November 2011 Newsletter


November 2011

Clinical Café Newsletter

By: Ronda Polansky M.S. CCC-SLP

Happy Thanksgiving!

There is no better time to express our appreciation for your business and friendship! The friendship of those we serve is the foundation of our success serving the DFW area!


This is the season to reflect on your blessings and those things for which you feel most thankful.  I know at DiagnosTEX, we are incredibly thankful for each and every one of you who use us as your preferred mobile MBSS provider and have shared your friendship and support over the years. We wish you and your families and very Happy Thanksgiving with many, many blessings this holiday season!



DiagnosTEX November Holiday Schedule        Swallow and be thankful!

DiagnosTEX will be closed on Thursday, Thanksgiving Day, November 24th and Friday the 25th, to count our blessings and spend time with our families. We want to meet all of your MBSS needs because we know PO feeding becomes important on many levels to many of your patients around the holidays, especially when Thanksgiving is traditionally planned and prepared with a great deal of attention to food.  We also want to be fair and accommodating to each DiagnosTEX employee and their families. We are so thankful for them as well!  Please keep our holiday schedules in mind when scheduling your MBSS at the end of November (and December)!  ******Please take note and keep in mind that during this busy time of year, specific requests for specific times and/or days become exponentially difficult to accommodate.  We may be unable to quickly schedule your patient with certain time and day requests. Please notify your staff, patients, and families of this. ****** DiagnosTEX bases our mobile clinic schedules by geographical areas for time, efficiency and cost. If your patient’s schedule is limited to certain days and times, we recommend an outpatient facility (such as a hospital).  Mobile service offers convenience in the equipment coming to you, not for the flexibility of specific days and time schedules.  Mobile offices also require flexibility in time; we are subject to many factors that can dramatically change our travel during the day and subsequently alter the exact time we may arrive.  We make a heartfelt effort to arrive during our scheduled time, but there are often things that are out of our control that may change our arrival time.  We will always call to keep you updated on our ETA.


The 2012 DiagnosTEX Dysphagia Calendar will be available next month! 

Upcoming ASHA Conference – November 17-19 in San Diego, CA


Trach Conference – So good to see everyone at the conference and a special thank you to Rehab Synergies for hosting!  We had a full house and appreciate everyone spending their Saturday with us.


New projected Medicare regulations changes and reductions in 2011 for Part A

Group Treatment – If there are fewer than 4 scheduled to participate, the session may not be categorized as group treatment. If only 2-3 participants are able to take part in a scheduled 4 person group, the SLP can only assign 15 min of time (60 divided by four) to each patient for reimbursement.  A recent survey indicated that of SLPs who provided group treatment, 76% of those groups consisted of only 2-3 participants. Only 25% of treatment per discipline can be group tx.

Assessments – Patients in a SNF have a 5 day treatment schedules. If they miss treatment for 3 days, an assessment is required for the patient to restart treatment.  Qualifications for “missed treatment” include such situations as weekends, patient illness, clinician illness, patient refusal, physician office visit.

Reduction in Medicare rates in SLP procedures – includes a 29% reduction in conversion factor.  On an average there is a significant $11.00-15.00 decrease in all dysphagia treatment and evaluation codes with the exception of a $2.00 increase in FEES.


Effective October 1, 2011, the Centers for Medicare Medicaid Services (CMS) is rescinding the requirement that became effective January 1, 2011, that supervision of the videostroboscopy (CPT 31579) and nasopharyngoscopy (CPT 92511) procedures required a physician to be in the room. In March 2011, representatives from ASHA and the American Academy of Otolaryngology – Head and Neck Surgery met with CMS officials. Additionally, ASHA members protested the need for such supervision to members of Congress. As a result, the CMS Administrator issued a letter in June 2011, acknowledging that “while physicians perform these diagnostic procedures, speech pathologists also perform these procedures to evaluate and treat a patient’s functional/use problems.” The letter removed all supervision levels previously assigned to the procedures, effective October 1. ASHA, in conjunction with Special Interest Group 3: Voice and Voice Disorders, has developed Frequently Asked Questions (FAQs) to clarify billing and supervision issues related to the CMS decision. The FAQs can be accessed on ASHA’s Billing Reimbursement Web page. Modified Barium Swallow Studies still require direct personal ( in room ) physician supervision during a study in the state of Texas.

Quality Assurance (QA)Each year we take at least 1 month and follow up on every patient we evaluate. QA was completed in order to assist DiagnosTEX to establish, maintain, and ultimately improve the provision of mobile MBSS. MBSS outcome measures are purposed to document compliance and efficacy of the recommended means of nutrition, diet, and/or liquid, and of determining effectiveness of corresponding recommendations regarding management and/or treatment. Follow-up on QA also assists in determination whether or not the recommendations outlined by the MBSS were followed, and if not, the reasons for noncompliance. The following areas are addressed within this QA report:

MBSS tallies per month vs. separate QA documentation, MBSS diet and treatment recommendations, analysis of patient’s outcomes post-MBSS, silent aspiration, removal of tube feeding/NPO status, use of strategies, esophageal disorders screened, and E-stim treatment. We appreciate your support and help with this as we contact you to follow up on your patients. This is not only helpful to DiagnosTEX but also to our profession and dysphagia evaluation because this information has been (and will be) shared at a national level.