Pennsylvania Orthopaedics Newsletter 2015... · Pennsylvania Orthopaedics ... BYLAWS CHAIR Dean...
Transcript of Pennsylvania Orthopaedics Newsletter 2015... · Pennsylvania Orthopaedics ... BYLAWS CHAIR Dean...
President’s Message...
Pennsylvania Orthopaedics
Inside:
WC Fee Schedule
Legisla ve Outlook
2014 Mee ng Highlights
2015 Calendar of Events ICD‐10 and more
Newsle er of the Pennsylvania Orthopaedic Society Winter 2015
The weather outlook is bleak. Punxsutawney Phil has
predicted six more weeks of winter. Prepare for more
Pennsylvania winter weather alerts and botched
weather forecasts! Fortunately, the POS Spring
Mee ng is in sunny Sco sdale Arizona. Interes ngly,
some meteorologists are predic ng an early
spring. One thing is certain; neither is 100% correct.
As we are all aware, Orthopaedic surgeons have varying ideas and a ‐
tudes and different views on prac ce environment, surgical technique, use
of physician extenders, regula ons, non‐surgical op ons, legisla on, poli‐
cs, etc.
My mission as president this year is to develop a be er understanding of
the different needs and opinions of our members to enhance the POS
membership experience. This is especially crucial as healthcare delivery
evolves throughout Pennsylvania and the United States.
One focus this year is an ac ve grassroots outreach to interested mem‐
bers and groups. Visi ng member prac ces throughout the state and
mee ng face‐to‐face increases collegiality and helps promote discus‐
sion. During these visits we will apprise members of our current legisla ve
efforts in conjunc on with development of an ac ve advocacy network to
communicate directly with lawmakers in their districts and in Harrisburg. In
addi on, I will soon be contac ng the chairpersons of orthopaedic depart‐
ments throughout the state to assess the needs of residents, fellows and
hospital employed physicians. I would like to incorporate sugges ons into
future POS ini a ves. Please directly contact the POS office if you are in‐
terested in helping schedule a local event.
If you are no ng any signs/symptoms of cabin fever please register now
for Controversies across the Commonwealth: Sports Medicine and Upper
Extremity, April 10‐11, 2015 in Sco sdale, AZ. Our program commi ee has
put together an impressive and engaging program that presents differing
points of view and approaches to Orthopaedic case dilemmas.
On behalf of the POS Board of Directors and staff I thank you for your con‐
nued support and look forward to a
challenging, yet successful 2015!
PRESIDENT
Tom Muzzonigro, MD
FIRST VICE PRESIDENT
Samir Mehta , MD
SECOND VICE PRESIDENT
Patrick Smith, MD
SECRETARY
Barry Snyder, MD
TREASURER
Angela Rowe, DO
ORTHOPAC CHAIR
Chip Hummer, MD
HISTORIAN
Jack Frankeny, MD
HEALTHCARE DELIVERY
Joshua Port, MD
MEMBERSHIP CHAIR
Paul Sherbondy, MD
BYLAWS CHAIR
Dean Harter, MD
DIRECTORS AT LARGE
Kim Accardi, MD
Jonathan Garino, MD
James Guille, MD
Paul Sherbondy, MD
AAOS COUNCILORS
Greg Gallant MD, MBA
Tom Muzzonigro, MD
Harry Schmaltz, MD
PAMED REPRESENTATIVES
Angela Rowe, DO
Dave Yucha MD
EXECUTIVE DIRECTOR
Beth Weachter
DIRECTOR, EDUCATION/EVENTS
Susan Sands
Tom Muzzonigro
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F ees for workers' comp services performed on or a er January 1, 2015, are calculated and paid in the following manner:
2015 WC Fee = 1994 WC Fee Schedule x 217%
THIS FORMULA DOES NOT APPLY TO NEW AND REVISED CODES. (See below*)
All workers' comp insurance carriers and self‐insured employers have received no ce of the 2% increase from the Bureau of Workers' Comp in Harrisburg. For your convenience, a link to this no ce can be found on our website. For‐warding a copy of this no ce with your 2015 claims may be helpful to insuring that you are paid at the updated rate.
