RSL Matters

Restrictive Compounding Law Repealed in Maryland
Thanks to grass roots efforts by allergists, the Governor of Maryland recently signed legislation repealing a sterile compounding facility permit law which was passed in 2013 while awaiting new FDA regulations. This restrictive and burdensome law included physician offices in which medication was reconstituted and mixed according to manufacturer guidelines. Drafted to regulate bulk compounders, the legislation would have affected nearly every physician office and would have created barriers to accessing allergen specific immunotherapy for patients. State allergy societies are reminded to monitor their sterile compounding regulations.

• Read an announcement from MedChi, the Maryland State Medical Society.

Reimbursement for Code 95165 Preparation of Allergen Immunotherapy
Several private insurers have adopted the Medicare payment limits for the preparation of maintenance concentrate vials of allergen specific immunotherapy. Members are reminded to check medical policy bulletins and notifications for updates in reimbursement and documentation requirements for the insurers in their areas. The Office of Practice Management continues to monitor trends in commercial insurance carriers through our subscription to Policy Reporter.

• Reference chapter 12 of the Medicare Billing Manual. Section 200, which covers allergy testing and immunotherapy, begins on page 204.

ICD-10 CM Coding for Insect Venom Patients
The new diagnoses codes for patients who are presenting for insect reactions are much more specific than past ICD-9 CM codes. The ICD-10 CM codes for insect are specific to each type of insect, as well as to the encounter with the patient. Do you have a coding question? Email it to coding@aaaai.org.

• Learn more about ICD-10 CM coding for insect venom patients.

Epinephrine Legislation Signed into Law in Iowa
On April 24, the governor of Iowa signed into law Senate Bill 462. This legislation permits healthcare professionals to prescribe epinephrine auto-injectors in the name of an accredited school or district, and allows schools to maintain stock epinephrine for administration by trained personnel with liability provisions.

• Read the Iowa law.

Advocacy Matters

AAAAI Responds to Asthma and Peanut Allergy Study in the News
A new study highlighted during the American Thoracic Society's Annual Meeting has been receiving considerable media attention. The study's authors suggest children who have poorly controlled asthma are more likely to be peanut sensitized, and that such patients may benefit from testing for possible peanut allergy. After seeing the resulting media coverage, the AAAAI took to Facebook and Twitter to urge caution and the AAAAI Adverse Reactions to Foods Committee quickly put together a response that was issued to top media outlets and bloggers. The response points out: "A recommendation to test asthmatic patients for peanut allergy will potentially lead to misdiagnosis, and an unnecessary use of resources. Testing for food allergy in the absence of clear symptoms of an acute allergic reaction is never recommended. Despite a high rate of peanut sensitization in this study, there is no relevance to the study's finding since diagnosing peanut sensitization does not improve asthma control."

• Read the full response from the Adverse Reactions to Foods Committee.
• Read the AAAAI's related Choosing Wisely item, "Don't perform food IgE testing without a history consistent with potential IgE-mediated food allergy."

School Asthma Management Plan Act Introduced in the Senate
The AAAAI is a supporter of the School Asthma Management Plan Act, a bill introduced by Senator Kirsten Gillibrand (D-NY) along with Senators Mazie Hirono (D-HI) and Bob Casey (D-PA). If passed, this legislation would allow schools to apply for grants to help them develop asthma management plans, and purchase medication and equipment necessary to treat students affected by asthma.

• Find more information and read the AAAAI's letter of support at the AAAAI advocacy webpage.

AAAAI Participates in NHLBI Strategic Visioning Process
The National Heart, Lung, and Blood Institute (NHLBI) is in the midst of a Strategic Visioning process that will help determine its future direction. To focus its efforts, NHLBI solicited input on the most Compelling Questions (CQs) it must answer and the Critical Challenges (CCs) it must overcome to achieve these goals. The AAAAI Research & Training Division reviewed the NHLBI Strategic Visioning information and submitted CQs and CCs related to asthma and allergies, drug allergies, and training.

• Read more at the AAAAI advocacy webpage.

AAAAI Supports Liability Provision for California Epinephrine Law
The California epinephrine law passed last year did not include a liability provision, which has led to physician concerns about issuing standing orders for epinephrine so the school can keep it on hand. Now, California SB 738 will provide physicians the necessary security they need to close the loop on implementing the epinephrine law. As the AAAAI was included in the original law as a resource to provide information on the necessary and appropriate training for school professionals who may need to administer epinephrine, we submitted a letter of support for the liability provision legislation.

• Read the letter sent to California State Senator Bob Huff.
  

Practice & Policy Matters

Need Help Recruiting Talent for Your Practice? Attend the 2015 Practice Management Workshop
Have you registered for the 2015 Practice Management Workshop in Denver, July 17-19? According to Practice Management Committee Vice Chair Weily Soong, MD, FAAAAI, "Staffing is usually the biggest challenge in an established medical practice and unfortunately, there is not a perfect way to identify the best candidate for a position. During the session 'Finding, Training and Keeping the Right Staff for Your Practice,' we will discuss different strategies to interview employees. We will also discuss which is more important: to hire based on personality and work ethic, or to hire based on skills and practice needs. We will look into other ways to enhance employee satisfaction as well."

• View the course brochure and register today. Members and their office staff can use coupon code SAVE100 to take $100 off the registration fee.

Updated Practice Parameter on Contact Dermatitis Available
An updated practice parameter on contact dermatitis is newly available. This marks the first update since 2006, and reflects recent advances in the field of contact dermatitis and optimal methods of diagnosis and management based on an assessment of the most current literature.

• Access the document directly here.
• Locate the document from the AAAAI's library of practice parameters and other guidelines. It can be found under Skin Allergy.

FDA Alert: Recall of Standardized Meadow Fescue Grass Pollen Allergenic Extract
According to the Food and Drug Administration (FDA), GREER Laboratories, Inc., has initiated a voluntary recall for Standardized Meadow Fescue (Festuca elatior) Grass Pollen Allergenic Extract, 1000,000 BAU/ML manufactured and distributed by Antigen Laboratories, Inc. The product is being recalled because ongoing stability evaluations indicate a decrease in potency for this lot (# F09021213). It is recommended to discontinue use and contact GREER to arrange for a return.

• View the FDA alert.

Xolair Patient Consent Form Now Online
After receiving a request from a member, the AAAAI now has a patient consent form for Xolair. As an AAAAI member benefit, the form can be edited and customized for individual practices. Simply log in with your username and password. The form will open in Word document format for editing.

• Access the form from the AAAAI Practice Tools page, along with a variety of immunotherapy forms.

CMS Provides New Guidance on Open Payments Database
The Centers for Medicare & Medicaid Services (CMS) has posted new frequently asked questions on the issue of when continuing medical education would be reported under the Physician Payments Sunshine Act, also known as the Open Payments program.

• Read the questions.

Hardship Exception Applications for EHR Incentive Program Due July 1
Medicare providers who have not successfully participated in the Medicare EHR Incentive Program in 2014, please take note. To possibly avoid payment adjustments that will begin on January 1, 2016, visit the link below to review the rules for a hardship exception. Applications for hardship exceptions are due July 1.

• Read more on payment adjustments and hardship exceptions.

Looking for past issues of Practice Matters? An archive is available at: aaaai.org/practicematters