Practice | Research | Education & Meetings | Journals & Publications | Announcements | News from the Literature
LEADING THE NEWS
CMS Releases Updates to 2011 Physician Fee Schedule
On Dec. 30, 2010, CMS posted a correction notice and a transmittal with operational issues related to the 2011 Medicare physician fee schedule as a result of congressional action overturning the 25 percent physician fee cuts that would have been effective on Jan. 1, 2011. All 2011 claims are expected to be paid on time and at the correct rates with no adjustments or claim holds necessary.
Due to adjustments to the fee schedule for budget neutrality and a rescaling of the Medicare economic index, the conversion factor for 2011 ($33.9764) is lower than 2010 ($36.8728). However, the lower conversion factor does not necessarily translate to a reduction in fees, and the impact varies by procedure code. CMS has advised the specialty societies that physician practices cannot compare the conversion factor from year to year because there are many factors affecting its calculation.
View the impact on the most commonly billed GI procedures for 2011. Most GI procedures see modest increases for 2011. The overall effect of the changes to the 2011 fee schedule on gastroenterology was a 1 percent increase. As a result of the continued phase-in of new practice expense survey data, many GI procedures see increases in practice expenses that help mitigate the negative effects of several years of payment freezes.
AGA's effort working through the AMA Relative Value Update Committee process to update the non-facility (office) practice expense inputs for several GI diagnostic tests was successful. CMS has established payment for electrogastrography Current Procedural Terminology® codes 91132 and 91133, which were previously carrier priced. In addition, CMS increased the payment for 91065 (breath hydrogen test) and more than doubled the payment for code 91038 (esophageal function test) when these procedures are performed in the office setting.
The AGA will continue to work with Congress on finding a long-term solution to the broken Medicare payment system. Continue to read AGA eDigest and the AGA Washington Insider for updates.
CMS Issues Guidance on PT Modifier
CMS issued an MLN Matters article, which provides guidance on the extension of waiver of deductible to services furnished in connection with or in relation to a colorectal screening test that becomes diagnostic or therapeutic.
Effective Jan. 1, 2011, the Affordable Care Act waives the Part B deductible for colorectal cancer (CRC) screening tests (codes G0104, G0105, G0106 and G0121) that become diagnostic. The AGA advocated heavily for this change and is pleased that CMS is implementing this waiver in all three outpatient settings — physician, hospital outpatient department and ambulatory surgery center.
Providers should append modifier PT (CRC screening test converted to diagnostic test or other procedure) to the diagnostic procedure code that is reported when the screening colonoscopy or flexible sigmoidoscopy becomes a diagnostic service. The claims processing system will respond to the modifier by waiving the deductible for all surgical services on the same date as the diagnostic test.
The diagnostic procedure would generally be a colonoscopy that began as a screening colonoscopy, but an abnormality was found. This could include the removal of a polyp, other tissue or a biopsy.
Co-insurance will continue to apply to the diagnostic test and to other services furnished in connection with, as a result of and in the same clinical encounter as the screening test. The GI societies continue to work with our advocates in Congress to ensure that the co-insurance is also waived when a screening colonoscopy becomes therapeutic.
Examples:
• A physician performs a screening colonoscopy (G0105, G0121) and nothing is found. The deductible and the co-insurance are waived.
• A physician performs a screening colonoscopy and a polyp is found (45385). The deductible is waived, but the patient or secondary payor is responsible for the co-insurance.
• A patient who never had CRC screening presents with reflux symptoms and is scheduled for an esophagogastroduodenoscopy (EGD). A screening colonoscopy is performed during the same session as the EGD. The deductible for the screening colonoscopy is waived, but the deductible for the EGD is not waived.
PRACTICE
2011 Electronic Prescribing Incentive Program Update
Beginning in 2012, eligible professionals who are not successful electronic prescribers may be subject to a payment adjustment on their Medicare Part B physician fee schedule (PFS)-covered professional services. In 2012, the payment adjustment for not being a successful electronic prescriber will result in an eligible professional or group practice receiving 99 percent of their Medicare Part B PFS amount that would otherwise apply to such services. The payment adjustment will increase each calendar year through 2014. The adjustment does not apply if less than 10 percent of an eligible professional's (or group practice's) allowed charges for the Jan. 1, 2011, through June 30, 2011, reporting period are comprised of codes in the denominator of the 2011 electronic prescribing (eRx) measure.
