Today’s Top Story
Two studies: Seniors’ bone health may not improve with increased calcium intake.
Research conducted in New Zealand and published in The BMJ suggests that increasing calcium intake through supplements or dietary sources is unlikely to lead to better bone health or a lower incidence of fractures in older patients. In the first study—a systematic review and meta-analysis that assessed calcium intake and bone mineral density (BMD)—investigators identified 59 eligible randomized controlled trials, 51 of which studied calcium supplements and 15 of which evaluated dietary sources of calcium (7 included trials studied both calcium supplements and dietary calcium). They concluded that taking calcium supplements or increasing calcium intake from dietary sources is associated with small, non-progressive increases in BMD (1 percent to 2 percent) that are unlikely to result in a clinically significant reduction in fracture risk. The other systematic review, which involved 2 randomized, controlled trials and 44 cohort studies, found that dietary calcium intake is not linked to risk of fracture. Furthermore, the researchers did not find any clinical trial evidence that increasing calcium intake from dietary sources can prevent fractures. An accompanying editorial comments on the research and poses questions regarding current recommendations for calcium intake in seniors. Read more…
Read the abstract of the study on calcium intake and BMD…
Read the abstract of the study on calcium intake and fracture risk…
Read the editorial from The BMJ

Other News

Study: HIV drug may result in lower bone mass in newborns.
According to a National Institutes of Health (NIH) study published in the journal Clinical Infectious Diseases, tenofovir disoproxil fumarate—a drug used to treat the human immunodeficiency virus (HIV) and reduce the transmission from mother to child—may lead to lower bone mineral content (BMC) in newborns who are exposed to the drug in the womb, compared to infants exposed to other anti-HIV drugs. The investigators, who studied 74 infants exposed to tenofovir and 69 infants not exposed to the drug with evaluable BMC measurements, found that pregnant women treated with the drug in their third trimester gave birth to infants whose bone mineral content was 12 percent lower than infants who had not been exposed to the drug in the uterus. Tenofovir use has been associated with bone loss and increased fracture risk in adults. The study authors called for longitudinal studies to further evaluate their findings. Read more…
Read the abstract…

CMS seeks public feedback on value-based payment programs.
The Centers for Medicare and Medicaid Services (CMS) seeks feedback on forthcoming value-based payment programs created as part of the repeal of the Medicare sustainable growth rate formula. The Medicare Access and CHIP Reauthorization Act (MACRA) consolidates several Medicare value-based payment models, including the meaningful use electronic health records incentive program, into the new Merit-Based Incentive Payment System (MIPS). Starting in 2019 under MIPS, physicians will see performance-based pay adjustments. Also starting in 2019, physicians who have enough of their Medicare payments tied to alternative payment models will get a 5 percent bonus and be exempt from MIPS. CMS is soliciting public comment on several aspects of the two programs, including whether or not physicians should be given partial credit for meeting some, but not all, of meaningful use measures. Comments must be submitted by Oct. 30, 2015. Read more (PDF)…

ICD-10 transition set for tomorrow, Oct. 1.
Beginning tomorrow—Oct. 1, 2015—all Medicare and Medicaid claims must be submitted using a valid ICD-10 (International Classification of Diseases, 10th edition) code. CMS has completed anticipated system changes needed to process ICD-10 codes. However, Medicaid programs in four states—Montana, California, Louisiana, and Maryland—will not be fully converting from the ICD-9 to the ICD-10 coding system on Oct. 1. Those states obtained approval from CMS to convert incoming claims coded in ICD-10 codes to ICD-9 codes, and to use ICD-9 codes to calculate healthcare provider payments. This approach is necessary because the four states’ systems are not yet ready to make the transition to ICD-10. Read more from InformationWeek
     CMS has released ICD-10: Clinical Concepts for Orthopedics—part of a series of guides that include common ICD-10 codes, clinical documentation tips, and a series of example clinical scenarios to familiarize providers with coding under ICD-10. Read the guide (PDF)…
Find more resources from the AAOS…(member login required)

New Jersey.
The New Jersey Law Journal reports that the state’s Supreme Court ruled in a 7-2 decision yesterday that a plaintiff in a medical malpractice suit cannot pursue a direct cause of action against a physician for failing to have the proper insurance, and that the informed consent doctrine is not violated if a physician fails to tell the patient whether or not he or she is insured. The court did determine, however, that an injured plaintiff can sue a healthcare facility that fails to ensure that their physicians have medical malpractice liability insurance, or have at least obtained a letter of credit, for the procedures they perform. Read more…

OKOJ October updates now online!
Check out the new topics and video in the Orthopaedic Knowledge Online Journal (OKOJ) on the AAOS OrthoPortal website. The following topics have been recently added or updated: “Chronic Hand Infections,” “Musculoskeletal Biopsy: Avoiding Potential Pitfalls and Improving Outcomes,” and “Practical Applications of Patient-specific Instrumentation in Shoulder Surgery.” In addition, three new videos have been made available: “Technique for Fine-Needle Aspiration,” “Patient-specific Instrumentation in Shoulder Surgery,” and “Technique for Core Needle Biopsy.” OKOJ now offers full-text, downloadable PDFs for articles in recent issues, with more on the way! View these topics and more…(member login required)

Call for volunteers: Annual Meeting Committee.
Dec. 1 is the last day to submit your application for a position on the Annual Meeting Committee. The following openings are available:

  • Allied health representative
  • Member-at-large

Applicants for the allied health position must be active fellows with knowledge of allied health educational needs. Applicants for the member-at-large position must be active fellows with experience, knowledge, and interest in the AAOS Annual Meeting. Learn more and submit your application…(member login required)

OrthoGuidelines free mobile app for AAOS CPG, AUC is now available.
The OrthoGuidelines platform is now available as a mobile app and can be downloaded for free from the Google Play store or iOS App Store. Launched in March 2015, OrthoGuidelines places all AAOS clinical practice guidelines (CPGs), appropriate use criteria (AUC), and related resources in one place. With keyword searches, users can now search all CPGs for any recommendation containing a keyword. Users can also sort recommendations by topic, stage of care, or recommendation strength. For more information about OrthoGuidelines…