- Email: [email protected]
Academy News
Volume 4
/
Issue 11
/
November 2012
PM&R - The journal of injury, function, and rehabilitation
Practice Resources From AAPM&R
●
Based on feedback from AAPM&R members, a strong focus is being placed on practice management resources. Many resources are currently being developed, but there are two practice management resources available now.
CPT ⫽ current procedural terminology. CPT is a registered trademark of the American Medical Association.
AAPM&R 2012 Coding Manual
Procedural Code Changes Coming in 2013
AAPM&R developed the AAPM&R 2012 Coding Manual, which covers changes that apply to PM&R in the following areas: ● ● ● ● ● ●
EMG and NCS Interlaminar/epidural/transforaminal injections Spinal cord stimulator implantable devices Peripheral nerve stimulators CPT® and HCPCS codes and descriptors Expanded procedure definitions and descriptions
Academy members receive a 20% discount on this manual. Plus, an addendum to the AAPM&R 2012 Coding Manual will be available in early 2013. CPT ⫽ current procedural terminology. CPT is a registered trademark of the American Medical Association. Purchase the AAPM&R 2012 Coding Manual today at www.aapmr.org. 2012 PM&R Compensation Survey Report In order for PM&R to be competitive with other specialties, physiatrists need to be able to properly gauge where they stand in terms of: ● ● ● ●
Compensation Personal benefits Typical workweek Information related to liability and malpractice issues
To help meet this need, AAPM&R recently conducted the 2012 PM&R Compensation Survey. As a result of this study, physiatrists now have access to comprehensive data, detailing such things as compensation distribution by gender, region, type of practice, and other demographic identifiers, as well as information on personal benefits, typical workweek (hours/allocation of time), and information related to liability and malpractice issues. The comprehensive 2012 PM&R Compensation Survey report is available for purchase on AAPM&R’s Web site at www.aapmr.org. ● ●
Member price: $150 Non-member price: $295
Special resident rates are available.
Each year, as part of ongoing advocacy efforts, the Academy actively participates in code change proposals and code valuations that impact the reimbursement of codes utilized by the specialty of physiatry. This is accomplished by the work done by AAPM&R’s Relative Value Scale Update Committee (RUC) CPT advisors who attend and work jointly with other specialty societies at CPT editorial panel and RUC meetings. Both of these committees meet several times a year, and with the help of the specialty societies, develop and present relative value unit (RVU) recommendations for new and revised codes to be considered by Centers for Medicare & Medicaid Services (CMS). In recent years, as mandated by CMS, AAPM&R, along with other specialty societies, such as the American Academy of Neurology and the American Association of Neuromuscular & Electrodiagnostic Medicine, have been working to update, revise, and revalue electrodiagnostic codes. In 2012, a set of electromyography codes were approved and went into effect. On January 1, 2013, new nerve conduction studies (NCS) codes will go into effect, and current NCS codes 95900 –95903, 95904, 95934, and 95936 will no longer be valid. Seven new codes have been created based on the number of NCS being performed. This is a clear distinction on how NCS were coded previously, based on each nerve tested. It is important to keep in mind, when coding, that a single conduction study is defined as a sensory conduction test, a motor conduction test with or without an F-wave test, or an H-reflex test. Each type of nerve conduction study counts only once when multiple sites on the same nerve are stimulated or recorded. The numbers of these separate tests should be added to determine which code needs to be utilized. Final RVU details for these new codes will be available in mid-November 2012, once CMS publishes the final rule regarding the 2013 physician fee schedule. Use of current codes should be continued through the end of the year. The following is the list of new 2013 NCS codes: 9590AX: 1–2 nerve conduction studies 9590BX: 3– 4 nerve conduction studies 9590CX: 5– 6 nerve conduction studies 919
920
9590DX: 7– 8 nerve conduction studies 9590EX: 9 –10 nerve conduction studies 9590FX: 11–12 nerve conduction studies 9590GX: 13 or more nerve conduction studies CPT is a registered trademark of the American Medical Association.