Earning an eRx incentive for 2011 will not necessarily exempt an eligible professional or group practice from the payment adjustment in 2011.
An eligible professional can avoid the 2012 eRx payment if he/she:
• Is not a physician, nurse practitioner or physician assistant as of June 30, 2011.
• Does not have prescribing privileges. He/she must report G8644 at least one time on an eligible claim prior to June 30, 2011.
• Does not have at least 100 cases containing an encounter code in the measure denominator.
• Becomes a successful electronic prescriber.
• Reports the eRx measure for at least 10 unique eRx events for patients in the denominator of the measure.
For group practices that are participating in eRx group practice reporting option I or II during 2011, the group practice must become a successful electronic prescriber. Depending on the group's size, the group practice must report the eRx measure for 75 to 2,500 unique eRx events for patients in the denominator of the measure.
| Are You E-Prescribing Yet? |
|---|
Take a free e-prescribing (eRx) readiness assessment on www.GetRxConnected.com/AGA. The site provides a host of valuable resources to help practices secure an eRx connection to their local pharmacies. |
RESEARCH
CMS to Host ICD-10 Preparation and HIPAA 5010 Calls
CMS will host a national provider teleconference on preparing for International Classification of Diseases (ICD)-10 implementation in 2011. Subject matter experts will review basic information on the transition to ICD-10 and discuss implementation planning and preparation strategies. A Q-and-A session will follow the presentations.
Registration will close at 1 p.m. ET on Jan. 11, so please register early. Learn more and register for this informative session.
CMS will also host its 14th national education call regarding Medicare fee for service (FFS) implementation of HIPAA version 5010 and D.0 transaction standards on Jan 19. This session will focus on the errata impact to HIPAA transactions and the Medicare FFS companion guides. Subject matter experts will review how Medicare FFS is implementing the errata, review the Medicare FFS companion guide and provide information to help the audience through the transition to implementation; the presentation will be followed by a Q-and-A session.
CMS will be adding a webinar as part of this national conference call. Participants who are not participating in the webinar should download the presentation for the call in advance.
Registration will close at 2 p.m. ET on Jan 18. To register for the call and receive dial-in information, visit http://www.eventsvc.com/palmettogba/011911. At the time of the call, first dial in for the call audio, then direct your browser to https://webinar.CMS.gov/MedicareFFS5010 and sign in as a guest.
UpToDate® Free Topic of the Month
Produced in cooperation with the AGA Institute, UpToDate® is a subscription-based clinical information resource available on the Web, CD-ROM and pocket PC handheld devices. Each month, a free topic is made available on the AGA website. This month's free topic is:
Nearly 232 physicians write more than 673 topic reviews for UpToDate in gastroenterology and hepatology alone. UpToDate provides gastroenterologists with access to more than 60,000 pages of original, peer-reviewed text, 160,000 MEDLINE abstracts, drug information and drug interactions databases, and hundreds of patient information handouts across 12 specialties. Moreover, UpToDate is used by tens of thousands of clinicians in more than 110 countries and by hundreds of premier medical institutions worldwide.
Order your subscription to UpToDate.
Your AGA Foundation gifts support ...
Catherine Rongey, MD, MSHS, at the University of California San Francisco, who received an AGA Research Scholar Award this year.
“The AGA Research award supports my academic and professional growth as I seek to expand my research skills. The award also supports my personal interest in providing equitable, accessible and high-quality health care for our nation’s veterans. My research is focused on rural versus urban health-care utilization and quality among veterans with chronic hepatitis C. Results of this study will inform subsequent interventions to improve liver specialty care access among rural veterans. It is a privilege and honor to be a recipient of the AGA Research Scholar Award.”
To make a donation, visit www.fdhn.org/contribute.
