February 2024 Newsletter

Happy Valentine’s Day!

Having a soft heart in a cruel world is courage, not weakness. Turn off the media and be kind to one another.

DiagnosTEX Website

www.dysphagiadiagnostex.com has been updated with all new 2024 paperwork for adults and peds, including the peds newsletters in the clinical café. Please go there to download anything you need. While you are there visit the Barium Barista Café and look through our SHOP for some new products. DiagnosTEX 2024 Dysphagia Calendar – The 20th edition We have a few left, if you did not get yours! Ask for one next time we see you!


DiagnosTEX is looking for a new FT SLP to join our team. DiagnosTEX usually does not advertise for this position because we used to interact so much more with local SLP’s on a regular basis, but since COVID, there are so few that we have contact with lately. The position will include 3 months of training and the skills acquired with this will be a professional lifetime of benefit. If you think you may be interested, please send your resume to us at Ronda@diagnostex.us or Pam@diagostex.us.


TSHA 67th Annual Convention & Exhibition is this month on February 22-24, 2024, in Fort Worth, Texas. Our backyard! DiagnosTEX (215) and Ampcare (808) will both have a booth in the exhibit hall! Please come by, we look forward to reconnecting with everyone. I will be presenting with Lisa Milliken, MA, SLPCCC, FNAP, CDP, RAC- CT and Janice Silva -Aranda on a course titled Evidence-Based Evaluation and Management of Dysphagia with Dementia on Thursday, February 22, 2024 10:30 AM – 11:30 AM. Pam and I will be speaking with TSHA Business’ Management Committee on Career Navigation Through a Changing World if Healthcare: A Panel Discussion with the TSHA Business Management Committee on Friday from 1-3pm. Hope you can join in on both of these sessions! Don’t forget the Medical Committee Happy Hour on Friday from 4:30-5:30. Great networking opportunity!

TSHA Business Management Committee 2023

Pam Ragland and I are in our last term as the committee chairs for the TSHA Business Management Committee. We feel we have expanded the committee in 2023 with strong leaders and talented members to provide their expertise to support our purpose to provide guidance and ongoing support to other clinicians in a wide variety of practice settings which include private practice, SNF, Rehab, HH, and telepractice. Historically this committee has focused on professional issues and educated on developing a private practice, effective documentation, proper billing practices, in addition to the overall ethical and professional standards of practice. Our goal this year is to continue to address professional and billing questions in these settings, expand TSHA education and resources on payor negotiations, and will present at TSHA in FW. Please let us know if you have any questions, we will connect you with the right people of this committee to answer any questions you may have.

Anyone having unhappy flashbacks? We are!

It is winter and now we have COVID, Flu, RSV, and Strep and the good ole common cold. Patients are still our highest priority but so is safety for all involved! Healthcare staff is allowed to observe the MBSS standing at the front of the van with face mask if there is COVID in the building. During these winter months, we staying diligent in protecting all of us against the uptick in cases. If there is anyone with even a slight cough or runny nose, we ask you not be on the mobile clinic observing.


Mobile provides the convenience of the patient not having to leave the facility location and a cost savings to facility bringing the radiological exam to you. We provide the staff or facility with 3 notifications of our arrival time. 1)The day before during scheduling, 2) a phone call as we leave the stop prior to you and 3) then 5 minutes before we arrive. We feel we go above and beyond, doing our due diligence to help prepare you for as accurate timing as possible. We are mobile and our ETA can vary depending on traffic, weather, difficult patients and other waiting times when we arrive at facilities who do not have their patient ready. We limit our waiting time to 15 minutes, if the patient is not brought out to us in 15 minutes, we will reschedule and a cancellation fee will be applied. If we wait 15 minutes for patients at just 4 facilities that can cause us to run an hour behind in the day. Without full cooperation with facilities, this can affect everyone’s schedule, ours and anyone scheduled later that day.

Unpredictable Weather in Texas

It’s been a warm winter… so far! - Unfortunately, in Texas we typically do not get a beautiful flaky snowfall, we get ice. Our weather can change overnight and last 1 day or last multiple days! This year we are in El Nino pattern which in a wet weather pattern. This kind of weather obviously becomes a problem with traffic or if temperatures drop below freezing, for anyone who travels the busy DFW roads. Most of our daily routine is traveling extensively in all directions! As winter approaches and the threat of severe weather conditions arise, DiagnosTEX owners and drivers will evaluate the conditions of the roads and DiagnosTEX will contact all scheduled facilities immediately if we are unable to meet our appointments for that day. If the weather conditions are below freezing or unsafe for driving, we will cancel the day and reschedule the studies as promptly as possible. Even though roads may be passable in one area, does not mean passing through another area to get there is possible and we have to take all routes and directions into consideration. We have precious cargo on board on mobile clinics, most importantly our staff! Please cover up your patients when bringing them to the van during cold days!

Volunteers needed!

More than 6 million Americans have Alzheimer’s. It is a devasting disease to the human body. Changing the trajectory of the disease before symptoms appear is such an important scientific pursuit. Clinical trials hold the key to new and better Alzheimer’s disease treatments. Approximately 55,000 volunteers are needed for more than 180 clinical trials. In addition to the AHEAD study, the Alzheimer’s Association offers Trial Match, a free service that connects people living with dementia, caregivers and healthy volunteers to clinical trials. Clinical trial volunteers are key to better treatments, prevention strategies and a future cure for Alzheimer’s disease. Visit trialmatch.alz.org or call 800-272-3900 to learn more.

New Codes for Training

Two of the new codes, 97550 and 97551 are for caregivers of an individual patient to facilitate the patient’s functional performance in their home and community relating to Activities of Daily Living. (ADL) These are timed codes, 30 minutes and 15 minutes respectively. The third new code, 97552 is for group training of multiple sets of caregivers (who are caring for different patients). That group training code is not assigned a time. More than one caregiver trained at the same session must be billed under the group code, as the treating practitioner’s time should not be counted multiple times. CMS states that conditions include, but are not limited to “stroke, traumatic brain injury (TBI), various forms of dementia, autism spectrum disorders, individuals with other intellectual or cognitive disabilities, physical mobility limitations, or necessary use of assisted devices or mobility aids.” p. 295. Patients may require assistance with “challenging behaviors in order to carry out a treatment plan” or with safe transfers, feeding or swallowing. They state this list of examples is not exhaustive. The services must be “reasonable and necessary.” CMS is also expressing concern that they could be duplicative of other training that a caregiver has received, and they want to avoid duplicate payments. The training should be directly relevant to the person-centered treatment plan for the patient in order for the services to be considered reasonable and necessary under the Medicare program. The patient is not present for the training so that the practitioner and caregiver attention is solely focused on the training. Each behavior should be clearly identified and documented in the treatment plan, and the caregiver should be trained in positive behavior management strategies. Caregivers are taught how to structure the patient’s environment, reinforce desired behaviors, to reduce the negative impact of the patient’s diagnosis on their daily live, and to develop structured technical skills to manage the patient’s challenging behavior. Professionals who will report the service are defined as services provided by a physician or other qualified health care professional. Consent from the patient or their representative is required, and CMS emphasized this is especially important because these are services that are performed without the patient present. CMS is not proposing to add these to the telehealth list.