Daniel Nagle, MD, Practice Division Director
The Practice Division of the American Society for Surgery of the Hand consists of 14 committees. These committees advocate for hand surgeons through their interaction with the American Medical Association, other medical specialty societies, the federal government and the public.
A significant amount of ASSH advocacy relates to reimbursement issues. Our representative, Dan Nagle, MD, participates in three meetings of the AMA CPT Editorial Panel and the AMA Relative Value Update Committee (AMA RUC) each year. The Center for Medicare and Medicaid Services (CMS) works with these two committees to determine reimbursement rates. ASSH is currently working on the following matters:
• A review of all soft tissue tumor codes
• Nomenclature associated with electro-diagnostic studies
• A review of codes that have demonstrated an increase in frequency during recent years, per a request of the Center for Medicare and Medicaid Services (CMS)
• The development and valuation of new upper extremity related CPT codes
The ASSH also regularly reviews and comments on the Correct Coding Initiative (CCI) and Medically Unlikely Edits (MUE) initiated by CMS. Dr. Mitch Nahra has been dealing with these edits for many years on our behalf. Each of us owes a great debt of gratitude to Dr. Nahra for his ongoing work.
The ASSH actively monitors the transition from the ICD9-CM to the ICD10 nomenclature scheduled to be completed by 2011. The implementation of the ICD10 will have a significant impact on every medical practice in the United States. Meanwhile, Marwan Wehbe, MD continues to update the hand surgery ICD9, providing an easy way for our members to match hand surgery procedures with the proper ICD9 codes.
The Society closely coordinates its coding and reimbursement activities with the American Academy of Orthopaedic Surgeons, the American Society of Plastic Surgeons and the American College of Surgeons. In an effort to standardize the contents of the ASSH and AAOS global services guides, John Bednar, MD and Dan Nagle, MD are working with the AAOS Coding Committee to reconcile the differences that exist between the two guides. It is hoped our members will experience fewer payment denials as a result of this work.
The transition to "evidence-based medicine" is moving ahead at a very rapid rate and the ASSH is fortunate to have Michael Keith, MD, Victoria Masear, MD and Peter Amadio, MD working in this vast, complex and rapidly changing arena. As co-chair of the AAOS evidence-based practice committee (and its ASSH homolog), Dr. Keith has shepherded the development of evidence-based guidelines for carpal tunnel syndrome and its care. Not only do these committees develop evidence-based guidelines, but they also monitor quality assurance and quality measures.
The Business of Hand Surgery Committee, co-chaired by Lionel Brown, MD and Dan Nagle, MD, with the assistance of Karen Zupko and Associates (KZA), has published two newsletters dealing with the business side of hand surgery practice. The committee continues to work with the Zupko organization to develop a basic business curriculum for our members. The possibilities of podcasts and other Internet-based resources are being explored. Mary LeGrand, of KZA, will once again dazzle our members with her knowledge of coding during her coding pre-course at the ASSH Annual Meeting this month.
To many, advocacy suggests interacting with governmental bodies on behalf of our members. Under the leadership of Mark Belsky, MD several members of the ASSH Government Affairs Committee participated in the AAOS National Orthopedic Leadership Conference in Washington, DC this spring. As “all politics is local,” Dr. Belsky is working with his committee on a “key man list” of ASSH members who have personal relationships with state and federal government officials. We also continue to explore ways we may avail ourselves of the services of the AAOS Office of Government Relations in our interactions with government agencies.
We continue to deepen our relationship with the AMA, as it is vital to our advocacy efforts. This year we are particularly pleased that ASSH Member, Andy Gurman, MD, has been elected Vice Speaker of the AMA House of Delegates. Having a hand surgeon in the hierarchy of the AMA will ensure that the interests of hand surgeons are known. We are also fortunate that our past president, David Lichtman, MD, represents us in the House of Delegates, accompanied by Stewart Haskin, MD, our alternate delegate and Charles Day, MD, our Young Physician Delegate.
On other fronts, Pat Howson, MD and the Volunteer Services Committee have worked hard to promote volunteerism among our members. Joe Jackson, MD has organized an outreach program to three cities in Vietnam, and a site in Nicaragua is being developed to educate local physicians in the art and science of hand surgery. While on the topic of volunteerism, the Lending a Hand Committee, chaired by Anthony Smith, MD, provides medical students with insight into the anatomy of the upper extremity from a hand surgeon's point of view. Currently, 58 institutions participate in the program with no less than 186 ASSH members spreading the word about hand surgery.
The ASSH continues its outreach to the public. Fred Fakharzadeh, MD and the Public Education Committee have issued seven new patient education brochures for release at this year’s annual meeting, and they are polishing up several existing titles. The Public Awareness Committee, under the direction of Keith Segalman, MD has partnered with the Public Awareness Task Force, led by A. Peter Weiss, MD, to explore new ways to promote hand surgery as a vital specialty. This summer, ASSH partnered with Paul Hamm and his surgeon, Lawrence Lubbers, MD to raise awareness of the work hand surgeons. Hamm fractured his fourth metacarpal prior to Olympic tryouts and his recovery was of great interest to the media. The print coverage alone garnered over 35,000,000 in circulation including all of the major dailies.
As you can see, the ASSH is advocating for its members and our patients on many levels. We are fortunate to have so many talented members who are willing to take time from their practices and families for the benefit of our Society and our patients. It is a privilege to work with such an amazing group of people.
Best wishes to all,
Dan Nagle, MD
ASSH Practice Division Director