ASCA News Digest (January 14, 2014)

 

     
   
     
     
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January 14, 2014
 
 
 
 

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ASCA Highlights


 ASCA 2014 Payment Resources Updated to Reflect Recent Changes

CMS posted changes to the 2014 ASC payment rates that were published in November 2013. ASCA’s payment resources, including ASCA’s Medicare Rate Calculator, have all been updated to reflect the revisions. To be safe, please delete all previously released materials and use these moving forward. MORE
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Immediate-use steam sterilization (IUSS), often referred to as flash sterilization, has become a major issue of concern in ASCs. IUSS is a very complex process that requires precise adherence to each step in the sterilization process. ASCA's next webinar, Tuesday, January 28, at 1:00 pm ET, will address professional recommendations and measures that your ASC can take to ensure the appropriate use and success of IUSS. MORE
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Bringing your ASC’s pre-admission process online can offer many benefits to patients, staff and physicians at your ASC. Nurses can save significant time when they no longer have to phone patients before a procedure. And as online pre-admission systems evolve, facilities enjoy additional benefits they did not consider initially. MORE
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ASCA's 2014 Winter Coding Seminar starts this Thursday at the Wynn Las Vegas Hotel. This two-and-a-half day conference is a "must" when it comes to learning best coding practices that assure you receive the reimbursements you deserve. There is still time to join us! Register on-site and get the coding information and tools you need to submit clean and accurate claims and improve your ASC’s collections in 2014. MORE
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Renewal notices for 2014 have been mailed to all current ASCA members. We encourage you to renew your 2014 ASCA membership online through the ASCA web site. We thank you for your continued support of ASCA, your membership allows us to provide the advocacy support and resources you need to continue to operate your ASC. MORE
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To take full advantage of all the resources that the ASCA News Digest has to offer, make sure that you allow Microsoft Outlook to display the pictures featured in the email every week. Simply right-click on one of the pictures that is not displaying and select "Add Sender to Safe Senders List" or "Add the Domain @ascassociation.org to Safe Senders List." MORE
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ASCA was inundated with questions in response to last week’s ASCA News e-alert regarding the new quality reporting requirements finalized by the Centers for Medicare & Medicaid Services (CMS). Here is a breakdown, by measure, of what is currently required. MORE
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Industry News


Maryland Will Limit Hospital Charges Statewide
Bloomberg Businessweek (01/13/14) Tozzi, John

In an effort to curb health care costs, Maryland will restrict how much money hospitals in the state can take in. Over the next five years, Maryland will strive to keep hospital charges from growing faster than the average growth rate of the state’s economy, which could save Medicare $330 million. Another change is that rather than bill for each service provided, hospitals will get paid for keeping people well. Maryland is currently the only state where a state commission sets hospital prices for all payers, including private insurers and Medicare. Under the new deal, Maryland will continue to set rates, but total per-capita hospital spending cannot increase by more than 3.58 percent per year--the average growth rate of the state's economy over the past 10 years. In addition, hospitals will agree to meet certain quality targets, and they will move from fee-for-service payments into a pay-for-performance system.
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FDA Approves First Gel for Sealing Corneal Incision After Cataract Surgery
FDA News Release (01/09/14)

A gel sealant designed to stop fluid from leaking through incisions in a patient's cornea following cataract surgery has been approved for adults by the U.S. Food and Drug Administration. The ReSure Sealant kit consists of two liquid solutions that a surgeon mixes together just before sealing the incision after an intraocular lens has been inserted in the cornea. Surgeons use a foam-tipped applicator provided in the kit to apply the mixture directly to the incision. The gel breaks down over the course of seven days and is cleared by tears naturally produced by the eye.
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Outbreak of 'Nightmare Bacteria' in Illinois Stirs Worry
Wall Street Journal (01/08/14) P. A6 Porter, Caroline

An extensive drug-resistant bacteria outbreak emanating from a hospital near Chicago has infected 44 people in Illinois over the past year, according to the Centers for Disease Control and Prevention (CDC). The bacteria in question, carbapenem-resistant enterobacteriaceae, carries an enzyme that breaks down antibiotics. Advocate Lutheran General Hospital, located in Park Ridge, Ill., said the bacteria was found on three of its instruments for endoscopic procedures, prompting the facility to use gas sterilization to clean the instruments instead of only washing and disinfecting them. The hospital has contacted 243 patients who may have had contact with the bacteria during a procedure called endoscopic retrograde cholangiopancreatography, which is used to examine bile and pancreatic ducts. Leo Kelly, the hospital's vice president of medical management, says Advocate Lutheran General will implement such strategies as software monitoring and partnering with the CDC to detect the bacteria and safeguard patients.
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Serrated and Adenomatous Polyp Detection Increases With Longer Withdrawal Time: Results From the New Hampshire Colonoscopy Registry
American Journal of Gastroenterology (01/14) Butterly, Lynn; Robinson, Christina M.; Anderson, Joseph C.; et al.

