Published: March 29, 2016


Since immigrating to the United States from South Africa 25 years ago, I have experienced numerous life lessons in my career, through my training, education, medical practice, patients, and varied leadership experiences within the Academy, other medical organizations, and community service roles.

setzenWhat life lessons in your career would you use to identify and strengthen portions of our strategic plan to improve our membership’s future?

How can we engage membership to be involved in outcomes research, specifically the RegentSM clinical data registry?

Since immigrating to the United States from South Africa 25 years ago, I have experienced numerous life lessons in my career, through my training, education, medical practice, patients, and varied leadership experiences within the Academy, other medical organizations, and community service roles. These have provided me intellectual, business, governance, management, negotiating, and emotional skills to deal with a wide range of circumstances, individuals, and problems, and have allowed me to make rational and thoughtful decisions under difficult circumstances.

As president of a single-specialty group (eight MDs and five PAs), with an academic faculty appointment (involved in resident training for ENT, Family Practice, and Physician Assistant programs), I have learned and understand the complexities and challenges facing otolaryngologists in varied practice settings.

In addition, I have learned the true meaning and value of mentorship, friendship, and collegiality in our field, and as such, I have a strong commitment to supporting our residents, fellows, young physicians, and researchers—the future of otolaryngology.

Diverse committee and governance participation since residency has provided broad-based exposure to every aspect of administrative and membership-related functions throughout the Academy. I recently completed my seven-year term on the Board of Directors and served as secretary-treasurer elect and secretary-treasurer (four years) while on the BOD Executive Committee. This AAO-HNS executive leadership experience has provided the highest level of continuity and oversight in decision-making capability related to overall Academy strategic plan function/operation/implementation, impacting every level of the organization and the entire membership.

The Academy mission, Members, colleagues, and patients, call for a specific skill set and philosophy in achieving the strategic plan objectives and I have harnessed my experiences and career lessons to focus on providing inspiring leadership, consistent with the Guiding Principles of the Academy—prioritizing high-quality programs, improving process and organizational performance, leveraging internal/external relationships, and ensuring stable funding­—to propel our organization and profession to new heights!

It is imperative to clearly demonstrate the value proposition that a clinical data registry (CDR)—RegentSM—brings to EVERY otolaryngologist in EVERY practice setting, in EVERY corner of the United States.

RegentSM is the great “leveler”—now every otolaryngologist will be able to more easily comply with regulatory burdens and reporting requirements (PQRS, MU, etc.), providing ease of data capture, processing, and retrieval across the care continuum in all practice settings.

In addition, it must be emphasized that in an era of ongoing payment reform with the MACRA (Medicare Access and CHIP Reauthorization Act) legislation recently passed, quality measurement and patient outcomes reporting will be integral to continued payment reform with Alternative Payment Models (APMs) blended with fee-for-service payments in the future.

Otolaryngologists can now drive/control the outcomes research that will in turn drive quality reporting and ultimately “value” payment for our services.

It should be made clear that this is a major priority for AAO-HNS and is a key Strategic Plan objective with extensive board-approved funding to ensure success.

Academy leadership and RegentSM pilot program participants will be important ambassadors for this program.

More from April 2016 - Vol. 35, No. 03

Correctly coding CPT 69209
For 2016, Current Procedural Terminology (CPT®) code 69209 Removal impacted cerumen using irrigation/lavage, unilateral was created. In order to help otolaryngologist-head and neck surgeons correctly code, the Academy helped the American Medical Association (AMA) draft a CPT Assistant article on the removal of impacted cerumen. In addition to the CPT Assistant article, the Academy’s CPT team has updated the CPT for ENT: Cerumen Removal to further clarify billing 69209 and 69210 Removal impacted cerumen requiring instrumentation, unilateral. The CPT for ENT article can be found at The following are excerpts from the AMA CPT Assistant article “Removal of Impacted Cerumen,” which can be found on page 7 of the January 2016 CPT Assistant, and are reprinted with permission from the AMA: In the CPT 2016 code set, code 69209 was added to the Auditory System subsection to report the removal of impacted cerumen (earwax) using irrigation or lavage. Impacted cerumen was defined in CPT Assistant October 2013, page 14, as having any of the following: Visual considerations: Cerumen impairs exam of clinically significant portions of the external auditory canal, tympanic membrane, or middle ear condition. Qualitative considerations: Extremely hard, dry, irritative cerumen causing symptoms such as pain, itching, hearing loss, etc. Inflammatory considerations: Associated with foul odor, infection, or dermatitis. Quantitative considerations: Obstructive, copious cerumen that cannot be removed without magnification and multiple instrumentations requiring physician skills. 69209 is reported when irrigation and/or lavage is used to remove impacted cerumen. This method uses a continuous flow of liquid (e.g., saline, water) to loosen impacted cerumen and flush it out with or without the use of a cerumen softening agent. Although direct physician work is not required, the removal of cerumen by irrigation or lavage usually takes longer to perform and may require additional staff time and equipment. Only one code (69209 or 69210) may be reported for the primary service provided on the same day on the same ear. Modifier 50, Bilateral Procedure, should be appended if either one of the cerumen removal procedures is performed on both ears. Codes 69209 and 69210 should not be reported together when both services are provided on the same day on the same ear. The appropriate evaluation and management (E/M) code based upon category and site of service (e.g., office or other outpatient, hospital care, nursing facility services) should be reported when non-impacted cerumen is removed. An E/M code may be reported if there is a separate and distinct service performed at the same session. The full article is available to Academy Members at (login required).