Auto Reimbursement To calculate fees for 2015 auto claims, mul ply the 2014 Medicare rate by 110%
Workers’ Comp Increase for 2015 is 2%
2015 Workers’ Comp Fee Schedule Oder Form
Prac ce Name ____________________________________________ A en on __________________
Address _____________________________________________________________________________
City _________________________________ State ______________ Zip _______________________
Phone ________________________ Email _____________________ Medicare Area # (if known) ____
QTY ITEM/PRICE
____ 2015 WC Fee Schedule — Hard Copy @ $85 for POS members;
$125 for non‐members = $_____
____ 2015 WC Fee Schedule — CD** @ $75 for POS members;
$105 for non‐members = $_____
_____ 2015 WC Fee Schedule — Compressed Folder** @ $75 for POS members;
$105 for non‐members = $_____
□ Check enclosed payable to Pennsylvania Orthopaedic Society
□ Charge my credit card: _____VISA _____ MC _____ AMEX
Card Number ______________________________________________ CV _________ EXP _________
Cardholder Name _____________________________________________________________________
*No ce to prac ces that have ordered the WC Fee Schedule in prior years: you are advised to order a new fee schedule each year because previous year will not contain truly new and revised codes. Therefore, revising your old schedule will result in inaccurate informa on.
**Includes MS Excel and PDF files.
2015 WC Fee Schedule Available
Check your actual workers' comp reimbursements against what they should be, according to law.
Available in hard copy, CD, or compressed folder, this POS member benefit lists the 2015 workers' comp fees as published by the PA Bureau of Work‐ers' Compensa on for all CPT and HCPCS codes con‐ceivably used by an orthopaedic prac ce.
To order, complete the informa on in the box be‐low and mail or fax to:
Pennsylvania Orthopaedic Society 510 North Third Street, 3rd Floor Harrisburg, PA 17101‐1111 FAX: 717/909‐8906
Ques ons? Call Susan at POS: 717‐909‐8901
Carpel tunnel codes will be included in the 2015 fee schedule. They were inadvertently deleted in the POS 2014 version.
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T he 2013 – 2014 legisla ve session ended with internal GOP fights for leadership posts, external con‐flicts with the governor over his legisla ve agenda and a Democra c statewide elected official sub‐ject to a grand jury inves ga on.
The 2015 – 2016 legisla ve session is barely two months old and while the GOP infigh ng has subsided for the moment, the Republican‐led General Assembly is already engaged in a significant ba le with the new Wolf Administra on over gubernatorial appointments and a different Democra c statewide elected offi‐cial resigning and pleading guilty to charges of extor on related to his campaign fundraising efforts.
In the words of Yogi Berra, “It’s déjà vu all over again.” Or is it?
The headlines are bleak and the high minded talk of bipar san coopera on seem to be vanishing, but the session is s ll young. And the POS is well posi oned in the new session for success. To wit:
Former POS Legislator of the Year Mike Turzai is now the Speaker of the House.
Former POS Legislator of the Year Jake Corman is now the Senate Majority Leader.
Several POS Champions are members of their respec ve caucus’ leadership teams.
The POS now is working with a new Administra on that is sympathe c to many of our top issues.
Our task in the new session is to stay away from the fray and to vigorously work our issues using aggres‐sive grassroots campaigns and effec ve Capitol Hill lobbying. The POS leadership is commi ed to this strategy and has already demonstrated their willingness to hit the highway to deliver this message to members in their hometowns as evidenced by the successful January 15, 2015 mee ng in Johnstown . But more is planned.