Colon Neoplasms Develop Early in IBD and Primary Sclerosing Cholangitis
Colon cancer surveillance guidelines for patients with IBD and primary sclerosing cholangitis (PSC) suggest annual colonoscopy once the diagnosis of concomitant disease is made, but there is little evidence to support this recommendation. Patients with IBD and PSC have a risk of developing colonic neoplasms soon after the coexistence of the two diseases is discovered, stated doctors in a study published in Clinical Gastroenterology and Hepatology. This finding supports the current colon cancer surveillance guideline recommendations of yearly colonoscopies for this patient population, beginning at the time of diagnosis of PSC in patients with IBD or with the diagnosis of IBD in patients with PSC.
Clinical Gastroenterology and Hepatology; 2011: 9(1): 52-56
Radiofrequency Ablation Is as Effective as Surgery
Differences in efficacy of radiofrequency ablation (RFA) and surgical resection are not clear for patients with hepatocellular carcinoma (HCC). According to a study in Clinical Gastroenterology and Hepatology, patients with small HCCs have a higher rate of tumor recurrence following RFA than surgery, but overall survival rates are comparable between therapies. RFA is as effective as surgery in patients with Barcelona Clinic liver cancer stage 0 HCC.
Clinical Gastroenterology and Hepatology; 2011: 9(1): 79-86
TDF Is Safe for Long-Term Management of Hepatitis B Patients
Tenofovir disoproxil fumarate (TDF), a nucleotide analogue and potent inhibitor of hepatitis B virus (HBV) polymerase, showed superior efficacy to adefovir dipivoxil in treatment of chronic hepatitis B through 48 weeks. Data published in Gastroenterology suggested that TDF was safe and effective in the long-term management of patients with chronic hepatitis B who were positive or negative for hepatitis B e antigen.
Gastroenterology; 2011: 140(1): 132-143
Idiopathic Gastroparesis Is a Diverse Syndrome
Idiopathic gastroparesis (IG) is a common but poorly understood condition with significant morbidity. In a study appearing in Gastroenterology, doctors found that IG is a disorder that primarily affects young women, beginning acutely in 50 percent of cases; unexpectedly, many patients are overweight. Severe delay in gastric emptying is associated with more severe symptoms of vomiting and loss of appetite. IG is a diverse syndrome that varies by gender, body mass, symptom onset and delay in gastric emptying.
Gastroenterology; 2011: 140(1): 101-115.e10
AGA, General Mills Announce Grant to Uncover Role Between Intestinal Bacteria, Health and Disease
Anisa Shaker, MD, is the recipient of the AGA-General Mills Bell Institute of Health and Nutrition Research Scholar Award in Gut Physiology and Health. This award provides $225,000 over three years for a young investigator working toward an independent career studying the relationship of gut microflora to physiology and immune function.
“This award will allow me to continue to cultivate and expand growing research interests that align with my clinical interest in inflammatory disorders and malignancies of the luminal GI tract. This generous funding will also provide me with protected time necessary for continued focused research, afford me the opportunity to continue to generate meaningful data and ultimately, to be a competitive candidate for independent federal grant support,” said Dr. Shaker.
Read the complete announcement.
Research Funding Helps Young Investigators Build Careers
AGA Research Scholar Awards provide $60,000 per year for two years to young investigators working toward independent careers in gastroenterology, hepatology or related areas. The awards' objective is to enable young investigators to develop independent and productive research careers in digestive diseases by ensuring that a major proportion of their time is protected for research. Applications are due Jan. 29.
Recipients will be selected based on the following criteria: significance, investigator, innovation, approach, environment, relevance to AGA's mission and evidence of institutional commitment. The candidate should state clearly how the additional training will benefit his/her research career.
To be eligible for this award, applicants must meet the following criteria:
• Hold an MD, PhD or equivalent degree.
• Hold a full-time faculty position at a North American university or professional institute by July 1, 2011.
• Be an AGA member at the time of application.
• Have a record of accomplishment in research.
• Be in the early years of a research career (i.e., no more than five years have elapsed since the completion of clinical or postdoctoral training).
Complete application instructions are available on the AGA Foundation's website.
| More Funding Opportunities |
|---|
Visit the foundation website for more information. |
EDUCATION & MEETINGS
It's Not Too Late to Register for Congress Events
It is not too late to register for AGA Clinical Congress 2011 events, which will be held over Martin Luther King weekend, Jan. 13–16, in Miami, FL. You may register on site starting Thursday, Jan. 13 at 11 a.m.
