Summer 2015Charleston, W.Va. Vol. 3, No. 3

Changes at WVU impacting WVAO and stateBy WVAO President Charles (Mike) Haislip, MD, FACS

OTOLARYNGOLOGY

West Virginia Academy of

Lend Us Your Ear (Nose & Throat)

First and foremost among the changes at West Vir-ginia University (WVU) is

the retirement from the posi-tion of department chair by Dr. Stephen Wetmore. Rest assured, though, fellow WVAO mem-bers and WVU alumni, that Dr. Wetmore will continue as a full-time member of the faculty, and working in the operating room, in clinics and in the research arena.

At our 2015 Alumni Confer-ence, we celebrated Dr. Wet-more’s years of service to WVU,

WVAO, patients and the state at Chairman of the Department of Otolaryngology. This was, I’m sure, the reason that the confer-ence drew one of our largest number of participants ever, with 24 alumnus attending this very successful conference.

Rest assured, though, that the WVU Department of Oto-laryngology will move forward in good hands. After a nation-wide search, Dean Clay March appointed our own Dr. Hassan Ramadan as Department Chair-man. On behalf of WVAO, we

offer him our congratulations.We also congratulate our

2015 graduating residents: Brian Kellermeyer has accepted an ENT faculty position here at WVU; Chadi Makary has ac-cepted an ENT faculty postition at WVU Eastern Division, Mar-tinsburg ENT; and Jordan Cain will pursue a fellowship in facial plastics in Cincinnati.

Our two new residents are Habib Zalzal from Georgetown Medical School and Daniel O’Brien from UC-Davis, whose article is on page 3.

Table of Contents

• Page 2 2015 is turning out to be a

year of change • Page 3 Why is advocacy important

for residents?• Page 4 Diagnosis: ICD-10 and your

patients• Page 5 A few degrees of difference

CME is nearly ready for 2015

Our 33rd Annual CME Conference will be here before you know it...

will you be joining us October 30 through November 1 at The Greenbrier?

Our speakers are Dr. John House of The House Clinic in Los Angeles, CA, Dr. Richard Waguespack of the University

of Alabama, Birmingham, and our own Dr. Ronald Wilkinson of West Virginia University.

We are still seeking exhibi-tors, so please ask your phar-maceutical and durable goods representatives to contact Diane Slaughter at 304.984.0308 or info@wvao-hns.org.

Make plans to join us for three great days of CME, golf, social events, exhibitors and more.

Registration information is now available online at www.wvao-hns.org, so register today!

Lend Us Your Ear (Nose and Throat)is published four times a year by the

West Virginia Academy of Otolaryngology - Head and Neck Surgery, Inc.

Charles (Mike) Haislip, MD, PresidentDiane Slaughter CAE APR, Executive Director

Scott McCarus, InternPO Box 11306

Charleston, WV 25339

WVAO reserves the right to determine suitability of advertisements and content. Correspondence

regarding subscriptions and changes of address should be directed to:

WVAO-HNS, Inc.PO Box 11306, Charleston, WV 25339

(304) 984-0308 • info@wvao-hns.org

Lend Us Your Ear (Nose and Throat) is a membership service of the WVAO-HNS and

may not be reproduced without permission. WVAO-HNS © 2015.

Vol. 3, No. 3 Page 2

2015 is turning out to be a year of changeBy WVAO Executive Director Diane Slaughter, CAE, APR, Fellow PRSA

WVAO members continue to show they find value in the services and benefits offered by the as-sociation, so please encourage an otolaryngologist to join you as a member or at the annual conference! Together, we can make the West Virginia Academy of Otolaryngology even more vital and supportive of your work. Please join us in making these efforts become reality!Wishing you all the best of 2015,

les, our own Ron Wilkinson from WVU and AAO-HNS Immediate Past President Richard Waguespack from University of Alabama Birmingham. If you haven’t already done so, please register for the October 30-November 1 meeting at www.wvao-hns.org. We look forward to seeing you there!

Changes are coming though:• Stephen Wetmore has

stepped down as Chairman of the WVU Department of Otolaryngology, although he remains in teaching, clinical and research activities at the University.

• Our own Hassan Ramadan has been selected to step into Stephen’s shoes, and we wish him well in that effort moving forward.

• Mike Haislip will become Immediate Past President of the WVAO-HNS at the an-nual conference, leading to vacancies in several offices. I hope you’ll consider stand-ing for one of the vacant offices.

• And now, the biggest change facing each of you...ICD-10.

