by Caroline Fife, M.D. | Nov 9, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Pressure Cooker: Rethinking Pressure Ulcers, Quality Payment Program, US Wound Registry
The Centers for Medicare and Medicaid Services (CMS) opened the Physician Compare quality measure preview period on October 5th. The 30-day preview period closed on Friday, November 6th. It provided an opportunity for individuals and group practices to review their...
by Caroline Fife, M.D. | Nov 2, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
You may remember a previous blog post of mine explaining why even though at first blush, the ICD-10 code cross-walked for the 990 “late effects of radiation” code might not seem to make sense, it really did? I won’t go back through the logic here, but the point is...
by Caroline Fife, M.D. | Oct 29, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Nutrition & Wound Healing, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
Earlier this month, I showed you some photos of a malnourished patient who I think has improved because of Argenaid. While there may be some things in the past that I miss, I confess that in the past I did not pay sufficient attention to nutritional issues. I’m...
by Caroline Fife, M.D. | Oct 23, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
It’s not IF but WHEN you get the notice of a payer audit. One day you will open your mail and receive the Notice of Audit. It’s no longer IF, but WHEN. What are you doing RIGHT NOW to ensure you will be successful when your time comes? Preparation is the key. ...
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 13, 2015 | Quality Payment Program
CMS will be publicly reporting a sub-set of the 2014 Physician Quality Reporting System (PQRS) measures on Physician Compare. Starting October 5, 2015, CMS is has set up a 30-day preview period for select quality measures through the PQRS portal—Provider Quality...
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 15, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
I am trying 2 new cellular-based products at the moment. I won’t say which ones they are. I am grateful to have sample products to try since there are always patients who don’t have secondary insurance and can’t afford the copays if I have to charge them, or whose...
by Caroline Fife, M.D. | Sep 7, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
The drug industry, patients and consumers are urging the FDA to find better ways to integrate the patient perspective in drug development, as well as a way to use “real world” data in drug development. It will be interesting to see how the FDA reacts to the growing...
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...
