Newsletter :: July 2004

Happy Independence Day!

Monthly Motivators

CHARACTER – We must adjust to an ever changing road while holding on to our unchanging principles.

PULL TOGETHER – The question is not how well each person works but how well they work together.

CEU CONFERENCE – Controversaries in Dysphagia

Hot Topics…Free water, E-Stim, DPNS, FEES, Medical treatments such as Myotomy, dilation, Variations on MBSS procedures, NPO status/PEGS, Syringe Feeding, etc. Plan to attend this conference! Registration forms will go out in next month’s newsletter. This will be an exciting conference with guest speakers. More information to come! Hope to see you there!

DiagnosTEX – A Dysphagia Consultation not just an MBSS

Do not sacrifice quality for a few dollars. If your facility is offered a competitive rate, please call us immediately to see what we can work out to meet that rate.

Be sure you are comparing Apples to Apples and not Apples to oranges

1. Are you getting 24-48 hour service with the other company, & do they run 5 days week?
2. Are the physicians involved in the study and are you getting a physician’s report?
3. Is all the necessary standard preventative equipment on board to meet JACHO and other medical standards?
4. How much malpractice coverage for the physicians and SLP’s is there?
5. Do they follow up on every patient they evaluate?
6. And most of all, quality of reports and MBS study, are you getting all of the information you need?

Dysphagia Cups on the market

1. Sip-Tip – one way valve holds fluid in straw – $16.99 pk.
2. Rolyan Millicup – Cup adjusts to measured sips of 2.5 ml- 20ml – $34.99
3. Pre-Set drinking Cup – 1 tsp preset measured cup – $32.00
4. People Feeder – an alternative to a syringe, for thick and puree food – $78.00
5. Gravity Assisted Drinking Cup – Control intake by adjusting position – $14.00
6. Dysphagia cup – weighted base slows tremors $18.99-20.00
7. Nosey Cutout Cup – $5.00
8. Whiplash cup – Designed for those who can not tilt head back – $6.00
9. Flexi-Cut Cups – generously cut out rims – $10.00-13.00

All these can be ordered from AliMed at 800-225-2610 or www.alimed.com

Quality Assurance with DiagnosTEX

DiagnosTEX follows up on all of the patients that we evaluate. We had some great statistics I wanted to share with you for the month of May. We eliminated 85% of patients off of Tube Feeding! Yeah! Forty percent (40%) of the patients utilized strategies to initiate or continue PO. Silent Aspiration was seen in 35% of the patients we evaluated and 24% were noted to have some form of esophageal dysfunction. Only 19 patients were given a recommendation of NPO. This is why we love our jobs! We are beginning to document the success stories of E-Stim so I will keep you informed as we go along.

DiagnosTEX is helping to enhance education on MBSS

We are working closely with area Universities and local Medical schools and having students, residents, fellows, and interns ride along and observe to provide them with further knowledge and education on dysphagia and Modified Barium Swallow Studies. This is so important to our profession as Speech Pathologists. We feel honored to have them spend the day with us!

New History Intake forms – Please discard your old one and use this new one when scheduling a patient for an MBSS. Please fill out all areas when completing this form! Thank you!

FYI – E-Stim cost justification passed on to us from local SLP’s

We have been told that for one Part B patient, that 1 month of treatment (20 visits) pays for an $800.00 E-stim unit, not mentioning the decrease in cost of thickened liquids and tube feeding. We are hearing so many success stories! Congratulations to all of you for improving Speech Therapy!

Consolidated Billing – There is so much confusion on this issue when it comes to billing with mobile MBSS. Fortunately there has been much clarified about this topic last month in the ASHA Leader as well as the Medicare Newsletter. We have copies of all this and will be happy to fax them to you upon request. A billing example in the May 28, 2004 Medicare Part B newsletter stated that “The provider (Example: DiagnosTEX ) would bill Medicare Part B for the professional component . If the provider has a business relationship with the SNF, the provider would directly bill the technical component to the SNF.” Refer to the web site www.cms.hhs/gov/medlearn/snfcode.asp. for a complete listing of codes included in SNF consolidated billing, there you will find the MBS code 92611. The ASHA Leader had an article that clarified that consolidated billing requirements will require the SNF to bill Medicare directly for Part A patients, and to submit Part B claims for PT, OT, and ST services, which does included the 92611 ST/therapy code for the MBSS. If your facility has any questions regarding Part A or Part B fees, please encourage them to call and speak with our Billing Dept.

Dysphagia Tidbit – Quinn’s Sign as a diagnostic of a Zenker Diverticulum

Complaints and symptoms of a Zenker’s Diverticulum range from dysphagia, weight loss, and coughing in the supine position, to severe aspiration and recurrent pneumonia. Regurgitation of undigested food boluses, rather than liquid, should raise suspicion of a Zenker’s Diverticulum. A positive Quinn’s sign is virtually diagnostic of Zenker’s diverticulum.. Quinn’s sign – wherein as the patient protrudes his tongue for mirror laryngoscopy, a bubble of air escapes the diverticulum into the hypopharynx producing a characteristic of a mini-belch. This can be elicited as well by manipulating the larynx and upper trachea with the examiners hand while the patient breathes through his mouth. A Modified Barium Swallow Study is the gold standard for diagnosis, because it shows the size and location of the diverticulum, and will document aspiration.