It is my sincere hope that you and your staff are ready for this next phase. We have additional information on the subject in this issue.

2015 is turning into quite a year of change.Are you ready?

As this is written, we are looking at some major changes just around the

corner. 2015 has been a good year

for the West Virginia Academy of Otolaryngology - Head and Neck Surgery, Inc. (WVAO):• Your investment in the asso-

ciation through dues income is 13% above budget, for which we thank you.

• Your investment in the profession through contri-butions to the WV ENT Foundation exceeded our goals by nearly 20%.

• Although attendance was small, we had a produc-tive meeting in August at The Greenbrier. Evidence of this is Daniel O’Brien’s article on the next page.

• The 33rd Annual Meeting is just around the corner and we have some great speakers lined up for you, including John House, from House Clinic in Los Ange-

Page 3 Vol. 3, No. 3

Why is advocacy important for residents?By Daniel O’Brien, MD, WVU Resident

large number of acronyms, like all things in medicine. However, as I learned the lingo I became increasingly more interested in health advocacy as the issues be-came people and not just ideas. I met physicians that closed their offices because of SGR, and fought with patients on prior authorizations. What began as a casual interest became a hobby and a passion.

So with that back drop why do I think it’s important for resi-dents to be involved in healthy policy, advocacy and organiza-tion? Well, I can only explain this by saying why I remain involved. The very nature of be-ing a resident implores us to ad-vocate for our patients and the future of medicine. The easiest argument to make is that patient care in and of itself is advo-cacy. Calling in prior authoriza-tions, helping patients navigate through the health system, and connecting them with repre-sentatives from Medicaid and Medicare is advocacy. For that reason alone we should be inter-ested and invested in organized medicine. The second reason, and the one that is a bit more nebulous, is the future of health care: health policy. Over the past two decades we have seen sig-nificant government legislation that has changed healthcare de-livery, the healthcare work force and has attempted to redefine

Advocacy and health policy will influence and de-fine our careers in medicine.

the patient-physician relation-ship. Whether we are discuss-ing the balanced budget act of 1997, the ARRA and meaningful use or PPACA, there have been boulders thrown into the river of health care and the direction of the river is still to be deter-mined. As an intern I am look-ing up at a 40-year practice, and I have some ideas what I think medicine does and should look like. If we do not invest of our resources today we will see our role in leadership and molding the future of healthcare erode even further in favor of those who do and will. The most im-portant resource we can contrib-ute is time: time to teach medical students on these issues, our patients, our families, our friends and our elected representatives. So with this in mind, I invest as much time, technology and fi-nancial resources as I can at this stage of my career. Our careers in patient care will be influenced, if not defined, by advocacy and health policy.

So why is it important to be involved in health advocacy and policy as a

resident? When I was asked to write this article, I was hoping to write something succinct and simple. The more I thought, and the more I procrastinated, the more difficult it became to write.

I became involved in health advocacy early in medical school and the reasons why I began are not the reasons why I stay involved today.

I became involved in health policy after I saw its impact in my own life. Going into medi-cal school I knew I would need jaw/dental surgery for mid-face hypoplasia. Over the years lead-ing up to my surgery, my family had to change insurance three times in order to find a provider who would cover the operation, maxillary advancement. As soon as we found one, I was about to age out of my parents’ insur-ance. Just before I began medi-cal school, the Patient Protection and Affordable Care Act (PPA-CA) was passed, and my health coverage under my parents was extended. In my limited personal experience, I was able to see how insurance prior authoriza-tions and legislation directly im-pacted patient care. Due to this experience I joined my county, state and medical association and tried to learn more. There was a steep learning curve and a

Vol. 3, No. 3 Page 4

The World Health Orga-nization’s (WHO) Inter-national Classification of

Diseases (ICD)has served the healthcare community for over a century. The United States implemented the current version (ICD-9) in 1979. While most in-dustrialized countries moved to ICD-10 a number of years ago, the United States is just now transitioning to ICD-10 with an anticipated final compliance date of October 1, 2015. ICD-10 is a classification system for diagno-sis codes only. The system does not contain a procedural code set. The U.S. is adopting a modi-fied version of ICD-10 known as ICD-10-CM. Any references to “ICD-10” throughout this article refer to ICD-10-CM.

ICD-10 provides greater specificity in coding diagnoses than ICD-9. While many of the

Diagnosis: ICD-10 and your patientsBy Scott McCarus, WVPA Intern

coding guidelines for diagno-sis remain the same in ICD-9, ICD-10 does include some new features, such as seventh charac-ter extensions and the concept of reporting laterality.

