Imaging Committee Update
Gavin Setzen, MD, chair Jenna Kappel, MPH, MA, director, Health Policy and Staff Liaison, Imaging Committee On behalf of the Imaging Committee, we want to share some of the recent efforts with members, including involvement in the new head and neck ultrasound accreditation program, updates on the joint survey with the American Rhinologic Society on CT imaging, participation in the Academy’s Clinical Practice Guideline on Bell’s palsy, comments on the Milliman Care Guidelines regarding their requirement for a CT scan for stapedectomy, and review of AcademyU® courses to develop a CME resource for members to help them meet accreditation requirements. New Opportunity for Academy Members: AIUM Head and Neck Ultrasound Accreditation The Academy’s Imaging Committee continues to educate members on CT imaging policy and regulation. During the past year the committee has also assumed a more proactive role in ultrasound imaging in the head and neck region as this modality has become an integral part of contemporary management of patients with a variety of head and neck conditions. The Imaging Committee and the Head and Neck Surgery Education Committee facilitated a course in thyroid and parathyroid ultrasound at its Annual Congress Meetings, and Head and Neck Ultrasound Exported Courses, provided by the American College of Surgeons, were available via a variety of selected venues to include the American Academy of Otolaryngology—Head and Neck Surgery. Individuals who attended these courses and took the online post-test completed the first step in developing the opportunity to provide point-of-care ultrasound in their practice. However, until now there was no way of accrediting a subsequent experience and documented expertise in ultrasound of the head and neck. The American Institute of Ultrasound in Medicine (AIUM) and our Academy have merged their interests in head and neck ultrasound to provide a comprehensive accreditation process, which should be available for application by the time of the Annual Meeting in Vancouver. This will require successful completion of an ACS-sponsored course, a waiting period of a minimum of six months to accrue adequate experience, submission, and examination by an appointed Review Board of a requisite number of cases to include documentation of guided FNA, and maintenance of AMA PRA Category 1 CreditsSM. This is a preliminary notice that will be followed by formal details and means of applying in a subsequent issue of the Bulletin. The ultrasound workshop, led by Robert Sofferman, MD, with Russell Smith, MD, Lisa Orloff, MD, and Merry Sebelik, MD, worked diligently with AIUM and ALS to develop this opportunity, and we thank them. AAO-HNS/ARS CT Imaging Survey The Academy’s Imaging Committee joined with the American Rhinologic Society (ARS) to develop a questionnaire to jointly survey Academy and ARS members, including residents and fellows in training, regarding practice patterns and other aspects of CT imaging in patients with paranasal sinus disease. The response rate to the survey was tremendous with more than 300 surveys completed. The Imaging Committee and the ARS are currently analyzing the data to assess potential areas to improve care provision, safety, and quality, as well as address potential issues relating to knowledge gaps and educational opportunities. These data, together with the Clinical Consensus Statement on Appropriate Use of Computed Tomography for Paranasal Sinus Disease, will be helpful to members and payers and policy makers alike. A subsequent issue of the Bulletin will include a summary of the results of the survey. Bell’s Palsy Clinical Practice Guideline The Imaging Committee was asked to participate in the external peer review process for the newly developed clinical practice guideline (CPG) on Bell’s Palsy, chaired by Reginald Baugh, MD. Members who participated in the external peer review process for the guideline included Joseph Scharpf, MD, and David Friedmann, MD. This multidisciplinary guideline addresses the management of acute idiopathic unilateral facial nerve paresis or paralysis, and is intended for any clinician involved in the care of a patient presenting with Bell’s palsy. The primary purpose of this guideline is to improve the quality of and reduce variation in the care Bell’s palsy patients receive. Review of Milliman Care Guidelines on Requirement of Use of CT Scan for Stapedectomy The Academy sent a letter on May 14 to leaders at Milliman Care Guidelines (MCG) regarding their guideline requiring a CT scan prior to a stapedectomy procedure. Many health plans utilize MCGs as the basis for coverage determinations. After thoroughly researching the issue, we received approval from Gavin Setzen, MD, and the Academy’s Physician Payment Policy (3P) workgroup to request that MCG provide a copy of the guideline and work with the Academy to align it with current clinical care, which does not require a CT scan. Early in August, the MCG Medical director responded that he had received our letter and found the information most helpful, noting it is under consideration along with the rest of the medical evidence base that might help inform improvements to the MCG guidelines as part of their current cycle of research and guideline updating. Any additional updates received on the outcome of this effort will be provided to members via the News, HP Update, and a future Bulletin issue. Review of 100-plus Online Courses The Imaging Committee is also in the process of reviewing more than 100 online courses to determine whether they are imaging-related or not. This is an important activity because the new CME library will provide members who perform CT Imaging with CME resources to meet accreditation, particularly if they cannot wait to attend the annual meeting. Accreditation for CT imaging is a requirement by the Centers for Medicare & Medicaid Services (CMS) for practices to receive payment for Medicare patients. The link to the online courses that are imaging-related will be available by the end of 2013.
