Practice Management

Practice Management

CMS Final 2020 Payment Rules for Medicare MPFS and OPPS

Late Friday, November 1, the Centers for Medicare and Medicaid Services (CMS) posted the final 2020 payment rules for the Medicare Physician Fee Schedule (MPFS) and the Hospital Outpatient Prospective Payment System (OPPS). These rules contain proposed policy and payment changes under the Medicare program.   

2019 Joint Committee on Infant Hearing (JCIH) Position Statement Released

This current 2019 document builds on prior Joint Committee on Infant Hearing (JCIH) publications (2013 JCIH supplement on Early Intervention and 2007 JCIH Guidelines), updating best practices through literature reviews and expert consensus opinion on screening; identification; and audiological, medical, and educational management of infants and young children and their families.

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Announcing Future Hub Presenter Meg Soper

Explore the topic of mindfulness and how important it is to take time for ourselves each day so that we find balance and thus can find the energy and inspiration to perform to the best of our abilities. 

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The Audiologist’s Obligation to the Vertiginous Patient

The Audiologist’s Obligation to the Vertiginous Patient

If you’ve ever experienced vertigo, then you’re aware of how horrible this type of dizziness can be. Certainly, talking to a few patients will give you a better understanding of the impact of this symptom on your life. It is incapacitating and there is often a sense of lack of control that can bring on an exacerbating anxiety contribution.

Most audiologists, and frankly many people, have become more familiar with benign paroxysmal positional vertigo (BPPV). There are videos online to help show people how to treat this problem and it is possible to do this successfully. Alternatively, it has been estimated that the annual costs associated with BPPV in the United States exceed $2 billion. How is it that something you can watch on your phone still costs this much to manage?

The reality is that patients (and often health-care professionals) have no idea which ear to treat or treat the wrong type of BPPV with a standard repositioning maneuver. They order many expensive tests (some studies indicate 75 percent of patients with BPPV undergo costly MRI scans). The audiologist is literally in the best position to be able to accurately identify the ear and canal. It should stand to reason, then, that the audiologist is also in the best position to implement the correct management technique to bring about a positive outcome.

Similarly, some would argue that vestibular migraine is one of the most common causes of vertigo and other dizziness. In fact, some recent work suggests that patients diagnosed with other primary causes of vertigo often have vestibular migraine as a secondary diagnosis. The reason for this relationship that appears to exist between vestibular migraine and other causes of dizziness is unknown. What is known is that lifestyle modifications can be very effective in addressing migraine in general.

For example, elimination of triggering food/drink has been shown to cause a significant reduction of migraine symptoms in 63-93 percent of participants. Restful sleep is another factor that seems to improve symptoms of migraine. One study found a 49 percent reduction of headache frequency for the experimental group compared to the control group (25 percent) at six weeks follow-up.

Missing meals or fasting is a trigger in as many as 57 percent of migraineurs. Other researchers have shown that by increasing physical activity through exercise, a 40 percent reduction in migraine headache frequency can be realized. Recommending a “migraine diet” is cited as a first line of intervention in almost all comprehensive articles on management of vestibular migraine. This is a helpful management technique that can be provided by audiologists to the benefit of many patients with this type of migraine.

Management of vestibular impairment is in our scope of practice. By intervening as one of the front-line health-care providers who work with patients with dizziness and imbalance, we can create improvement for the individual. This will decrease the burden of health-care costs, lost days of work, etc.

After attending the Practice Management Specialty Meeting, you will be ready to identify and manage all types of BPPV and provide an initial solution to many patients with vestibular migraine.

About the Presenter

Richard A. Roberts, PhD

Richard A. Roberts, PhD, is vice chair of clinical operations and an assistant Professor in the Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.

Learn more from his presentation at the Academy’s Practice Management Meeting, January 9-11, 2020, in Hawaii:
"The Audiologist’s Obligation to the Vertiginous Patient".

Medicare Audiologist Access and Services Act of 2019 Introduced in the Senate

On September 9, 2019, U.S. Senators Elizabeth Warren (D-MA), Rand Paul (R-KY), Sherrod Brown (D-OH), and Roger F. Wicker (R-MS) introduced the Medicare Audiologist Access and Services Act of 2019 (S.2446).

Innovative Strategies for Hiring: Become an Employer of Choice

Identifying and procuring top talent to support your practice may seem secondary to patient care or other day-to-day operational needs, but employee recruitment is a key element to effectively serving patients, constructing a successful practice, and ultimately, leaving a remarkable professional legacy.

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ACADEMY NEWS | Clinical Practice Guidelines for Cochlear Implants Now Available

Cochlear implants are auditory sensory devices designed to provide auditory perception for individuals with significant hearing loss. A majority of individuals who use a cochlear implant have the ability to understand speech in quiet and complex listening environments, and children who were born with hearing loss are now able to develop excellent auditory and spoken language skills with the device. 

Topic(s): Practice Management, Patient care, Cochlear Implants (CI), Hearing Assistive Technologies (HAT)

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Billing modifiers were created to provide additional information to the payer about the performed procedure(s) and help describe and/or qualify the services provided. There are common modifiers used by commercial payers and the Centers for Medicare and Medicaid Services (CMS), that indicate to the payer that the services provided have been altered in a way that is different than the ascribed definition of the billing code. For example, a modifier should be used when all of the tests in a bundled code were not performed or when only one ear was tested.

Topic(s): Centers for Medicare and Medicaid Services (CMS), Medicare, Advance Beneficiary Notice (ABN), CPT - Current Procedural Terminology, Coding, Reimbursement, Practice Management, Patient care, Treatment

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Our Responsibility to Move Audiology Forward

A culture of quality is needed if we are to bring audiology into the spotlight and highlight our expertise in hearing and balance. Ritz-Carlton co-founder and former president Horst Schulze states that we can create transactions every day, but until we place the person next to us as the most important person in the world in that moment, we will never create an experience.

Topic(s): Professional, Patient care, Public Awareness, Centers for Medicare and Medicaid Services (CMS), Coding, Reimbursement, Practice Management, Hearing Assistive Technologies (HAT), Balance/Vestibular, Hearing Aids, Hearing Health Care


Publication Issue: Audiology Today September/October 2019

Take Stock of Your Office

Best practices in audiology recommend defining set protocols and procedures for patient care and follow up. We have many resources to pull from for this guidance in our audiology organizations, in the current evidence-based literature, as well as our state and local legislative and licensure guidelines.