Academy Member’s Advocacy Efforts Lead to New Hampshire Governor’s Signature on Concussion Safety Bill New Hampshire Governor John H. Lynch signed a concussion safety bill. Effective August 17, 2012, the new law acknowledges that concussions have become a serious problem for student athletes and establishes guidelines for evaluating and managing concussions. Under the new law, all student athletes who are suspected of sustaining a concussion will be immediately removed from practice or a game. The law states that “a student athlete who has been removed from play shall not return to play on the same day or until he or she is evaluated by a health care provider and receives medical clearance and written authorization from that health care provider.” Further, the law defines “health care provider” as a “person who is licensed, certified, or otherwise statutorily authorized by the state to provide medical treatment and is trained in the evaluation and management of concussions.” The return-to-play provisions are consistent with Washington state’s Zackery Lystedt Law, which the Academy strongly recommends as model legislation for the states. AAPM&R Board of Governors member Stuart J. Glassman, MD, said that the first effort to pass a concussion bill in 2011 was unsuccessful, but he and others did not give up and they came back to the legislature in 2012 with a better proposal that passed. New Hampshire is no stranger to brain injury regulation. In 2011, the state enacted SB 102, which created a commission to study the impact of service-related post-traumatic stress disorder and traumatic brain injury suffered in the line of duty by members of the armed forces and veterans. Prior to that, in 2010, the governor signed SB 517, a law that established a veteran’s legal aid advocacy project to address the legal needs of veterans including those with traumatic brain injury based on a 2009 committee study. The Academy greatly appreciates the tremendous efforts of Dr. Glassman and other AAPM&R members in getting this measure enacted. Dr. Glassman also leads the Academy’s National Concussion Stakeholders Coalition, which strategizes and collaborates on ways to advocate for good legislation. He also volunteers as a concussion spokesperson throughout the US. To read the full bill, visit www.nhliberty.org/bills/view/ 2012/SB402.
AAPM&R ACADEMY NEWS
Status of Concussion Laws Across the US With the heightened national attention to serious head injuries among youth athletes over the last three years, and at the time of this writing, 40 states and the District of Columbia and Puerto Rico, have enacted concussion legislation—the majority of which targets youth sports-related concussions. Related legislation debated by state legislatures has included traumatic brain injury in veterans, appropriations to fund to traumatic brain injury prevention or treatment programs, and requirements for insurers, hospitals, and health maintenance organizations to provide insurance coverage for survivors of traumatic brain injury. Physiatrists Needed to Advocate for Concussion Legislation in 9 States The Academy has more work to do in regard to state concussion legislation. Nine states (Arkansas, Georgia, Mississippi, Montana, Nevada, Ohio, South Carolina, Tennessee, and West Virginia) have not passed concussion legislation. We need your help with efforts in all 9 states now. The Academy is asking AAPM&R members with an interest in passing concussion legislation in these states to contact Dr. Glassman at [email protected]. We also recommend that you collaborate with your state medical associations, other state specialty societies, and other stakeholders on efforts to pass a bill. Dr. Glassman said, “Working in a coalition was key to the success of this effort.” Physiatrists can play a significant role in advocating for passage of appropriate concussion legislation. Please volunteer your time and expertise and participate in grassroots’ campaigns and provide testimony as needed before your state legislature. We are pleased to announce that as of October 2012, 9 states enacted concussion legislation in 2012: California, Florida, Hawaii, Idaho, Kentucky, Maine, Michigan, New Hampshire, and Wisconsin. The Academy appreciates the work of AAPM&R members who made a difference and helped to get legislation passed and signed by the governors. Get Started: Be an Advocate for Your State AAPM&R wants to help members get involved in state advocacy efforts, and we make it easy. Members can visit PhyzForum (www.phyzforum.org), and use it as a tool to coordinate legislative strategies with other physiatrists in your state. You can also visit the AAPM&R Web site; type “concussion resources” in the search box, and click on the link in the first bullet point on that Web page to take you directly to the state advocacy groups page on PhyzForum. Interested in learning more about this initiative? E-mail the Academy at [email protected].
PM&R
Vol. 4, Iss. 11, 2012
AAPM&R’s Collaboration in the COAMI Work Group Earlier this year, AAPM&R, represented by D.J. Kennedy, MD and health care providers from more than 20 leading professional societies came together as part of the Chronic Osteoarthritis Management Initiative (COAMI) Work Group to assess current practice in the management of osteoarthritis. Osteoarthritis affects 27 million Americans or more than 10% of adults. The Academy is proud to say that information in the May 2012 PM&R osteoarthritis supplement was used as a resource to aid in the work group’s discussion and development of seven priority actions in view of scientific advances made in recent years. The priority actions include: ●
●
Developing a call to action targeted to health care professionals who treat patients with OA, as well as policymakers and the public Convening a larger conference that leads to further recommendations that would build agreement across disciplines
●
●
●
● ●
921
and specialties within the health care system, so that current inconsistencies in approach could be resolved and models of care developed Reaching out to other partners beyond the work group members (both existing and new members) to include them in future COAMI initiatives Exploring standardized screening tools and indicators of OA to make early diagnosis both more consistent and more likely Developing tools and prompts that promote patient engagement in learning about and managing OA, especially before symptoms become debilitating Lending COAMI’s support to existing advocacy and awareness efforts that are already under way Developing and supporting an OA-specific research agenda that would fill gaps in evidence and practice
For more information, type in “COAMI” in the search box on the AAPM&R Web site.