At the board of directors mee ng on February 23, the POS leadership will approve a legisla ve agenda that will focus on ini a ves designed to preserve and protect your prac ce as well as to secure your eco‐nomic wellbeing. The list will include advocacy on:
Mcare Coverage Limits – By July of 2015, the Wolf Administra on will determine whether to:
1) Maintain the Mcare coverage limits at $500,000 in private insurance and $500,000 in Mcare coverage; or
2) Phase out the Mcare Program and increase the private insurance mandate to $750,000 while lower Mcare coverage limits to $250,000.
The POS will again advocate for maintaining the $500,000/$500,000 split. This is your best insurance op‐on un l a phase out plan can be developed to hold physicians harmless for the more than $1 Billion un‐
funded Mcare liability. We con nue to work on such a plan, but will request the Wolf Administra on maintain the status quo for the next two years.
Retroac ve Review – The POS will lead a coali on of healthcare providers in vigorously advoca ng for State Sen‐ator Dave Argall’s (R. Berks and Schuylkill) legisla on to prohibit healthcare insurers from reviewing paid claims beyond 12 months. This ini a ve will save your prac ce me and expense in defending paid claims and prevent
insurers from recouping your reimbursements at their will. Following the February 23 board mee ng, the POS leader‐ship will join Senator Argall, representa ves of other healthcare providers and our yet to be named House spon‐sor for a press conference to kick off our efforts to gain this vital legisla on. ...cont’d on page 6
New Legislative Session; Same Old Problems – Internal Fighting, External Conflict and a Guilty Plea Jonathan Bigley, Esq.
Johnstown Travel Team: Joshua Port MD, Chris Donaldson MD, Angela Rowe DO, Kelly Agnew MD, Don Lowry MD, and Tom Muzzonigro MD. Not pictured, also in attendance: Peter Ridella MD, Richard Schroeder MD, Vincent Vena MD, Trevor Yardley MD, and Charles Price.
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“The Sweetest Place on Earth” hosts Orthopaedic Surgeons
T hanks to over 150 members of the orthopaedic commu‐nity who a ended our 2014 Spring Scien fic Mee ng at the Hotel Hershey, April 10‐11! Charles “Chip” Davis III,
MD, PhD, put together an extensive program: Trea ng Muscu‐loskeletal Disease in an Aging Popula on, accredited for 13.5 CME credits™. The agenda featured many informa ve presen‐ta ons designed to educate a endees on orthopaedic care and treatment of Pennsylvania’s increasingly growing demo‐graphic. Pennsylvania Lieutenant Governor James Cawley ad‐dressed a lively luncheon crowd and reminded everyone of the importance of physician engagement in the legisla ve pro‐cess. General Assembly members need to hear from their cons tuents to understand the issues facing orthopaedic surgeons in the Commonwealth. ▪
C ongratula ons to orthopaedic resi‐dents Paul Millhouse, MD (Jefferson) and Kris n McPhillips, MD (Geisinger)
for their award winning presenta ons. McPhillips was named winner of the resi‐dent paper compe on for her talk “Healing Time and Complica ons in Opera vely Treat‐ed Atypical Femur Fractures Associated with Bisphosphonate Use: A Mul center Series”. Millhouse's paper, “Incidence of Injury to the Infrapatellar Branch of Saphenous Nerve a er ACL Reconstruc on: A Prospec ve Study”, received second place honors. Well done! ▪
Paul Millhouse, MD, Kris n McPhillips, MD, Resident Ses‐sion Moderator Angela Rowe, DO
Tom Muzzonigro MD, LT Gov Cawley, and Kevin Black MD
A endees: Jason Ye, MD (UPMC), Penn Sate Hershey Residents—Brian Stapinski, MD , (Mark) Daniel Hatch, MD , Wesley Flint, MD, Edward Sirlin, MD , Gary Updegrove, MD
P OS held its second program for residents: Residency Doesn’t Last Forever! Are You Pre‐pared for Orthopaedics in the REAL WORLD?