Gavin Setzen, MD, chair
Jenna Kappel, MPH, MA, director, Health Policy and Staff Liaison, Imaging Committee
On behalf of the Imaging Committee, we want to share some of the recent efforts with members, including involvement in the new head and neck ultrasound accreditation program, updates on the joint survey with the American Rhinologic Society on CT imaging, participation in the Academy’s Clinical Practice Guideline on Bell’s palsy, comments on the Milliman Care Guidelines regarding their requirement for a CT scan for stapedectomy, and review of AcademyU® courses to develop a CME resource for members to help them meet accreditation requirements.
New Opportunity for Academy Members: AIUM Head and Neck Ultrasound Accreditation
The Academy’s Imaging Committee continues to educate members on CT imaging policy and regulation. During the past year the committee has also assumed a more proactive role in ultrasound imaging in the head and neck region as this modality has become an integral part of contemporary management of patients with a variety of head and neck conditions. The Imaging Committee and the Head and Neck Surgery Education Committee facilitated a course in thyroid and parathyroid ultrasound at its Annual Congress Meetings, and Head and Neck Ultrasound Exported Courses, provided by the American College of Surgeons, were available via a variety of selected venues to include the American Academy of Otolaryngology—Head and Neck Surgery. Individuals who attended these courses and took the online post-test completed the first step in developing the opportunity to provide point-of-care ultrasound in their practice. However, until now there was no way of accrediting a subsequent experience and documented expertise in ultrasound of the head and neck.
The American Institute of Ultrasound in Medicine (AIUM) and our Academy have merged their interests in head and neck ultrasound to provide a comprehensive accreditation process, which should be available for application by the time of the Annual Meeting in Vancouver. This will require successful completion of an ACS-sponsored course, a waiting period of a minimum of six months to accrue adequate experience, submission, and examination by an appointed Review Board of a requisite number of cases to include documentation of guided FNA, and maintenance of AMA PRA Category 1 CreditsSM. This is a preliminary notice that will be followed by formal details and means of applying in a subsequent issue of the Bulletin.
The ultrasound workshop, led by Robert Sofferman, MD, with Russell Smith, MD, Lisa Orloff, MD, and Merry Sebelik, MD, worked diligently with AIUM and ALS to develop this opportunity, and we thank them.
AAO-HNS/ARS CT Imaging Survey
The Academy’s Imaging Committee joined with the American Rhinologic Society (ARS) to develop a questionnaire to jointly survey Academy and ARS members, including residents and fellows in training, regarding practice patterns and other aspects of CT imaging in patients with paranasal sinus disease. The response rate to the survey was tremendous with more than 300 surveys completed. The Imaging Committee and the ARS are currently analyzing the data to assess potential areas to improve care provision, safety, and quality, as well as address potential issues relating to knowledge gaps and educational opportunities. These data, together with the Clinical Consensus Statement on Appropriate Use of Computed Tomography for Paranasal Sinus Disease, will be helpful to members and payers and policy makers alike. A subsequent issue of the Bulletin will include a summary of the results of the survey.
Bell’s Palsy Clinical Practice Guideline
The Imaging Committee was asked to participate in the external peer review process for the newly developed clinical practice guideline (CPG) on Bell’s Palsy, chaired by Reginald Baugh, MD. Members who participated in the external peer review process for the guideline included Joseph Scharpf, MD, and David Friedmann, MD. This multidisciplinary guideline addresses the management of acute idiopathic unilateral facial nerve paresis or paralysis, and is intended for any clinician involved in the care of a patient presenting with Bell’s palsy. The primary purpose of this guideline is to improve the quality of and reduce variation in the care Bell’s palsy patients receive.
Review of Milliman Care Guidelines on Requirement of Use of CT Scan for Stapedectomy
The Academy sent a letter on May 14 to leaders at Milliman Care Guidelines (MCG) regarding their guideline requiring a CT scan prior to a stapedectomy procedure. Many health plans utilize MCGs as the basis for coverage determinations. After thoroughly researching the issue, we received approval from Gavin Setzen, MD, and the Academy’s Physician Payment Policy (3P) workgroup to request that MCG provide a copy of the guideline and work with the Academy to align it with current clinical care, which does not require a CT scan. Early in August, the MCG Medical director responded that he had received our letter and found the information most helpful, noting it is under consideration along with the rest of the medical evidence base that might help inform improvements to the MCG guidelines as part of their current cycle of research and guideline updating. Any additional updates received on the outcome of this effort will be provided to members via the News, HP Update, and a future Bulletin issue.
Review of 100-plus Online Courses
The Imaging Committee is also in the process of reviewing more than 100 online courses to determine whether they are imaging-related or not. This is an important activity because the new CME library will provide members who perform CT Imaging with CME resources to meet accreditation, particularly if they cannot wait to attend the annual meeting. Accreditation for CT imaging is a requirement by the Centers for Medicare & Medicaid Services (CMS) for practices to receive payment for Medicare patients. The link to the online courses that are imaging-related will be available by the end of 2013.