This year's congress includes four days of integrated, educational programming relevant to the entire GI practice — physicians, clinical staff and practice managers/administrators. Sessions will explore the very latest in clinical gastroenterology, endoscopy and practice management, and offer 38.75 AMA PRA Category 1 Credits™.
Congress events include:
• AGA Clinical Congress main sessions, Best Practices in 2011 (Jan. 14 and 15) — provides a comprehensive, evidence-based review of the field's major clinical topics and explores how key data from recent clinical trials have impacted new therapies and management strategies. Plus, examine the latest clinical research from interns, residents and trainees at a poster session during the wine and cheese reception.
• AGA Practice Management Course: From Surviving to Thriving in a New World (Jan. 13 and 14) — offers physicians and practice managers/administrators the essentials for running a successful practice in a demanding health-care environment.
• AGA Practice Skills Workshop (Jan. 16) — for GI fellows and young GIs — presents essential tools and information for building a successful clinical practice career.
• AGA Hands-on Course: Endoscopy for Barrett's Esophagus and Associated Neoplasia (Jan. 16) — this course is currently full. If you would like to be placed on a wait list, please call Linda St. Julien at 301-941-2658 or send an e-mail to lstjulien@gastro.org. You will be notified by Tuesday, Jan. 11 if space becomes available.
AGA member trainees can register for the congress and the practice skills workshop for free. For more information and to register, visit www.gastro.org./clinicalcongress.
The educational sessions at the AGA Clinical Congress are supported in part by educational grants from Abbott, Bristol-Myers Squibb, Gilead, Salix Pharmaceuticals, Shire and Vertex.
Hands-on course equipment and materials provided by BÂRRX Medical, Inc.; Boston Scientific Endoscopy; Cook Medical; ERBE USA, Inc.; Fujinon Endoscopy; GI Supply; Mauna Kea Technologies; PENTAX; and Olympus America, Inc.
AGA Spring Postgraduate Course Delivers Practical Information for Clinicians
The 2011 AGA Spring Postgraduate Course, Emerging Concepts and Their Practical Applications, will be held May 7 and 8 in conjunction with DDW® in Chicago, IL. The course will provide practical information for the most common digestive disorders that attendees can instantly transfer into practice. Participants will examine the latest science behind recent clinical advances, find out about new and updated diagnostic methods, and learn the best approaches for handling controversial management issues. The course offers up to 11.75 AMA PRA Category 1 Credits™.
Course directors, Maria T. Abreu, MD, and David C. Whitcomb, MD, PhD, and course co-directors, Frank G. Gress, MD, and Esther A. Torres, MD, AGAF, have assembled a diverse faculty comprised of more than 60 internationally recognized experts as well as young innovative gastroenterologists. The expert faculty will share fresh perspectives on how to manage complex clinical cases, address challenging diagnostic dilemmas and offer the best options for treating common GI and liver disorders. Participants will take away brand new research findings on future therapies for hepatitis C and the latest developments in the endoscopic treatments for obesity.
The course offers a variety of dynamic learning formats that include five general sessions, 15 small-group luncheon breakout sessions and 12 clinical challenge sessions. Registrants may select which of the luncheon breakouts and the clinical challenge sessions they would like to attend according to their unique needs and interests. These small-group sessions provide an excellent opportunity to examine topics in greater depth and exchange ideas with experts.
Attendees will receive a course syllabus containing abstracts, key points, references, slides, graphs, charts and tables. The syllabus is also available for purchase, as is a course DVD and access to online sessions, both of which include audio and slides from the lectures and clinical challenge sessions. Those who purchase the DVD can access the online sessions for an additional $10.
Register by March 23 to take advantage of a $75 early bird discount. Advanced registration is encouraged. For complete course information and to register, visit www.gilearn.org/pgcourse.
| Trainee and Young GI Track Helps Jumpstart Careers |
|---|
AGA's new trainee and young GI track at DDW® features exciting new sessions that provide the necessary tools and information for a successful clinical practice career, including: • Mentor and advisor networking reception. Learn more at www.gilearn.org/traineetrack. |
JOURNALS & PUBLICATIONS
New Gastroenterology Policy: Publishing Fees
Gastroenterology now requires authors of original research articles to pay a $75 submission fee for article processing. This fee applies only to the following original research manuscript types:
• Basic — Original Alimentary Tract.