In ICD-10, injuries are grouped by body part rather than by category.

It seems like a lot but is qiute simple once you’ve adjust-ed. In fact, if you use books to do your coding you can pur-chase an ICD-10 code book or access the ICD-10 codes online. If who or whatever machine is responsible for coding in your practice—cannot identify codes accurately using the code book or ‘look-up’ functionality in your software, explore their ICD-10 training options and determine if formal training is necessary. CMS has developed a tool called the General Equivalency Map (GEMS) to help with the cross-walk from ICD-9 to ICD-10. This tool is not a substitute for learning ICD-10. GEMS should not be used to code patient encounters. GEMS is a tool that you can use to help convert data from ICD-9 to ICD-10 and vice versa and most often used by software vendors for developing transitional products.

Helpful References • American Health Informa-

tion Management Associa-tion (AHIMA) Coding Injuries in ICD-10-CM ICD-10-CM/PCS Docu-mentation Tips

• Electronic Documentation Templates Support ICD-10-CM/PCS Implementation

• ICD-10-CMS/PCS Transi-tion: Planning and Prepara-tion Checklist

• ICD-10 Experts Push Back on Physician Concerns

• Medicare CMS/AMA Fre-quently Asked Questions – http://www.coa.org/docs/CMSAMAFAQ.pdf

• Medicare Clarifying Ques-tions and Answers Related to the July 6, 2015 CMS/AMA Joint Announcement and Guidance Regarding ICD-10 Flexibilities

• Medicare CMS- ICD-10 - http://www.cms.gov/Medicare/Coding/ICD10/ProviderResources.html

• Medicare CMS – Road to ICD-10 - http://www.roadto10.org/

• AAOS - http://www3.aaos.org/member/prac_manag/ICD-10.cfm

• ICD-10: The Documenta-tion is in the Details, “AAOS Now,” March, 2014

Are you ready for ICD-10?

Page 5 Vol. 3, No. 3

A few degrees of differenceBy Ron Rosenberg, Business Self-Defense®

We all have that favor-ite pair of jeans, or a “comfy chair” that

seems to fit just right. And if you’re a cyclist, your bike should feel that way too.

In fact, proper bike fit is essential for comfort, safety, and performance, and is actually an important consideration when you’re selecting what bicycle to purchase.

If the handlebar stem is too short, for example, you might feel cramped when you’re riding. If the seat it too low (or too high) you could hurt your knees.

But once you have the major considerations taken care of, then it’s the small adjustments that can really make a difference in your performance.

I noticed on a couple of recent rides that the “nose” of the seat (the end towards the front of the bike) seemed to be

tilted down just a little too much. This can hap-pen over time as the bolts loosen, and it’s really easy to fix.

So when I set out on a ride last week, I ad-justed the seat, tilting the nose up slightly - maybe just a degree or two.

The results were surprising - because that slightly increased the overall height of the seat so that my pedaling be-came more efficient...and more effective.

In fact, on a 45-mile route I had ridden the previous week - in virtually identical conditions - my average speed increased from 17.5 MPH to 18 MPH. That may not seem like a lot, but on a bicycle, it’s fairly significant.

Similarly, in business - and in

life - it’s often the small adjust-ments you make in your attitude and in your level of commit-ment that can make the differ-ence in your own performance.

What are the small changes you can make today that can help you get the results you want to achieve?

Want to keep your good em-ployees at all levels? Avoid these mistakes...

See you at The GreenbrierOct. 30 - Nov. 1, 2015!

Vol. 3, No. 3 Page 6

PresidentMike Haislip, MDMorgantown, WV

Vice PresidentGarrison Morin, MD, MBAMartinsburg, WV

Secretary-TreasurerF. Thomas Sporck, MDCharleston, WV

Past President Scott Gibbs, MDHuntington, WV

Directors

Steven Coutras, MDMorgantown, WV

John W. Wyllie, MDWeston, WV

Mark Armeni, MDMorgantown, WV

Executive DirectorDiane Slaughter, CAE, APR, Fellow PRSAPO Box 11306Charleston, WV 25339Phone:304.984.0308Email:info@wvao-hns.org

InternScott McCarus

Consider contributing to ENT PAC

to help make your voice heard on issues of importance to

otolaryngologistsand your patients!

Register now for the 33rd Annual Conference

at The Greenbrier Oct. 30 - Nov. 1

www.wvao-hns.org