12 percent showed anterior bony impingement lesions.

From the article of the same title
Foot & Ankle International (06/15) Odak, S.; Ahluwalia, R.; Shivarhatre, D.G.; et al.
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Ligament Reconstruction with Single Bone Tunnel Technique for Chronic Symptomatic Subtle Injury of the Lisfranc Joint in Athletes
Researchers conducted a study that yielded a new technique for Lisfranc ligament reconstruction, which treats chronic symptomatic subtle injuries that failed to respond to initial treatment. Five athletes diagnosed with chronic subtle injury of the Lisfranc joint underwent the procedure. In the novel technique, only a bone tunnel between the medial cuneiform and second metatarsal bone is needed for near-anatomical reconstruction of the dorsal and interosseous ligaments. Follow-up was completed one year after surgery. The average American Orthopaedic Foot and Ankle Society score improved significantly from preoperation to the one-year follow-up. All patients returned to their previous athletic activities and experienced no complications.

From the article of the same title
Archives of Orthopaedic and Trauma Surgery (05/15) Miyamoto, W.; Takao, M.; Innami, K.; et al.
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The Fate of the Fixed Syndesmosis over Time
Previous studies have shown that syndesmosis significantly widens after elective screw removal. No studies have shown the radiographic outcomes of screw retention. Researchers observed 166 patients with ankle fractures and concomitant syndesmotic injuries to evaluate radiographic syndesmotic widening and talar shift over time. After an elective syndesmotic screw removal at three months or more, the fibula shifted an insignificant amount on radiographs. The medial clear space did not change from preoperative to postoperative screw removal. Radiographic markers did not change when screws became loose or broken or when they remained intact. Researchers noted this study's results were in contradistinction to prior work because only very mild widening of the tibia-fibula space occurred after syndesmotic fixation. Any differences between preoperative and postoperative radiographs were statistically insignificant.

From the article of the same title
Foot & Ankle International (06/15) Gennis, Elisabeth; Koenig, Scott; Rodericks, Deirdre; et al.
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The Improvement of Postural Control in Patients with Mechanical Ankle Instability After Lateral Ankle Ligaments Reconstruction
Lateral ankle sprain is one of the most common injuries and can sometimes result in postural control deficits. Researchers sought to confirm that reconstruction of lateral ligaments could improve postural control in patients with mechanical ankle instability. Fifteen patients with a history of an ankle sprain with persistent symptoms and instability were observed. The patients underwent arthroscopic debridement and reconstruction of lateral ligaments with a modified Broström procedure. Follow-up was completed after six months. There was a significant decrease in postural sway in the anteroposterior direction, the circumferential area and the total path length of the operated ankles, when patients had their eyes closed. With eyes open, no difference was found. The study revealed that reconstructing the lateral ligaments could lead to better postural control.

From the article of the same title
Knee Surgery, Sports Traumatology, Arthroscopy (05/28/15) Li, H.Y.; Zheng, J.J.; Cai, Y.H.; et al.
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Practice Management

ICD-10 Could Spur Takeovers of Unprepared Medical Practices, Consultant Says
Practices around the country have been preparing for the October transition to ICD-10, and one expert believes that the change could have a particularly detrimental effect on smaller practices. Paul Keckley, managing director of Navigant Center for Healthcare Research and Policy Analysis, says the massive changes could overwhelm small practices and leave them vulnerable to a takeover. Keckley's theory is based on the idea that smaller practices could find benefit in merging with hospitals simply to make the ICD-10 transition simpler. Surveys have consistently shown that practices are generally unprepared for the switch. One study indicated that 30 percent of practices were against any transition, 54 percent were concerned about the compliance deadline, and 25 percent were not even familiar with ICD-10 coding standards. It is likely that one out of four practices will not implement IDC-10 in time for the Oct. 1 deadline. While that number should decrease slightly, it is still a concerning figure. A practice struggling with implementation would conceivably turn to a larger entity for help. Mergers and acquisitions could rise as a result of this.

From the article of the same title
Healthcare Finance News (05/29/15) Morse, Susan
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Increasing Productivity with Your EHR: 5 Strategies
The HITECH Act of 2009 was passed to create a mandate for physicians to adopt electronic health record (EHR) technology. More than five years later, studies have yielded mixed results as to how effective productivity is after EHR implementation. Many practices struggle with the transition, but several strategies can be considered to ease any potential troubles. First, and perhaps most importantly, you must provide quality training. It is very unlikely that everyone in your practice will be able to naturally adapt to EHR technology. Creating a learning environment will allow for less confusion and more productivity. Also, do not be afraid to delegate tasks to staff. Everyone needs to pitch in to ease the transition. Customize your EHR so that you can streamline patient encounters and bend the system to your own comfort. Another good tip is to hire a medical scribe who can type quickly and reduce the typing you would need to do. If that is not an option, consider voice recognition software. Finally, implement a patient portal to allow your patients to access information online. This will improve office efficiency and cut down on patient and physician confusion. It will allow for fewer superfluous office visits and more time to focus on the things a patient really cares about.

