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Published On September 22, 2014
POLICY
Second Opinion Fall 2014
Readers weigh in on more efficient methods of coding medical conditions and current debates in hormone therapy.
A Tough, Needed Transition
As Proto highlighted (“An Imperfect 10,” Summer 2014), our current tools for coding medical conditions and procedures are often obsolete, don’t even include many modern therapies, and are not suitable for new health care delivery models. Adopting the International Classification of Diseases, tenth edition (ICD-10), though burdensome and costly, will ultimately allow physicians and hospitals to convey a more robust and precise account of care. Since billing data will actually reflect the complexity of the care delivered, clinical documentation and coding will be more synchronized. These alignments should enhance quality of care, improve communication among providers, serve as a platform for health outcomes research, and enable providers to make a better case for reimbursement. Many breathed a sigh of relief this past April when ICD-10 implementation was delayed to the fall of 2015. However, on September 4, 2014, the Centers for Medicare and Medicaid Services (CMS) ruled (Transmittal 540) that if an admission or diagnostic test is deemed not “reasonable or necessary,” then CMS will also deny the physician service associated with that activity. With this ruling, don’t be surprised if physicians now demand earlier implementation of ICD-10 so that their work can be more precisely and accurately coded and their work justly compensated.
Robert A. Philips, Executive Vice President and Chief Medical Officer, Houston Methodist
Regaining Balance
The recent publication of the main results of the Kronos Early Estrogen Prevention Study (KEEPS) continues the trend toward re-establishing a balanced approach to menopausal hormone therapy (MHT), as Proto discussed in “New Fuel for the Hormone Therapy Debate” (Spring 2014). In a group of 727 healthy women starting cyclic MHT early in menopause, there was no excess of vascular complications or evidence of worsening markers of atherosclerosis over the four-year study. There was clear improvement of menopausal symptoms, blood lipids and decreased bone mineral loss.
So, what have we learned? Mainly, that there was an overreaction to the initial dire conclusions of the Women’s Health Initiative and that MHT given to the correct women at the correct time is safe and appropriate. Doctors and patients must take this lesson to heart; when a single study bucks the tide of dozens of other studies, this is the time to increase the scrutiny of that study, not to toss the metaphorical baby out with the bathwater.
Frederick Naftolin, Professor of Obstetrics and Gynecology, New York University
Dispatches

What Makes a Kid Clumsy? More research into coordination disorders shows why some children are more prone to trip, fumble and spill the milk.

Eyes in the Sky Satellite data can be used to assess the health impact of dust storms and the spread of mosquito-borne diseases. Additional applications could be on the horizon.

Could This One Change Help Curb the Opioid Crisis? To prescribe an effective bridge to addiction treatment, emergency physicians must get special training and receive a waiver. Making that process easier—or eliminating the requirement altogether—could make a big impact.

One Thing Leads to the Next Robert Lefkowitz is best known for revealing the mechanism behind hundreds of drugs in use today. But he thinks of himself as a storyteller first and has a new book out to make his case.

Podcast: The Research Year That Was Medical research labs have faced a difficult stretch of closed buildings and competing priorities. Yet they have also produced milestone discoveries—and not only on COVID-19.

The Shape of Us Two milestone discoveries in protein modeling promise to change the fundamentals of drug discovery.

Universal Flu Vaccines Move Forward In the shadow of coronavirus vaccine development, another vaccine was making solid progress.

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