by Caroline Fife, M.D. | Oct 20, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
How can we get out of this silly problem of trials that don’t enroll our patients to get coverage for patients who really don’t need the product anyway? We need a way to risk stratify wounds that includes patient factors. Thanks to partial funding from a grant by KCI...
by Caroline Fife, M.D. | Oct 15, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
Today I got an in-service on a new product and my Program Director informed me that since we were moving to a new system for ordering supplies and charging them, it was about to become darn near impossible to get new products. I remember back in the early 1990’s I...
by Caroline Fife, M.D. | Oct 14, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
What is this? It’s a relatively new off-loading device called a TOAD or T brace. I am trying it in a patient with bilateral plantar DFUs who is not a good candidate for a total contact cast. Caroline Fife, MD I’ve got a NEW Facebook Page – be sure to follow me there...
by Caroline Fife, M.D. | Oct 12, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
At the recent fall Symposium on the Advancement of Wound Care (SAWC), I had the honor of speaking at the opening session entitled, “The Power of Numbers, Predictive Outcomes in Diverse Populations” with 2 eminent statisticians, Charles Cowan and Nigam Shah. It sounds...
by Caroline Fife, M.D. | Sep 30, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
I never get tired of seeing the before and after of a total contact cast change. This ulcer started out much larger but this is just the change with one week. She was healed the next week. Caroline Fife, MD I’ve got a NEW Facebook Page – be sure to follow me there...
by Caroline Fife, M.D. | Sep 28, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
ICD-10 is almost here. In a previous blog I discussed the unique thought logic that would be required to correctly code “late effects of radiation” in ICD-10. Now I am just going to say it—best of luck to those of you who do not have Intellicure. Intellicure is using...
by Caroline Fife, M.D. | Sep 24, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
I remember about 20 years ago a coder came to talk to me about my wound care documentation. I can’t remember if she was sent from the University or the hospital. I was a relatively young faculty member and the wound center I started at UT Houston had not been open for...
by Caroline Fife, M.D. | Sep 23, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
We talk about “livedoid patterns” on the skin but this has got to be one of the most amazing ones I have ever seen. This lady burned her backside falling asleep on a heating pad. The burn healed but these livedoid skin changes remained. Caroline Fife, M.D.Dr. Fife is...
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...
