Newsletter :: December 2006


We wish you a beautiful Holiday Season and a New Year of Peace and Happiness.

Merry Christmas from all of us at DiagnosTEX.

We look forward to serving you next year!


DiagnosTEX Christmas Gifts to our SLP’s

This is just a token of our appreciation for your support and friendship.  We are also celebrating our 3rd year in business, and everyone at DiagnosTEX thanks you for the honor of being part of your dysphagia management team and trusting us with your patients! 


DiagnosTEX Website!  Check it out as we launch it this month on December 7th!  On the DiagnosTEX website you can find out about us! Check on conferences, newsletters, required scheduling paperwork, email us, see MBSS videos, shop our bookstore, download our SLP handouts, and so much more to come!  We are excited about this! 


DiagnosTEX 2007 December Holiday Schedule

DiagnosTEX will also be closed the Monday Christmas Day and the Monday of New Years Day. We will operate all 3 vans the day after Christmas and the day after New Years. (I had a typo in the November newsletter saying we would run Christmas Eve which is Sunday.  OOPS!  I had an

up-roar here with our employees! Ha!)  We want to meet all of your MBS needs as we know PO feeding becomes important on many levels to many of patients around the holidays, as well as being fair and accommodating to all of our DiagnosTEX employees and their families as well as our own families.  Please keep these holiday schedules in mind when scheduling your MBSS in December! 


2007 Dysphagia Calendar and Dysphagia Holiday Food Handout

Be sure to get your new DiagnosTEX 2007 Dysphagia Calendar! If you have not received your SLP handout for the dysphagia holiday foods to share with your patients and families as they prepare their holiday meals, let us know next time we see you!


Medicare Reimbursement

It is still unclear how Congress will ultimately address the issue of Medicare Outpatient reimbursement: it could delay the proposed cuts for another year; require the reporting of quality data; or totally revamp the payment update process (ASHA Leader, November 7, 2006)

Sample Changes in Speech-Language Pathology Services

CPT Code


% Fee Change

2007 Rate


Speech & language evaluation




Speech & language treatment




Dysphagia clinical evaluation   




Dysphagia treatment



The total RVUs for speech-language pathology services will have changes as well. Speech and language evaluation will have an increase to 3.65 from 3.49. Speech-language treatment will see a modest increase to 1.67 from 1.65 and dysphagia treatment increases to only 2.22 from 2.21. There will be problematic reductions in dysphagia clinical evaluation (to 3.06 from 3.52) and in the modified barium swallow evaluation (to 3.12 from 3.52). These artificial fluctuations should stop if ASHA efforts are successful and a truly relative value approach based on professional work as instituted by Medicare.


Provale Cup

I have had many questions re: the Provale cup and thickened liquids. I have had several facility SLP’s share different experiences with me regarding the use of nectar liquids with this cup.  This obviously depends on what one facility considers nectar vs. the other.  The most recent question, which I could not answer, was whether pre-thickened liquids worked in this cup.  So I contacted Provale and this was the response:

The cup is for “thin” liquids only. Thickened liquids will not work. All of our literature and web site refer to “thin” liquids. Actually, we often send a cost study to our LTC accounts demonstrating a significant cost savings ($800 – $1000 per year per patient) utilizing Provale Cups in place of “pre-thickened” liquids, if they can tolerate small sips of  thin but not cup sips and were recommended thickened liquids due to this.  Hope this answers some questions for everyone.


Dysphagia Tidbit – Failure to Thrive, Dying of Old Age

(ASHA Leader, October, 17, 2006, Joseph Murray and Paula Sullivan)

In 1951 the National Office of Vital Statistics required all states to adopt a standard list of 130 contributing and underlying causes of death.  None of the 130 causes were “old age”.  Here in America, no one is officially permitted to die of old age, only diseases! J  The medical community has identified a syndrome know as “Failure to Thrive (FTT). FTT is considered a process of deterioration, and for many, a condition at end of life.  Screening alerts for FTT

  1. Taking 3 or more prescription drugs, OTC and or vitamins and minerals daily
  2. Weight loss
  3. Modified diet
  4. Housebound or bed bound
  5. Needs assistance with self care and ADL’s
  6. Depression
  7. Cognitive impairments
  8. Multiple admissions for a wide variety of problems
  9. Albumin lower than 3.5

(ASHA Leader, October, 17, 2006, Joseph Murray and Paula Sullivan)

SLP’s can help families accept and understand the natural progression of an illness to death by teaching them that suffering will not occur when nutrition and or hydration are with held at end of Life (EOL)  Terminally ill patients do not have hunger or thirst as we know it.  If you need some education material on this, call us at DiagnosTEX for our NPO booklet or next time you see us, ask us for our handout on this. (FYI – NPO – Ethical Decisions and Challenging Case Management Decisions Conference will be presented in Houston and East Texas the first quarter of next year, be looking for the information in upcoming newsletters)