A endees were privy to candid accounts of ortho‐paedic prac ce and what to expect a er residen‐cy. Special thanks to all who sacrificed a Saturday morning to par cipate in this invaluable program. We look forward to the next session!
Have a sugges ons for a future program?
Contact: [email protected]
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Controversies in Orthopaedic Trauma
2014 2014 2014 VENDOR SUPPORTVENDOR SUPPORTVENDOR SUPPORT
T hanks to all who a ended our 2014 Fall Scien fic Mee ng at Nemacolin Woodlands Resort, October 23‐24. J. Spence Reid, MD and April Armstrong,
BSc(PT), MSc, MD, FRCSC put together an extensive pro‐gram accredited for 13.5 AMA PRA Category 1 Credits™. Highlights included a session en tled "What Would You Do?" during which Drs. Reid and Armstrong presented up‐per and lower extremity trauma cases to facilitate audience par cipa on and feedback. Senator Rich Alloway II also stopped by to address the luncheon crowd on Thursday and to receive accolades as POS Legislator of the Year. Alloway, who also serves on the Professional Licensure and Law and Jus ce Commi ees was honored for his support of many healthcare ini a ves important to POS members. ▪
K udos to orthopaedic residents Benjamin Zmis‐towski, MDA (TJU), Ma hew Schessler, MD (AGH), and Aakash Chauhan, MD, MBA (AGH)
for par cipa ng in the resident paper compe on. Chauhan took first place for his talk: “Post‐Opera ve Bracing Compared to No Bracing A er Tibial Plateau
Fixa on Shows No Difference in Radiographic, Func onal, and Subjec‐
ve Out‐comes".
Bravo! ▪
Arthrex Aspect Imaging
Automated Healthcare Solutions Auxilium Pharmaceuticals
Biomet Community Tissue Services
DePuy Synthes DePuy Synthes - Reconstruction
DePuy Synthes - Trauma DJO Surgical
Eli Lilly ERMI
EUFLEXXA IMSI/Medical Imaging/IMCO
JANSSEN LifeNet Health Masimo Corp.
Medeast Post-Op & Surgical Medical Concepts
Medtronic
Mid-Atlantic Surgical Systems Molnlycke Healthcare
NORCAL Mutual Insurance Co OBERD OrthoFix Pacira
Pacira Pharmaceuticals, Inc. Positive Physicians Ins Exchange
Rebound Medical/Elizur/DJO Global
Sanofi BioSurgery Smith & Nephew
Spine Wave Stryker
Swiss Ray Synergy Orthopedics
Tornier Trice Medical
Zimmer
Silver Level Exhibitors:
Mid-Atlantic Surgical Systems | OrthoFix Sanofi BioSurgery | Zimmer
Platinum Level Exhibitors:
Special thanks to Kevin Black MD for a wonderful term as POS President! We look forward to 2015 as Tom Muzzonigro MD, takes the reins in what is sure to be an exci ng and challenging year.
Program Chairs Spence Reid MD and April Armstrong BSc(PT), MSc, MD, FRCSC with Kevin Black MD. Thanks for a great program!
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Upcoming Programs: Coding, Controversies and more...
2015 Calendar
POS Coding Seminar/ICD-10 Update March 3, 2015
Crowne Plaza, King of Prussia, PA
POS Coding Seminar/ICD-10 Update March 19, 2015
Sheraton Station Square, Pittsburgh, PA
POS Spring Scientific Meeting Controversies Across the Commonwealth:
Sports Medicine and Upper Extremity April 10-11, 2015
JW Marriott Scottsdale Camelback Inn Resort & Spa
POS Fall Scientific Meeting Avoiding and Managing Complications
October 15-16, 2015 Philadelphia Hyatt at the Bellevue
Cont’d from page 3
Self‐referral Prohibi on – State Representa ve Tony DeLuca (D. Allegheny) has re‐introduced his legisla on to prohibit pa ent referrals to physician‐owned facili es. The POS suc‐cessful stopped this legisla on in the prior session. Your leadership team is commi ed to doing the same in the new session.