From the article of the same title
Physicians Practice (05/30/15) Prasad, Alok
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What King v. Burwell Could Mean for Medical Practices
The U.S. Supreme Court is expected to rule on King v. Burwell to decide whether tax subsidies for eligible Americans under the Affordable Care Act are valid. The invalidation of those subsidies could have far-reaching effects for practices around the country. Two decisions are possible, so preparing for both is necessary. Should the subsidies be removed, the subsidies purchased in non-state-based exchanges will be gone and could potentially disrupt the insurance market in those states. In this scenario, practices should not make any quick decisions. The better choice is to wait and see what Congress may do to intervene and mitigate disruptions. The most important thing a practice can do is have a solid eligibility verification process prior to a patient entering the practice. This is essential because if patients have a high-deductible health plan and the Supreme Court decides to discontinue the subsidies, it will be vital that practices verify eligibility to make sure they know exactly what patients are insured for and if their insurance will lapse.

From the article of the same title
Medical Economics (05/29/15) Martin, Keith
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Health Policy and Reimbursement

CMS Opens its Data to the Private Sector
For the first time, the Centers for Medicare and Medicaid Services (CMS) will make its data available to the private sector, CMS Acting Administrator Andy Slavitt announced. Information was previously available only to researchers not intending to develop commercial products, but now it will be available to innovators and entrepreneurs as well. “We do this with the clear expectation that you will create new streams of tools to improve care,” Slavitt said. Companies will be allowed to combine CMS data with private data. The CMS data would not identify individual patients but would identify healthcare providers. Starting in September, CMS will accept research requests. The data will be accessed through the CMS Virtual Research Data Center.

From the article of the same title
Health Data Management (06/02/2015) Kalish, Brian M.
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GAO Doubts Accuracy of RUC Data Used to Set Medicare Pay
The U.S. Government Accountability Office (GAO) has issued a report claiming that Medicare issues reimbursement rates for physicians based on flawed recommendations from an American Medical Association committee. The Specialty Society Relative Value Scale Update Committee (RUC) makes recommendations on the value of physician work by using a formula that drives fee-for-service rates. This formula has come under fire because many physicians resent the lack of transparency involving how values are distributed among roughly 7,000 physician services.

From the article of the same title
Medscape (05/29/15) Lowes, Robert
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Medicare Updates Data on Pay to Individual Physicians
The Centers for Medicare and Medicaid Services' (CMS) recent release of fee-for-service payment data for individual physicians is more comprehensive than previous iterations and allows for more specific information. In this year's report, CMS differentiates between payments for medical services and payments for administered Part B drugs. This is due in part to oncologists last year who claimed their Medicare payments mostly reflected reimbursement for drugs they had to purchase. The entire report covers $90 billion in fee-for-service payments, spread out across 950,000 medical professionals. In addition, there was data on payments to hospitals for the 100 most common Medicare inpatient stays. These stays generated $62 billion in Medicare payments. Since this is the second year the data has been released, trends exist for analysis and the records have been made public on the CMS website.

From the article of the same title
Medscape (06/01/15) Lowes, Robert
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Medicine, Drugs and Devices

House Panel Votes to Repeal Health Law's Medical Device Tax, Medicare Savings Board
A House committee has voted to repeal a 2.3 percent medical devices tax that helps pay for the Affordable Care Act. It is estimated that the loss of the tax will cost $24.4 billion in lost revenue over the next decade. Democrats claim Republicans have no plan in place to cover those losses. This is the third time the GOP-led House has voted to repeal the medical device tax since 2010. The Ways and Means committee, which conducted the vote in question, also approved a separate bill repealing another aspect of the Affordable Care Act. An independent panel will no longer propose ideas to reduce Medicare spending. The Independent Payment Advisory Board has too much power, according to proponents of the bill. Repealing the board would cost another $7 billion over the next decade.

From the article of the same title
Associated Press (06/02/15) Fram, Alan
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U.S. Drug Shortages Frustrate Doctors, Patients
The number of drugs in short supply in the United States has risen over the last several years, and patients and physicians alike who depend on certain medications for treatment and diagnosis are finding it difficult to administer proper care. About 265 drugs are in short supply in the U.S., a 74 percent increase over recorded figures from five years ago.

From the article of the same title
Wall Street Journal (06/01/15) Loftus, Peter
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This Week @ ACFAS
Content Reviewers

Mark A. Birmingham, DPM, AACFAS

Robert M. Joseph, DPM, PhD, FACFAS

Daniel C. Jupiter, PhD

Jakob C. Thorud, DPM, MS, AACFAS

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This Week @ ACFAS is a weekly executive summary of noteworthy articles distributed to ACFAS members. Portions of "This Week" are derived from a wide variety of news sources. Unless specifically stated otherwise, the content does not necessarily reflect the views of ACFAS, and does not imply endorsement of any view, product or service by ACFAS.

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