Today’s Top Story
CMS will not impose 2017/2018 payment penalties on certain providers if ICD-10 issue impacted their ability to report.
The U.S. Centers for Medicare & Medicaid Services (CMS) has identified an issue with quality reporting measures related to a recent update to the ICD-10 diagnosis and procedure codes, and will therefore not apply the 2017 or 2018 Physician Quality Reporting System (PQRS) payment penalties, as applicable, to any eligible professionals or group practice that fails to satisfactorily report for CY 2016 solely as a result of the impact of ICD-10 code updates on quality data reported for the 4th quarter of 2016. The agency notes, however, that the majority of ICD-10-CM coding changes that impacted 2016 PQRS measures were related to diabetes, pregnancy, cardiovascular, oncology, mental health, and eye disease diagnosis.
AAOS recommends that physicians continue to report even if they plan to make a claim that the ICD-10 conversion prevented them from doing so satisfactorily.
Read more in AAOS Advocacy Now…
Read the CMS question and answer page (PDF)…
View the CMS ICD-10 page…

Other News

Study: Wide range between best-performing and poorest-performing hospitals for TJA.
Data from a study published in the Jan. 4 issue of The Journal of Bone & Joint Surgery attempts to develop risk-adjusted models for Medicare inpatient and post-discharge adverse outcomes in elective lower-extremity total joint arthroplasty (TJA). The authors reviewed information on 253,978 total hip arthroplasty (THA) patients and 672,515 total knee arthroplasty (TKA) patients from the Medicare Limited Data Set database. They found that the overall adverse outcome rates were 12.0 percent for THA and 11.6 percent for TKA. Z-scores for 1,483 hospitals performing THA varied from -5.09 better than predicted to +5.62 poorer than predicted, and the risk-adjusted adverse outcome rates were 6.6 percent for the best-decile hospitals and 19.8 percent for the poorest-decile hospitals. Z-scores for 2,349 hospitals performing TKA varied from -5.85 better than predicted to +11.75 poorer than predicted, and the risk-adjusted adverse outcome rates were 6.4 percent for the best-decile hospitals and 19.3 percent for the poorest-decile hospitals. The authors write that the “risk-adjusted outcomes demonstrate wide variability and illustrate the need for improvement among poorer-performing hospitals for bundled payments of joint replacement surgical procedures.”
Read the abstract…

Study: Outpatient TAA may be cost-effective alternative to inpatient TAA.
According to a study published online in the journal Foot & Ankle International, outpatient total ankle arthroplasty (TAA) may be a cost-effective and safe alternative to inpatient TAA. The researchers retrospectively reviewed data on 36 TAA patients, 21 of whom were treated as outpatients. They found that the average length of stay for the inpatient group was 2.5 days, and the overall cost differential between the groups was 13.4 percent—a savings of nearly $2,500 per case. There were no 30-day readmissions in either group, although one patient in the outpatient cohort presented for urinary retention to the emergency department on postoperative day 1. Overall, 71 percent of the outpatient group and 93 percent of the inpatient group stated that they would not change to a different postoperative admission status if they were to have the procedure again.
Read the abstract…

Study: Is there a difference in treatment for spine patients treated under FFS or in a DOD facility?
A study published online in the journal Clinical Orthopaedics and Related Research compares the rate of certain spinal procedures under performed under a fee-for-service (FFS) system and in Department of Defense (DOD) facilities. The research team reviewed information on 28,344 patients who were surgically treated for lumbar disc herniation, spinal stenosis, or spondylolisthesis, 21,290 of whom were treated in at a civilian facility with expenses covered by TRICARE insurance and 7,054 of whom were treated in Department of Defense facilities. They found that TRICARE beneficiaries treated for lumbar spinal disorders in the fee-for-service setting were 1.25 times as likely to receive interbody fusions. Overall, purchased care patients were more likely to receive interbody fusions for a diagnosis of disc herniation and for spinal stenosis. The research team noted no difference for patients with spondylolisthesis.
Read the abstract…

Study: Use of antidepressants may be linked to increased risk of hip fracture for older patients.
Findings from a study conducted in Finland and published online in the International Journal of Geriatric Psychiatry suggest that use of antidepressant medications may be associated with increased risk of hip fracture among older patients. The researchers conducted a retrospective, cohort study of 50,491 persons with Alzheimer’s disease (AD) and 100,982 comparison persons without AD. Compared with non-use, they found that current use of antidepressants was associated with a 3.01 times increased risk of hip fracture per 100 person-years among patients in the AD cohort, and a 2.28 times increased risk of hip fracture in the no-AD cohort. Overall, risk was most prominent in the beginning of use and was elevated for up to 4 years. The researchers note that the risk was increased with all commonly used antidepressants.
Read more…
Read the abstract…

Study: Opioids may be more often prescribed to those at increased risk of abuse.
Data from a study published in the January issue of the journal Pain suggest that patients with preexisting psychiatric and behavioral conditions may be more likely to receive prescriptions for opioids. The authors reviewed insurance claims for 10,311,961 patients who filled prescriptions for opioids and found that, relative to those without, patients with all assessed psychiatric conditions and psychoactive medications had modestly greater odds of subsequently filling prescriptions for opioids and substantially greater odds of long-term opioid receipt.
Read more…(registration may be required)
Read the complete study…

Presentation and discussion on proposed hip and knee surgeon rating system to be held at AAOS Annual Meeting.
Two representatives from U.S. News & World Report will present plans for and seek input on a proposed methodology to create a new rating system for hip and knee surgeons. The presentation will be followed by a question and answer session and an open discussion period. Participation is free, but limited to hip and knee surgeons only. The event will be held at 10:00 a.m., Wednesday, March 15, at the AAOS Annual Meeting in San Diego. To participate, please register by Feb. 15, 2017.
Register online…