by Caroline Fife, M.D. | Sep 22, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Yesterday I posted some of the reasons for denial of HBOT under prior authorization. I thought I’d point out something that should be obvious but might not be. It appears that HBOT is being denied for DFUs unless—at a bare minimum: Hemoglobin A1C is being checked and...
by Caroline Fife, M.D. | Sep 21, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
The Centers for Medicare & Medicaid Services (CMS) has implemented a prior authorization model for non-emergent hyperbaric oxygen therapy in Illinois, Michigan, and New Jersey. It is the position of CMS that it can reduce spending on HBOT services while...
by Caroline Fife, M.D. | Sep 4, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Good morning and Happy Friday! Friday’s on the blog are reserved for “Ask the Physician Friday.” If you have any questions for me please feel free to leave them in the comments below, ask on Twitter (@carolinefifemd), or on Facebook (@Woodlands Wound Physicians). I...
by Caroline Fife, M.D. | Sep 1, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Here’s some straight talk on clinical pathways. We’ve all gotten the message on “evidence based” medicine by which payers use data, primarily from randomized controlled trials (RCTs) to decide what treatments they will cover. I’ve had some concerns about that since...
by Caroline Fife, M.D. | Aug 14, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Good morning and Happy Friday! Friday’s on the blog are reserved for “Ask the Physician Friday.” If you have any questions for me please feel free to leave them in the comments below, ask on Twitter (@carolinefifemd), or on Facebook (@Woodlands Wound Physicians). I...
by Caroline Fife, M.D. | Aug 4, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
There is a lot going on about hyperbaric oxygen therapy documentation. The start of the prior authorization demonstration program for non-emergent hyperbaric oxygen therapy was delayed a bit but is it now active in Illinois, Michigan, and New Jersey. If prior...
by Caroline Fife, M.D. | Jul 28, 2015 | Fight the Good Fight, Health Information Technology and Wound Care, US Wound Registry
Every Tuesday this month we’ve been having some straight talk about a US Wound Registry Quality Measure. I’d like to talk about the measure “Appropriate use of hyperbaric oxygen therapy for diabetic foot ulcers”. This was the first HBOT measure the USWR asked CMS to...
by Caroline Fife, M.D. | Jul 27, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
Last month, the Centers for Medicare and Medicaid Services made public more hospital and physician billing data. The 2013 data covers about 950,000 providers who received $90 billion in Medicare payments. Medicare’s highest physician payments went to hematologists and...
by Caroline Fife, M.D. | Jul 20, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Every Tuesday this month we’ve been having some straight talk about a US Wound Registry Quality Measure. In the Jan/Feb 2-13 issue of Today’s Wound Clinic, Darlene Carey discussed the results of a pilot study of 3 quality measures: 1) vascular screening of leg ulcer...
by Caroline Fife, M.D. | Jun 30, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Tuesdays in the month of June, I’m offering some straight talk about a few of the MANY ways in which payment for hyperbaric oxygen therapy is going to change and FAST. Another issue is that of decreased payment of Physician Supervision for HBOT. The American Medical...