• Basic — Liver, Pancreas & Biliary.
• Clinical — Alimentary Tract.
• Clinical — Liver, Pancreas & Biliary.
All other article types, as well as solicited content, are exempt from submission fees. This fee is collected via the journal's manuscript uploading system, Editorial Manager, and applies only to the first submission of a manuscript and not to any subsequent revisions of the same manuscript.
In addition, authors of accepted original research articles first submitted Jan. 1, 2011, or later will be required to pay for publication at a rate of $100 per published page. Authors will receive invoices for page charges after the corrected proof of their manuscript has been finalized. First or corresponding authors who are AGA members at the time of manuscript submission receive a 15 percent discount on page charges.
Gastro & CGH Video Abstracts of the Month
Watch Jasmohan S. Bajaj, MD, discuss his recently published Gastroenterology article, “Rifaximin Improves Driving Simulator Performance in a Randomized Trial of Patients with Minimal Hepatic Encephalopathy.” Provide your thoughts and comments on this important study via the YouTube comments tool.
Watch Stanley Martin Cohen, MD, discuss his recently published Clinical Gastroenterology and Hepatology article, “Legal Ramifications for Physicians of Patients Who Drive with Hepatic Encephalopathy.” Provide your thoughts and comments on this important study via the YouTube comments tool.
Journal Editors' Picks
The editors of Gastroenterology and Clinical Gastroenterology and Hepatology (CGH) would like to bring to your attention the following highlighted articles from the February issues of the journals:
Gastroenterology
- Budesonide 9 mg Is at Least as Effective as Mesalamine 4.5 g in Patients With Mildly to Moderately Active Crohn's Disease; By Andreas Tromm, et al.
- Telaprevir Is Effective Given Every 8 or 12 Hours With Ribavirin and Peginterferon Alfa-2a or -2b to Patients With Chronic Hepatitis C; By Patrick Marcellin, et al.
- Radioembolization Results in Longer Time-to-Progression and Reduced Toxicity Compared With Chemoembolization in Patients With Hepatocellular Carcinoma; By Riad Salem, et al.
- Cdx2 Levels Modulate Intestinal Epithelium Maturity and Paneth Cell Development; By Mary Ann S. Crissey, et al.
- Krüppel-Like Factor 5 Protects Against Dextran Sulfate Sodium−Induced Colonic Injury in Mice by Promoting Epithelial Repair; By Beth B. McConnell, et al.
CGH
- Esophageal Eosinophilic Infiltration Responds to Proton Pump Inhibition in Most Adults; By Javier Molina-Infante, et al.
- Legal Ramifications for Physicians of Patients Who Drive With Hepatic Encephalopathy; By Stanley Martin Cohen, et al.
- A Combination of the Pediatric NAFLD Fibrosis Index and Enhanced Liver Fibrosis Test Identifies Children With Fibrosis; By Naim Alkhouri, et al.
- Increased Risk for Malignant Neoplasms Among Patients With Cirrhosis; By Evangelos Kalaitzakis, et al.
- Diagnostic Accuracy of Capsule Endoscopy for Small Bowel Crohn's Disease Is Superior to That of MR Enterography or CT Enterography; By Michael Dam Jensen, et al.
Patient Books on IBS, IBD, Celiac and Obesity
Patients often look to their health-care providers for information and advice on how to cope with a multitude of GI conditions. Keep your patients well informed by referring them to the AGA, the most reliable source for GI patient information. Four patient books, published by AGA Press and written by leading experts in the field, are now available, including:
"Master Your IBS: An 8-Week Program to Control the Symptoms of Irritable Bowel Syndrome” — shows your patients — step by step through an eight-week program — how to reduce the severity and frequency of their IBS symptoms, without special diets, drugs or equipment.
"IBD Self-Management: The AGA Guide to Crohn's Disease and Ulcerative Colitis" — provides practical, yet detailed, advice for living with Crohn's disease or ulcerative colitis and includes valuable information on coping with flares, ensuring good nutrition, and medications and surgical options.