/
Issue 11
/
November 2012
PM&R - The journal of injury, function, and rehabilitation
Practice Resources From AAPM&R
●
Based on feedback from AAPM&R members, a strong focus is being placed on practice management resources. Many resources are currently being developed, but there are two practice management resources available now.
CPT ⫽ current procedural terminology. CPT is a registered trademark of the American Medical Association.
AAPM&R 2012 Coding Manual
Procedural Code Changes Coming in 2013
AAPM&R developed the AAPM&R 2012 Coding Manual, which covers changes that apply to PM&R in the following areas: ● ● ● ● ● ●
EMG and NCS Interlaminar/epidural/transforaminal injections Spinal cord stimulator implantable devices Peripheral nerve stimulators CPT® and HCPCS codes and descriptors Expanded procedure definitions and descriptions
Academy members receive a 20% discount on this manual. Plus, an addendum to the AAPM&R 2012 Coding Manual will be available in early 2013. CPT ⫽ current procedural terminology. CPT is a registered trademark of the American Medical Association. Purchase the AAPM&R 2012 Coding Manual today at www.aapmr.org. 2012 PM&R Compensation Survey Report In order for PM&R to be competitive with other specialties, physiatrists need to be able to properly gauge where they stand in terms of: ● ● ● ●
Compensation Personal benefits Typical workweek Information related to liability and malpractice issues
To help meet this need, AAPM&R recently conducted the 2012 PM&R Compensation Survey. As a result of this study, physiatrists now have access to comprehensive data, detailing such things as compensation distribution by gender, region, type of practice, and other demographic identifiers, as well as information on personal benefits, typical workweek (hours/allocation of time), and information related to liability and malpractice issues. The comprehensive 2012 PM&R Compensation Survey report is available for purchase on AAPM&R’s Web site at www.aapmr.org. ● ●
Member price: $150 Non-member price: $295
Special resident rates are available.
Each year, as part of ongoing advocacy efforts, the Academy actively participates in code change proposals and code valuations that impact the reimbursement of codes utilized by the specialty of physiatry. This is accomplished by the work done by AAPM&R’s Relative Value Scale Update Committee (RUC) CPT advisors who attend and work jointly with other specialty societies at CPT editorial panel and RUC meetings. Both of these committees meet several times a year, and with the help of the specialty societies, develop and present relative value unit (RVU) recommendations for new and revised codes to be considered by Centers for Medicare & Medicaid Services (CMS). In recent years, as mandated by CMS, AAPM&R, along with other specialty societies, such as the American Academy of Neurology and the American Association of Neuromuscular & Electrodiagnostic Medicine, have been working to update, revise, and revalue electrodiagnostic codes. In 2012, a set of electromyography codes were approved and went into effect. On January 1, 2013, new nerve conduction studies (NCS) codes will go into effect, and current NCS codes 95900 –95903, 95904, 95934, and 95936 will no longer be valid. Seven new codes have been created based on the number of NCS being performed. This is a clear distinction on how NCS were coded previously, based on each nerve tested. It is important to keep in mind, when coding, that a single conduction study is defined as a sensory conduction test, a motor conduction test with or without an F-wave test, or an H-reflex test. Each type of nerve conduction study counts only once when multiple sites on the same nerve are stimulated or recorded. The numbers of these separate tests should be added to determine which code needs to be utilized. Final RVU details for these new codes will be available in mid-November 2012, once CMS publishes the final rule regarding the 2013 physician fee schedule. Use of current codes should be continued through the end of the year. The following is the list of new 2013 NCS codes: 9590AX: 1–2 nerve conduction studies 9590BX: 3– 4 nerve conduction studies 9590CX: 5– 6 nerve conduction studies 919
920
9590DX: 7– 8 nerve conduction studies 9590EX: 9 –10 nerve conduction studies 9590FX: 11–12 nerve conduction studies 9590GX: 13 or more nerve conduction studies CPT is a registered trademark of the American Medical Association.