Researchers say detection rates of polyps and adenomas reached their peak when colonoscopy withdrawal time was 9 minutes long. Using data from the New Hampshire Colonoscopy Registry, the researchers studied how an endoscopist's withdrawal time in normal colonoscopies affects adenoma and serrated polyp detection. The study involved nearly 8,000 patients who underwent colonoscopies between 2009 and 2011 from 42 endoscopists at 14 ambulatory surgery centers, hospitals, and community practices. According to the data, the incident rate ratios for detection of adenomas or clinically significant serrated polyps increased for each minute of normal withdrawal time beyond 6 minutes, with the maximum benefit at 9 minutes. "Colonoscopy quality may improve with a median normal withdrawal time benchmark of 9 min.," the researchers suggest.
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Report Finds More Flaws in Digitizing Patient Files
The New York Times (01/08/14) P. B1 Abelson, Reed; Creswell, Julie

A new report by the U.S. Department of Health and Human Services' Office of the Inspector General indicates that the federal government has not instituted safeguards to prevent electronic health record (EHR) systems from being used for inflating costs and overbilling, even as it spends more than $22 billion to get hospitals and physicians to implement the systems. The report takes aim at the copy-and-paste function available in many EHRs, which can save providers time when it comes to inputting patient data but also can lead them to overcharge Medicare for services provided. Government estimates indicate that fraud related to EHRs could total hundreds of millions of dollars. Meanwhile, the American Hospital Association contends that hospitals have strong safeguards in place, but the federal government continues to push them to quickly implement these systems, overloading them with demands to input electronic data.
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Epidemiology of Musculoskeletal Upper Extremity Ambulatory Surgery in the United States
BMC Musculoskeletal Disorders (01/08/14) Vol. 15 Jain, Nitin B.; Higgins, Laurence D.; Losina, Elena; et al.

A recent study sought to examine the overall and age-adjusted utilization rates of rotator cuff repair, shoulder arthroscopy, carpal tunnel release, and wrist arthroscopy performed in the United States based on the 2006 National Survey of Ambulatory Surgery. The results show that an estimated 272,148 rotator cuff repairs were conducted, in addition to 257,541 shoulder arthroscopies excluding those for cuff repairs. The results also show 576,924 carpal tunnel releases and 25,250 wrist arthroscopies, excluding those for carpal tunnel release. The researchers said their data reports show significant age and demographic differences in the utilization of these commonly performed upper extremity ambulatory procedures and that evidence-based clinical indications for these procedures continue to be poorly defined.
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Patient Age, Diabetes Increase Mortality Risk After TKA
Orthopedics Today (01/14)

Older patients and people with diabetes have an increased risk of mortality and postoperative complications following primary total unilateral knee arthoplasty, researchers report. They looked at 15,321 patients who underwent primary unilateral total knee arthroplasty. Patients had a mean age of 67.3 years, and 61.2 percent of patients were classified as being obese, while 18.2 percent of patients had diabetes. The researchers found a 30-day mortality rate of 0.18 percent. Overall, 1.83 percent of patients had major complications and 5.6 percent of patients experienced overall complications. The study is published in the Journal of Bone & Joint Surgery.
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Outpatient Hip and Knee Replacement Surgery Comes to the First Coast
WJCT News (01/03/2014) Ross, Melissa

In northeast Florida, people requiring hip or knee replacement surgery have the option of undergoing an outpatient procedure called Anterior-Supine Intermuscular (ASI) hip replacement. ASI involves putting the patient under general anesthesia and making an incision over the front of the hip to cut and remove the bone. Replacement parts are then inserted, the joint is put back together, and the tissue layers are closed. The entire process takes about 45 minutes. "Instead of a hospital stay, the patient can rest up at home and enjoy a faster recovery," explains Dr. Michael Patney with Coastal Orthopedic Associates. Patney is the only doctor in the region who specializes in ASI, which is offered at the Orange Park SurgCenter.
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Ankle Arthroscopy: A Study of Tourniquet Versus No Tourniquet
Foot & Ankle International (01/14) Vol. 35, No. 1 Zaidi, Razi; Hasan, Kamrul; Sharma, Aadhar; et al.

Tourniquets may not need to be used in ankle arthroscopy, a new study has found. Orthopedic surgeons in the U.K. examined 63 patients who underwent ankle arthroscopy using a standard arthroscopic technique, all of whom had a tourniquet placed on their thigh. The tourniquet was routinely inflated in 31 patients and not inflated in the other 32. No significant differences were observed between the two groups in terms of length of operation, maximum intraoperative fluid pressures or visibility, and postoperative complications. The surgeons proposed carrying out a larger randomized clinical trial to confirm if tourniquets are indeed unnecessary during ankle arthroscopy.
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Arthroscopic Partial Meniscectomy Versus Sham Surgery for a Degenerative Meniscal Tear
New England Journal of Medicine (12/26/13) Vol. 369, No. 26, P. 2515 Sihvonen, Raine; Paavola, Mika; Malmivaara, Antti; et al.

One of the most widely performed orthopedic surgeries is arthroscopic partial meniscectomy, but a thorough examination of the procedure's efficacy has not been conducted. To this end, researchers in Finland carried out a multicenter, randomized, double-blind, sham-controlled trial with 146 patients between the ages of 35 to 65. These patients had knee symptoms consistent with a degenerative medial meniscus tear and no knee osteoarthritis, and they were randomly assigned to arthroscopic partial meniscectomy or placebo surgery. The researchers found that patients' outcomes following arthroscopic partial meniscectomy were no better than those after a placebo surgical procedure.
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