"Real Life with Celiac Disease: Troubleshooting and Thriving Gluten Free" — offers broad and practical information on celiac disease and gluten-related disorders, empowering those who are undiagnosed and those living with the disease to achieve the best possible health and well-being.
"The No-Diet Obesity Solution For Kids" — provides the parents of your overweight and obese pediatric patients with the knowledge they need to improve the health of their children, plus more than 60 kid-friendly recipes.
To learn more about AGA's resources for patients, visit www.gastro.org/patient.
Call for Papers on Clinical Trials: Gastroenterology
Gastroenterology is committed to advancing clinical practice in the field of digestive disease. Recognizing that clinical trials generally have the greatest impact of all studies on clinical practice, Editor Anil K. Rustgi, MD, and his associate editors strongly encourage authors to submit their manuscripts on clinical trials (diagnostic validation, therapeutic efficacy) of drugs, biological materials and devices in digestive, liver and pancreatic diseases, including studies at phases I, II and especially III, to Gastroenterology for consideration. The journal is also interested in publishing trials in endoscopic and imaging modalities.
There are several important reasons to submit clinical trial research for publication in Gastroenterology:
- With an impact factor of 12.9, Gastroenterology is the premier journal in the field.
- Gastroenterology is the journal that will directly reach the largest portion of physicians who care for and make treatment decisions for patients with GI or liver disease.
- Authors who submit their manuscripts to Gastroenterology typically will receive decisions within three weeks or fewer.
- Accepted manuscripts will be published online and indexed on PubMed within 10 days of acceptance.
To submit your manuscript to Gastroenterology, go to www.editorialmanager.com/gastro.
For important information on how to report clinical trials, go to www.gastrojournal.org/authorinfo. To review the current and past issues of the journal, go to www.gastrojournal.org.
ANNOUNCEMENTS
Jan. 31 Deadline for Tax-Free 2010 IRA Transfers
President Obama signed legislation extending the charitable individual retirement account (IRA) rollover for 2010 and 2011. This allows individuals 70 ½ or older to make tax-free gifts of up to $100,000 to qualified charitable organizations, including the AGA Foundation, using funds transferred directly from their IRAs. If you act by Jan. 31, 2011, you can make a gift effective for 2010. Plus, you can make a second contribution for 2011 anytime between Jan. 1 and Dec. 31, 2011.
Benefits:
• The transfer generates neither taxable income nor a tax deduction, so you will receive the benefit even if you do not itemize your tax deductions.
• The transfer may count against your unsatisfied required minimum IRA distribution.
• You will make an immediate impact on the AGA, allowing you to witness the benefits of your generosity. Your gift can qualify for membership in the AGA Legacy Society.
Learn more about this opportunity online, or contact Rick Podgorski at 760-635-0451 or rpodgorski@fdhn.org for additional information.
NEWS FROM THE LITERATURE
yeah
yeah
0 out of 0 users found this page helpful.
Was this page helpful?
Only current members of the American Gastroenterological Association may post comments to this page.
Login To CommentClassifieds
For only $82.50, you can place an ad of 100 words or less in two consecutive issues and for $165 in four consecutive issues. Ads can also be placed in AGA Perspectives, AGA's bi-monthly magazine. Ads that are placed in either or both of these publications are automatically posted in the classifieds section of our website. If you place ads in both AGA Perspectives and AGA eDigest, you will receive a 10 percent discount. For more information, contact Alissa Cruz at acruz@gastro.org or 301-272-1603.
Global Probiotics Council — Young Investigator Grant for Probiotics Research (YIGPRO)
The Global Probiotics Council (GPC), a committee established in 2004 by DANONE and Yakult Honsha Co., Ltd., has announced the fourth annual Young Investigator Grant for Probiotics Research (YIGPRO). The purpose of the two annual grants of $50,000 each is to contribute to the advancement of probiotics and gastrointestinal microbiota research in the U.S., and to impact academic and career development of young investigators, attracting them into the field of probiotics and microbiota.
Deadline: Feb. 15, 2011.
The official announcement and description of this opportunity may be found at: http://www.probioticsresearch.com/.
