August 2021 Newsletter
Blue Skies, Humidity, Hot Sun! Summer is still here!
Your work is to discover your skill and then with all your heart to give yourself to it.
Be thankful for the opportunities given to you to make a difference in the world and someone’s life. That's the mark of a true professional.
DiagnosTEX August Schedule
Due to some unique staffing issues this summer, we will be running mobile clinics many Monday-Fridays in the months of August and September and will return to regular schedules of Monday – Thursday in the Fall.
New addition to the DiagnosTEX Family
Many have been asking and we wanted to let everyone know that Veronica had a healthy baby boy. Both are doing well. She will be off for maternity leave for several weeks but we look forward to having her back at the beginning of Fall.
New DiagnosTEX Educational Handout!
Importance of an Instrumental Exam
Get one next time we see you!
On Board Observers
We are so excited to be reunited and interact “facemask to facemask” with everyone and to have you on board again! We missed you! Please remember, we are allowing one observer in attendance at this time and those should stand in the stairwell only, no one is allowed to sit in any of the seats on the van. No exceptions will be made, if someone is unable to stand for long periods of time, they should not attend. We are so over the virus, but unfortunately the virus is not over us yet. When you look at how it has been changing, there's still a lot of room for it to mutate and the virus could still carry a lot of surprises. The delta variant has spread just as fast through the U.S. as epidemiologists feared it would. It now accounts for more than half the cases in the U.S. and far more than that in certain states. It is affecting both vaccinated and the unvaccinated. DTEX will continue with all current COVID precautions. This 1 observer to the study can only be an SLP or healthcare staff, no family members.
August CE course – Don’t miss it! Become Certified in ESP, the Most Comprehensive FDA-Cleared Treatment for Dysphagia
- Deciphering Dysphagia with Ampcare’s ESP™ (Effective Swallowing Protocol)
- Zoom Webinar Tuesday and Wednesday, August 17 - 18, 2021 *8 Hours Advanced ASHA CE
DiagnosTEX Consult Forms
Please fill these forms out in their entirety with interest, purpose and concern for the patient and direction towards proper treatment. For example, include proper DX for dysphagia. We often see “feeding difficulties” checked and nothing else, but yet there is a dx of CVA, COVID, PD in other HX etc. Please remember these forms that you sign and fill out go in with any audits or legal cases requesting records.
CMS has released the 2022 proposed rule for the Medicare Physician Fee Schedule (MPFS) for outpatient services.
CMS uses an annual Conversion Factor (CF) to calculate MPFS payment rates. For 2022, CMS estimates that the CF will be $33.59, representing a nearly 4% decrease from the $34.89 CF for 2021, and a nearly 7% decrease from the 2020 CF. CMS’s regulatory impact analysis (RIA) of the proposed rule notes that audiologists will see a cumulative 1% decrease in payments and SLPs a 2% decrease in 2022. However, it does not appear that CMS factored in the temporary 3.75% increase implemented to mitigate the cuts into the analysis. As a result, absent additional intervention by Congress or CMS, ASHA anticipates audiologists and SLPs will continue to face significant payment cuts beyond what CMS identified in the RIA, based on the changes to the CF. It is important to note that cumulative reimbursement changes experienced by individual clinicians or practices will vary because actual payment depends on several factors, including locality-specific rates and the specific procedure codes billed.
New Remote Therapeutic Monitoring (RTM) Code
Effective January 1, 2022, clinicians will see a new family of codes for RTM services, including three codes that would be of interest to audiologists and SLPs, as follows:
- 989X1 Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on use of equipment
- 989X4 Remote therapeutic monitoring treatment management services, physician/other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; first 20 minutes
- 989X5 each additional 20 minutes (list separately in addition to code for primary procedure)
However, the proposed rule notes that these codes are considered general medicine codes under CMS’s definition, meaning that certain nonphysician providers, including audiologists and SLPs as well as physical and occupational therapists, cannot bill these codes under the MPFS as currently written. Lets Advocate!
Dysphagia Tidbit - Aging and swallowing - Aging can make it more difficult to swallow
As adults age, they all experience a natural loss of muscle mass and function. Up to 33% of people age 65 and older are known to have swallowing problems due to physical changes, yet dysphagia also may be the result of underlying disease, Jeremy Applebaum, M.D., from Johns Hopkins University said. A new study finds that as the loss of muscle and function in the throat occurs it becomes more difficult for efficient constriction to occur while swallowing—which leads to an increased chance of food and liquids being left over in the throat. The study, published in Dysphagia by Sonja M. Molfenter, an assistant professor of communicative sciences and disorders at New York University's Steinhardt School of Culture, Education, and Human Development, and her colleagues, helps to explain why 15 percent of seniors' experience dysphagia, or difficulty swallowing. Other studies have demonstrated that when patients with dysphagia are admitted to the hospital, they normally experience a 40 percent longer length-of-stay than those without dysphagia—estimated to cost $547,000,000 per year. Molfenter and her colleagues noted that dysphagia in older adults is particularly relevant as the proportion of seniors in the United States is projected to increase to over 20 percent by 2030. Peter Belafsky, director of the University of California at Davis Voice and Swallowing Center and an adviser on Anderson's case, says the hardest-hit patients can choke on up to 1.5 liters of spit every day – the upper limit pumped out by our salivary glands. "It's like being constantly waterboarded," says Belafsky, because of the sensation of drowning that it produces. "That's the best way I had a patient describe it to me: 24 hours a day being waterboarded." Common causes of swallowing problems may differ significantly between older men and women, according to physician researchers. About half of patients diagnosed with dysphagia die within one year of diagnosis, according to Dr. Alba Azola, a Hopkins resident in physical medicine and rehabilitation. Treatments include rehabilitative therapy such as swallowing exercises that include strength training. We need innovative thinking and technologies to be rapidly translated into clinical practice now, more than ever. All patients deserve proper quality dysphagia evaluation and treatment, esp. as they age.
Our promise to YOU as co-workers and our clients!
In the age of endless use of social media by treating SLPs, we have become keenly aware that despite our best effort to serve our community, and the deep care we have for each and every patient, we will never make everyone happy all the time. There will always be times where there is a difference of opinion. What all of society needs to learn is that, everyone needs to take the time to learn all sides of an issue and be able to encounter philosophies that we disagree with and have balanced conversations between those you disagree with. The trend is to find strangers to agree with your opinion, although their credentials and skill level is unknown on the world wide web.
As a company and fellow SLPs, there is one promise we will make to all of you. No matter what we personally think of you or your patient, your choice of therapy, your bedside evaluation and your diet recommendations, we will NEVER share our personal feelings or opinions about any SLP on a social media platform. As SLP’s who take very seriously what we do, we promise to always speak to you directly and to never ask for the opinion of the masses about what they think about you, your patient, your evaluation or your therapy skills.
We honor our ASHA code of ethics, HIPAA and most of all we genuinely respect our colleagues as individual’s and what they stand for as a treating therapist. May we ask the same from all of you?