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November 2015
Vol. 2, Issue: 6
 

JACI: In Practice Announces Upcoming Issue Themes, Call for Papers

The editors of JACI: In Practice are offering a call for papers for the following upcoming 2016 issue themes:

  • March/April: Food allergy
  • May/June: Mold allergy
  • July/August: Chronic rhinosinusitis phenotypes
  • September/October: Medication adherence in asthma and COPD
  • November/December: Immunodeficiency disorders

If you have unpublished research that fits any of these themes, the editors invite you to submit manuscripts at the submission site. JACI: In Practice covers the spectrum of diseases in the allergy/immunology specialty, with an emphasis on practical clinical research and the latest recommendations for diagnosis and treatment. Any questions regarding the submissions process or specific manuscripts can be sent to the Editorial Office at InPractice@njhealth.org.
 

-RSL Matters-

Missed AAAAI's ICD-10 Webinars Earlier This Month? View Them Online
If you were unable to attend the AAAAI's ICD-10 webinars earlier this month, you can still catch up on what you missed. Visit the AAAAI website below to watch recordings of the presentations. "Readiness Review of ICD-10: The Basics" revisits recommended steps to successfully transition to ICD-10, while "Addressing Issues in Implementing ICD-10," responds to current ICD-10 questions and concerns. Both webinars were presented by AAAAI coding consultant Teresa Thompson, CPC, CMSCS, CCCC.

Save the Date: AAAAI Board Regional Forum Webinar Set for December 2
The AAAAI would like to invite all members to participate in the next AAAAI Board Regional Forum on Wednesday, December 2 at 8:00 pm Central Time (7:00 pm Mountain; 6:00 pm Pacific; 5:00 pm Alaska). These one hour interactive web-based discussions facilitated by the At-Large Directors who represent the regional, state and local societies and RSL Governors are intended to enhance and facilitate greater bidirectional communication between the AAAAI Board of Directors, the Governors and you, our members.

2016 RSLAAIS Assembly Forum to Focus on the Future of Allergy Practice
Allergy/immunology thought leaders will speak about the future of allergy/immunology practice at the AAAAI RSLAAIS Assembly Forum and Business Meeting during the 2016 AAAAI Annual Meeting, Friday, March 4 from 4:45 to 6:30 pm. This year's forum will focus on several areas of practice including the future application of technology, healthcare payment systems strategies, quality measures, future practice frameworks and the role of academic allergy in community practice. This session is open to all AAAAI members.

-Advocacy Matters-

AAAAI Responds to CMS Request for Information Regarding MACRA
The Centers for Medicare & Medicaid Services (CMS) issued a Request for Information regarding implementation of the Merit-based Incentive Payment System (MIPS), Promotion of Alternative Payment Models, and Incentive Payments for Participation in Eligible Alternative Payment Models (APMs) to inform the development of regulations and programs for the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. The AAAAI responded with comments, in addition to signing on in support of comments developed by MIPS and APM workgroups convened of specialty societies by the American Medical Association (AMA).

 

Practice Changers

We have partnered with the editors of JACI: In Practice to bring you monthly "Practice Changers" from recently published journal articles.

Highlighting cutting-edge information keeps you current and assists you in educating patients and physicians who rely on the expertise of our specialty!

An Hourly Dose-Escalation Desensitization Protocol for Aspirin-Exacerbated Respiratory Disease. By Justin R. Chen et al.

A major barrier to aspirin desensitization therapy in patients with Aspirin-exacerbated respiratory disease (AERD) is the substantial time commitment required by existing protocols. In a recently published study, Chen and colleagues present a novel approach for patients reacting to aspirin within one hour utilizing escalating doses of aspirin prepared from commercially available tablets at hourly intervals. The protocol is safe, easy to administer, and represents significant time and cost savings, with all patients finishing in 2 days or less and 40% within a single day.

Click here to read the abstract.

Performance and Pain Tolerability of Current Diagnostic Allergy Skin Prick Test Devices. By Jody R. Tversky et al.

A team of researchers at Johns Hopkins University School of Medicine led by Dr. Jody Tversky examined the performance and pain tolerability of ten modern allergy skin prick test devices. Notable differences were found in the sensitivity, specificity, and pain among the devices examined. Proper interpretation of the wheal and flare depend greatly on the specific device used, technique employed, and the concentration of histamine applied. 6mg/ml histamine control may not be appropriate for use with certain devices. The researchers also warn that the use of 3mm wheal as an arbitrary positive control threshold could lead to false negative results and missed diagnoses.

