Microsoft word - 9-13-2005 cents quarterly meeting minutes.doc

COMMUNITY EAR, NOSE and THROAT SPECIALISTS (CENTS)
Monday, September 13, 2005 (6:30 p.m.– 8:30 p.m.) Catherine Palmer, PhD Opening of Meeting-Jonas Johnson, MD Dr. Johnson opened the meeting at 6:30 p.m. by welcoming the members who were able Introduction of Residents in Attendance-Jonas Johnson, MD No residents in attendance at this meeting. Overview of ENT Products offered by Schering Plough Pharmaceuticals-Cheryl Kahn Cheryl Kahn summarized two products available through this Pharmaceutical Company. The first is an antibiotic called Avelox, which can be used as first line treatment for patients who have failed on other antibiotic treatments. This drug is on HMO plans and the UPMC hospital formulary. The second product discussed was Nasonex, a nasal inhaler. This product, per Ms. Kahn, is preferred over Flonase. Dr. Ferguson requested samples of Nasonex. Approval of Minutes-Jonas Johnson, MD Dr. Johnson asked the members for their approval of the June 6, 2005, meeting minutes Presentation on Cyberknife-Jennifer Grandis, MD/Dwight Herron, MD Dr. Grandis and Dr. Dwight Herron did a presentation on an Image Guided Radiosurgery There are only 12 installations of this system in the country. This is a team process-joint clinic between ENT and Oncology. Equipment is lightweight linear accelerator mounted on a robotic arm that has 6 axes of rotation. Two (2) ceiling mounted cameras perform near real-time image tracking. Radiation Therapy-history back to gamma knife. This equipment provides accurate radiation delivery. Robot relates the identified lesion to radiographic landmarks and guides the therapy beam to the intended target. Cyberknife allows for fractionation-allows for saving some of the normal tissue. Can treat lung/pelvis/head and neck/spine and skull based cancers. Equipment is remarkably accurate. Robot: - <1 mm clinical accuracy - Arbitrary CENTS Meeting Minutes Of September 13, 2005 Page 2 Candidates for Head and Neck Radiosurgery o Well circumscribed lesions o May be previously irradiated lesions o Boost to radio resistant tumors o Residual or recurrent after surgical therapy/difficult surgical approaches o Relative short life-expectancy for metastases o Significant medical co-morbidities. Typically the treatment includes 5 outpatient treatments of 30-45 minutes in duration. Patient has the opportunity to sop and rest during the process. Gamma Knife works for small lesions and only in head while cyberknife treats bigger lesions and can be used on various body parts. Treatment is delivered in a multidisciplinary approach. >70 patients treated to date with little toxicity (most off protocol) noted. Heterogeneous indications (recurrence, boost, other tumor types/skull based). Sleep Apnea Presentation-Jonas Johnson, MD- tabled until next meeting in December. Hearing Aid Update-Catherine Palmer, PhD CENTS members can still do business with 5 manufacturers. In phone discussions, they have increased their discounts for CENTS members. Catherine Palmer, PhD will mail the new packet to all CENTS members this week. Mid Atlantic is offering 6% off calibration and equipment (new and used) purchases. Ray-o-Vac has decreased battery prices. An update on Hearing Aid insurance has been received and this information will be Coding Update-Kathi Flaherty, Revenue Cycle Coordinator, Department of UPP Otolaryngology Kathi Flaherty summarized the course contents provided by KarenZupko & Associates at the August 13th coding session presented by Mary LeGrand. As always, Karen Zupko’s team presented clear and defined coding expertise with the documentation standards needed to get you to the specific coding level. Ms. LeGrand reminded attendees that scope procedures have a zero day global period so when seeing the patient the next time in clinic it is appropriate to bill the E&M level. New codes for 2005 were 31545 Microflap and 31545 Microflap with reconstruction; both are permitted to be billed bilaterally, as that is the patient for whom the vignette was created. There was an error by CMS, and they are not correcting to allow for proper payment. When removing a lesion the size and margin size should both be documented, as billing permits out to the margins as of 2004. It is very important to detail how the wound was closed, single layer, multiple layer, debridement was needed or advancement of tissue, or flap, as this changes the coding and reimbursement. Neck dissections codes that ride along with more aggressive codes such as Thyroidectomy and Laryngectomy, Glossectomy have not kept up with the times as most refer to radical neck dissections. Dr. Ferris and Kathi will work this coming year to bring those codes up to date. The billing on concho bullous as well as turbinate removal along with sinus cases is billable and payable. When it comes to authorization, the consultant recommended CENTS Meeting Minutes Of September 13, 2005 Page 3 getting prior authorization for the post op scopes at the same time we are authorizing the surgery as this could help reduce the authorization clean up work later. The question came up which is the higher paying scope. Nasal endoscopy 31231 has 1.1 WRVU with a Medicare fee schedule of $161.77. Flex larnygoscopy 31575 has 1.1 WRVU Medicare Fee Schedule of $110.39. General Updates -Dr. Froman included two articles of interest in the meeting packet regarding Medicare cuts planned. The articles were: Stop the Cuts Medicare Effort in High Gear Dr. Froman requested that everyone review these articles (attached) and get involved with government to voice their opinions on this subject. -Dr. Johnson announced that we would be conducting a CENTS Survey of the membership to determine how we can improve the CENTS Network to be as beneficial as possible to the members. Dr. Johnson asked members in attendance their thoughts on this subject. Dr. White and Maslov agreed that for physicians in a solo practice they enjoy the collegial nature of the meetings and having the opportunity to communicate with other professionals in their field. Community physicians also enjoy the educational presentations at the meetings. Dr. Froman would like to continue on with Dr. Myers’ idea of bringing the Grand Rounds and Tumor Board to the membership and possibly getting CME credits for this. Dr. Johnson stated that these were all good thoughts and asked that everyone complete the survey so that we can move forward with improvements. Drs. Hirsch, Eibling and Golla stated that they could learn a lot from ENT physicians in private practice in the community. A recent visit to Dr. Lipman’s office was very educational for them in terms of office administrative issues and use of various office staff. -Julie Truver announced that as follow up to the June meeting the following letters were sent from the CENTS Network: Letters Sent from CENTS Membership to Senators Santorum and Specter regarding Letter Sent from CENTS Membership to Medicare Letters are attached to the minutes.
Other Business
Dr. Johnson adjourned the meeting at 8:15 p.m. Respectfully Submitted, Julie Truver Director of CENTS Operations Murat Bankaci, M.D. Secretary, CENTS

Source: http://otolaryngology.medicine.pitt.edu/cents/Internal/9-13-2005%20CENTS%20Quarterly%20Meeting%20Minutes.pdf