April 2013 Newsletters

April 2013

Happy Spring                         & Happy Easter

Clinical Café Newsletter

By: Ronda Polansky M.S. CCC-SLP

Monthly Motivator:

April hath put a spirit of youth in everything.

—William Shakespeare

TSHA – It was so great to see everyone at TSHA.  It always fun when it comes to our home town.  If anyone is interested in purchasing our educational video, we are taking orders. Volume 1 will include educational MBSS videos on a Normal Swallow, Parkinson’s Disease, Osteophyte, Reduced Mastication, Aspiration with Chin Forward position, and a Zenker’s Diverticulum.  These are good MBSS images to show to other staff and students for education to what cannot be seen at bedside. Cost for DVD is $40.00

DRS – Our trip to DRS this year was tiring but we enjoyed the new information on research and also mingling with the leaders in our profession. There are a lot of promising new trends in the evaluation and treatment of dysphagia.  We hope healthcare regulations do not stifle this necessary advancement in all populations. I share some of the research we heard in the May newsletter.

Parkinson Awareness Luncheon  – Former NASA Astronaut, Rich Clifford, to speak at luncheon to highlight Parkinson Awareness Month  RICHARDSON, TX – Former NASA Astronaut Rich  Clifford will be the featured speaker at Parkinson Voice Project’s annual Parkinson Awareness Luncheon to be held Wednesday, April 3, 2013 from 11:30am to 1:30pm at the exclusive Dallas Country Club. Tables for ten guests are $1,500, and individual tickets are $150 per seat. Sponsorship, advertising, and underwriting opportunities are available. For more information, call (469) 375-6500 or visit www.ParkinsonVoiceProject.org.

UPCOMING E-STIM ASHA CEU course – in Arlington, Texas on Saturday April 13th! Limited seating, reserve you spot quickly! Mark your calendar! Registration for Arlington course included. There will be a course in Corpus on April 20^th and Austin, May 4^th. For more information on these courses, call 682-561-2444.

DiagnosTEX Travel FEE – In 2013 DiagnosTEX has implemented a travel fee to all facilities and HH visits.  This fee is $25 each time we travel to the facility (NOT per patient). If you have 4 patients scheduled, the facility will be charged only 1 travel fee of $25. Yet, if you have 2 patients on Monday and 2 patients on Thursday, there will be 2 travel fees for that week.  It is beneficial for the facility to schedule in multiples.  The average rate for an ambulance trip in DFW is anywhere from $15-$17 per mile, portable X-ray bills $265 travel fee per patient. This has become necessary to cover expenses as a mobile MBSS has many additional expenses that a free standing facility does not have, including gas, mileage and wear and tear on vehicles and equipment.  DiagnosTEX completes approximately 600 -700 studies in the DFW area each month with approximately100K miles on our mobile clinics in a year.

DiagnosTEX Update 2013 History/Consult Form for 2013

2013 has brought many new changes to healthcare and 2014 will bring us even more.  April 1, 2013 the G-codes with NOMS levels are now required.  We have added this required information to our HX/consult form as well as our own reports.  As always, we ask you fill out these forms COMPLETELY, filling in ALL blanks as this information is needed from you for proper documentation.  This form will be a part of the patient’s medical record and will be reviewed if ever audited and your name is attached as author. If you are able to provide us with a copy of your dysphagia evaluation or progress notes, those are so very helpful to us.  Be sure to start using the new HX/consult form ASAP.

Upcoming Research – DiagnosTEX will be partnering with TWU and Parkinson’s Voice Project on a research study focusing on motor control mechanisms of individuals with Parkinson’s disease, including dysphagia.

Booklet for Sale – ABOVE and BEYOND By: Ronda Polansky M.S. CCC-SLP                                  Patient, Caregiver, and Healthcare Professional Educational Reference Sheets and Handouts for Effective Dysphagia Rehabilitation.  Over 30 handouts on specific disorders in dysphagia in ONE location to use in your practice, plus a resource section for SLP’s on cranial nerve testing, pharyngeal exercises, and treatment techniques. A need to have in your therapy bag!!   Cost: $40.00. Spring Discount $30.00 (plus S&H). Call us and we will get one out to you asap! Sold many of them at TSHA, thank you for all your support!

Medicare – Revisions of the Therapy Cap The 2013 program for dates if service: January 1, 2012 through December 31, 2013. Pre-approval is not required. MAC will not accept pre-approval requests for dates of service in 2013.  Providers will the follow instruction ion the ADR for submission of documentation. The Therapy Cap Cover/Transmittal Sheet and related fax numbers are no longer applicable. There are no penalties to providers or MACs if a 10 business day recommendation is not met.  The exception process for the $3700 annual cap threshold for claims has not changed.

Rehab Therapy Information Resource for Medicare

• Therapy Services – http://www.cms.gov/TherapyServices
• Hospital – http://www.cms.gov/center/hospital.asp
• Skilled Nursing Facility – http://www.cms.gov/center/snf.asp
• Therapy related Outreach and Education – http://www.cms.gov/MLNProducts on CMS website
• Therapy Studies and Reports – Policy and Utilization – www.cms.gov/TherpayServices/SAR/list.asp  on CMS website
• ASHA – – www.asha.org

E-STIM Outpatient Therapy – We get multiple calls from people looking for outpatient services around DFW for dysphagia with use of E-Stim.  If you are interested in being on our list to refer to, please call us and provide us with your contact information, location, and insurance accepted.

QA for 2013  DiagnosTEX completes QA on a month every year.  I am sure most of you received calls from us and we thank you for your help with this. Summating averages over previous years of quality assurance (QA) performed at DiagnosTEX (from 2003-2013), many relevant and consistent trends have been identified.  In January 2011, the oldest of the baby boomers turned 65.  Each day for the next 19 years, about 10,000 more will cross that age threshold.  By 2030 (when all baby boomers have turned 65), 18% of the nation’s population will be at least that age.  This is particularly relevant to this diagnostic procedure, as health care issues become intertwined with this surge of aging population and dramatic changes in healthcare regulations with the implementation of Obamacare.  Combine health consequences of skipping preventative care with an increasingly aging population, and the result is both predictable and profound.  The modified barium swallow study (MBSS) allows diagnostic identification of dysphagia to enhance treatment for swallowing disorders, and prevention of aspiration pneumonia. I will be sharing the results next month!

National Institute of Health – PUBMED  PM R 2012 Apr;4(4):273:82.

A cost-effectiveness analysis of screening methods for dysphagia after stroke. By: Wilson RD, Howe EC       Metrohealth Rehabilitation Institute of Ohio

RESULTS: The strategy of having each patient undergo a videofluoroscopic swallowing study for dysphagia was more effective and less costly than strategies of clinical bedside swallowing evaluation alone of combine approached. The model was influenced by the reduction in the risk of pneumonia attributable to the treatment of mil/moderate and severe dysphagia, the effectiveness of treatment with the clinical bedside swallowing evaluation, the baseline probability of pneumonia, and the cost of a videofluoroscopy swallowing study.

Dysphagia Tidbit – New line of chef inspired, pureed meals easy to make, easy to store and inexpensive. The Pure-a line of meal components has interesting, flavorful varieties maintaining sound NDD texture and nutrition. Check out website, www.pur-afoods.com to get product specifications including nutrition, ingredients and a free sample. NutriCuisine Food Co. 1 -888-620-9912