Click here to read the abstract.

 

AAAAI Advocacy Impacts ICD-10 Codes for Reimbursement
Since the transition to ICD-10 coding on October 1, 2015, AAAAI leadership has contacted several of the Medicare Area Contractors (MAC) to request diagnosis code revisions to the MAC's Local Coverage Determinations (LCD). Several diagnosis codes which were previously approved for medical necessity have been omitted from the ICD-10 list of diagnosis for allergy testing and allergy immunotherapy. LCD policies in question include: Novitas LCD 36240 and LCD 36241, and National Government Services LCD 32553.

From correspondence with Wisconsin Physician Services (WPS) regarding LCD 34597, WPS recently informed AAAAI leadership that codes from T63.421A to T63.464S will be retroactively reimbursable to October 1, 2015. In addition, as a result of the AAAAI's request for review, First Coast Service Options notified leadership that (L33804) allergen immunotherapy will be revised to include the entire range for toxic effect of venom diagnosis codes (T63.001A-T63.94XS) in the section "ICD-10 Codes that Support Medical Necessity" for CPT codes 95115 and 95117. These modifications to the LCD and updates to the system will be made over the next several weeks. Reimbursements will be made for the date of care provided, or on or after October 1, 2015.

Novitas is expediting the AAAAI's request for review, and will update its website regarding LCD 36240 and LCD 36241. If revised, ICD-10 code updates will be retroactive to October 1, 2015. A response from National Government Services is pending.

2016 Physician Fee Schedule Update
As you previously read in October Practice Matters, the AAAAI signed on to two collaborative letters around important issues in the CMS 2016 Physician Fee Schedule, in addition to submitting a letter of our own. These letters are available on the advocacy webpage. The results in the final 2016 Physician Fee Schedule rules were mixed for the specialty. We were disappointed to see core A/I codes still included on the potentially misvalued codes list, but very pleased to see few changes to the rules for Quality Clinical Data Registries like the AAAAI QCDR. Analysis of the payment and quality provisions prepared by Hart Health Strategies are available for your review below.

AAAAI Holds School-based Management for Asthma Summit, White Paper Coming
The School-based Management for Asthma Summit, sponsored by the AAAAI with additional support from the National Association of School Nurses (NASN), took place October 8-10 near Washington, DC. The Summit is part of a larger initiative of AAAAI President Robert F. Lemanske, Jr., MD, FAAAAI, to improve the care of asthmatic children within the school setting. Participants included over 40 stakeholders from various lay and professional organizations who have relevant interest or expertise, or have developed programs that relate to the school-based management of asthma. The focus is now on creating a white paper that will summarize recommendations for future achievement of the goals and action items that were developed and formalized during the Summit. The paper is expected to be published by April 1, 2016.

-Practice & Policy Matters-

Auvi-Q Nationwide Recall
Sanofi US has issued a voluntary nationwide recall of Auvi-Q® (epinephrine injection, USP) due to potential inaccurate dosage delivery. The concern is that if a patient was experiencing anaphylaxis and ended up not receiving the intended dose, there could be significant implications due to the potentially life-threatening nature of anaphylaxis. The recall covers all Auvi-Q units currently on the market in both the 0.15 mg and 0.3 mg strengths. This includes lot numbers 2081278 through 3037230, which expire October 2015 through December 2016.

Now Available: New Primary Immunodeficiency Practice Parameter
Brush up on your knowledge of primary immunodeficiency disease with a newly updated practice parameter titled, "The Diagnosis and Management of Primary Immunodeficiency." The practice parameter was developed by the Joint Task Force on Practice Parameters and has been published in The Journal of Allergy and Clinical Immunology (JACI). Share this document with your colleagues to encourage wider recognition of primary immunodeficiency, increase uniformity and efficiency in evaluation, and enhance application of specific diagnoses.

How is Healthcare Information Technology Working in Your Practice?
With the recent release of Stage III requirements for the CMS Meaningful Use program, there is considerable discussion at the national level regarding the challenges of electronic health record implementation and other technology in physician practices. The Healthcare Information Management Systems Society (HIMSS) has asked the AAAAI to invite our members to participate in a survey gathering information on the value and use of healthcare information technology in practice. The AMA has also asked the AAAAI to invite our membership to participate in a survey regarding the summary of care document that is produced to meet the Transfer of Care objective in Stage II of Meaningful Use.


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

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