Workers’ Compensa on Payment Issues – In the new ses‐sion, the POS will con nue to defend the Workers’ Compen‐sa on (WC) fee schedule from a ack by the insurance and business communi es. We will also advocate WC payment issues including a ban on silent discoun ng and increasing penal es on insurers for un mely or incorrect payment of clean claims. The POS will likewise pursue legisla on to re‐quire WC insurers to accept electronic billing and to create standing for physicians to receive medically relevant infor‐ma on from a WC claim. All of these measures will ensure that you receive just compensa on for your efforts and re‐duce the costs of your prac ce.
Visi ng Team Physician – The POS is also pursuing legisla‐on to allow out‐of‐state visi ng team physicians to treat
their athletes and team staff while in Pennsylvania. This ini a ve will be sponsored by Senate Majority Leader Jake Corman (R. Centre). We an cipate swi movement of this important legisla on.
The headlines may look bad, but the POS leadership is mov‐ing forward with an aggressive and achievable agenda. We will be looking for grassroots support for these ini a ves, so be ready when we call upon you. ▪
B e sure to reg‐ister for the POS spring
mee ng in Sco s‐dale! Program Chairs Kim Accardi MD, Dave Yucha MD, and Greg Altman MD have created an ex‐tensive program that is sure to enlighten a endees on ortho‐pedic controversies across Pennsylvania!
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I t’s February 2015, and orthopaedic prac ces must implement the Interna onal Classifica on of Diseases, 10th edi on (ICD–10) on October 1 — just 8 months away.
By now, your prac ce should have accomplished the following ac ons: Begun physician and staff training in the new coding system nomenclature and codes Iden fied all prac ce processes and systems that require conversion from ICD–9 to ICD–10 Contacted your claims clearinghouse regarding ICD–10 readiness Contacted payers regarding ICD–10 readiness Determine how you might handle revenue payment shor alls to sustain your prac ce
During February, it is recommended that your prac ce undertake the following ac ons: Completely install any new or updated so ware required to implement ICD–10. Begin tes ng new or updated so ware. Con nue physician and staff training.
Addi onal informa on and resources: Centers for Medicare and Medicaid Services is the official industry resource for ICD‐10 and HIPAA Version 5010—www.cms.gov/Medicare/Coding/ICD10/Index.html American Academy of Orthopaedic Surgeons—www.aaos.org/member/prac_manag/icd‐10 Pennsylvania Orthopaedic Society—plan to a end our coding seminar in March!
ICD-10 is Coming — Are You Ready?
ICD‐10 has 141,000 codes—more than 8 mes the 17,000 codes in ICD‐9. The addi onal codes will enable prac ces to be more specific on claims forms in repor ng the care provided to pa ents.
POS ANNUAL CODING SEMINAR CPT & ICD‐10 TRAINING Two Dates … Two Locations
March 3, 2015 – Crowne Plaza Valley Forge March 19, 2015 – Pi sburgh Sheraton Sta on Square
Plan to a end the annual POS Coding Seminar to learn ICD‐10 updates and more! Once again POS is partnering with Zupko and Associates to provide up to date informa on on coding essen als for orthopaedic prac ces.
CPT Update for 2015
Most Common Orthopaedic diagnoses reviewed in depth
Common Documenta on Issues in ICD ‐10
Implementa on Plan for ICD‐10 ‐ Where are you?
REGISTRATION and ADDITIONAL INFORMATION
[email protected] | www.paorthosociety.org | 717.909.8901
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Pennsylvania Orthopaedic Society
510 North Third St., 3rd Floor
Harrisburg, PA 17101
phone: 717.909.8901 • fax: 717.909.8906
www.paorthosociety.org • [email protected]