Academy Member’s Advocacy Efforts Lead to New Hampshire Governor’s Signature on Concussion Safety Bill New Hampshire Governor John H. Lynch signed a concussion safety bill. Effective August 17, 2012, the new law acknowledges that concussions have become a serious problem for student athletes and establishes guidelines for evaluating and managing concussions. Under the new law, all student athletes who are suspected of sustaining a concussion will be immediately removed from practice or a game. The law states that “a student athlete who has been removed from play shall not return to play on the same day or until he or she is evaluated by a health care provider and receives medical clearance and written authorization from that health care provider.” Further, the law defines “health care provider” as a “person who is licensed, certified, or otherwise statutorily authorized by the state to provide medical treatment and is trained in the evaluation and management of concussions.” The return-to-play provisions are consistent with Washington state’s Zackery Lystedt Law, which the Academy strongly recommends as model legislation for the states. AAPM&R Board of Governors member Stuart J. Glassman, MD, said that the first effort to pass a concussion bill in 2011 was unsuccessful, but he and others did not give up and they came back to the legislature in 2012 with a better proposal that passed. New Hampshire is no stranger to brain injury regulation. In 2011, the state enacted SB 102, which created a commission to study the impact of service-related post-traumatic stress disorder and traumatic brain injury suffered in the line of duty by members of the armed forces and veterans. Prior to that, in 2010, the governor signed SB 517, a law that established a veteran’s legal aid advocacy project to address the legal needs of veterans including those with traumatic brain injury based on a 2009 committee study. The Academy greatly appreciates the tremendous efforts of Dr. Glassman and other AAPM&R members in getting this measure enacted. Dr. Glassman also leads the Academy’s National Concussion Stakeholders Coalition, which strategizes and collaborates on ways to advocate for good legislation. He also volunteers as a concussion spokesperson throughout the US. To read the full bill, visit www.nhliberty.org/bills/view/ 2012/SB402.
AAPM&R ACADEMY NEWS
Status of Concussion Laws Across the US With the heightened national attention to serious head injuries among youth athletes over the last three years, and at the time of this writing, 40 states and the District of Columbia and Puerto Rico, have enacted concussion legislation—the majority of which targets youth sports-related concussions. Related legislation debated by state legislatures has included traumatic brain injury in veterans, appropriations to fund to traumatic brain injury prevention or treatment programs, and requirements for insurers, hospitals, and health maintenance organizations to provide insurance coverage for survivors of traumatic brain injury. Physiatrists Needed to Advocate for Concussion Legislation in 9 States The Academy has more work to do in regard to state concussion legislation. Nine states (Arkansas, Georgia, Mississippi, Montana, Nevada, Ohio, South Carolina, Tennessee, and West Virginia) have not passed concussion legislation. We need your help with efforts in all 9 states now. The Academy is asking AAPM&R members with an interest in passing concussion legislation in these states to contact Dr. Glassman at [email protected]. We also recommend that you collaborate with your state medical associations, other state specialty societies, and other stakeholders on efforts to pass a bill. Dr. Glassman said, “Working in a coalition was key to the success of this effort.” Physiatrists can play a significant role in advocating for passage of appropriate concussion legislation. Please volunteer your time and expertise and participate in grassroots’ campaigns and provide testimony as needed before your state legislature. We are pleased to announce that as of October 2012, 9 states enacted concussion legislation in 2012: California, Florida, Hawaii, Idaho, Kentucky, Maine, Michigan, New Hampshire, and Wisconsin. The Academy appreciates the work of AAPM&R members who made a difference and helped to get legislation passed and signed by the governors. Get Started: Be an Advocate for Your State AAPM&R wants to help members get involved in state advocacy efforts, and we make it easy. Members can visit PhyzForum (www.phyzforum.org), and use it as a tool to coordinate legislative strategies with other physiatrists in your state. You can also visit the AAPM&R Web site; type “concussion resources” in the search box, and click on the link in the first bullet point on that Web page to take you directly to the state advocacy groups page on PhyzForum. Interested in learning more about this initiative? E-mail the Academy at [email protected].
PM&R
Vol. 4, Iss. 11, 2012
AAPM&R’s Collaboration in the COAMI Work Group Earlier this year, AAPM&R, represented by D.J. Kennedy, MD and health care providers from more than 20 leading professional societies came together as part of the Chronic Osteoarthritis Management Initiative (COAMI) Work Group to assess current practice in the management of osteoarthritis. Osteoarthritis affects 27 million Americans or more than 10% of adults. The Academy is proud to say that information in the May 2012 PM&R osteoarthritis supplement was used as a resource to aid in the work group’s discussion and development of seven priority actions in view of scientific advances made in recent years. The priority actions include: ●
●
Developing a call to action targeted to health care professionals who treat patients with OA, as well as policymakers and the public Convening a larger conference that leads to further recommendations that would build agreement across disciplines
●
●
●
● ●
921
and specialties within the health care system, so that current inconsistencies in approach could be resolved and models of care developed Reaching out to other partners beyond the work group members (both existing and new members) to include them in future COAMI initiatives Exploring standardized screening tools and indicators of OA to make early diagnosis both more consistent and more likely Developing tools and prompts that promote patient engagement in learning about and managing OA, especially before symptoms become debilitating Lending COAMI’s support to existing advocacy and awareness efforts that are already under way Developing and supporting an OA-specific research agenda that would fill gaps in evidence and practice
For more information, type in “COAMI” in the search box on the AAPM&R Web site.