TWC News Update

Tactile Medical Unveils Ambulatory Wound System

  Minneapolis-based Tactile Medical (formerly Tactile Systems Technology Inc.) has launched what it’s calling a first-of-its-kind ambulatory device for patients living with chronic wounds. The ACTitouch Adaptive Compression Therapy system reportedly combines intermittent and sustained compression in one device to heal venous leg ulcers.    “For decades, there has been little tangible progress in establishing new methods to improve outcomes for the most challenging patients with chronic venous disease,” said Alan T. Hirsch, MD, chief medical officer of Tactile Medical, a developer and provider of home therapy devices. “New products must treat these conditions with real-world comfort and sustained efficacy. The ACTitouch Adaptive Compression Therapy system offers the benefits of dual-compression therapy in one easy-to-wear device, giving patients the freedom to stay active while receiving safe and effective treatment.”   According to Tactile officials, experts suggest the addition of intermittent pneumatic compression to treat venous leg ulcers may be particularly effective for patients who:     • have wounds resistant to healing;     • are noncompliant or intolerant of compression bandage systems; or     • are immobile or have impaired calf muscle function.   Some compression therapies are uncomfortable or difficult to use, creating barriers to utilization for many patients. The ACTitouch system’s lightweight, wrap-around sleeve is easy to apply and can be removed for bathing or sleeping, officials said. Air-filled chambers and a padded undersock provide a comfortable fit, and the device can be worn discreetly beneath clothing and with regular shoes.   The system also includes a “Therapy Tracker” to further support and improve patient utilization. The tracker automatically records and displays average daily use in each of the two compression modes, generating data that clinicians can use to reinforce patient therapy goals.

New Diabetes Drug Heart-Safe, Study Shows

  Onglyza® (saxagliptin), a new drug approved for the treatment of diabetes, has no effect on a patient’s risk for heart attack, whether for better or worse, a recent study claims. Researchers from Brigham and Women’s Hospital in Boston did, however, reportedly learn of a rise in hospitalizations for heart failure among those who took the medication compared to those who didn’t, according to a report by HealthDay.   The study was funded by AstraZeneca and Bristol-Myers Squibb, the drug’s manufacturers, and questions and concerns about the impact of diabetes drugs on the heart have been highly debated since the drug Avandia was reported to result in a 43 percent increase in [heart attacks] and a 64 percent increase in death from “cardiovascular causes” through a highly publicized meta-analysis in 2007, which prompted the FDA to issue a new mandate regulating that “preapproval and postapproval studies for all new antidiabetic drugs rule out excess cardiovascular risk.” The Onglyza trial involved nearly 16,500 patients from 26 countries living with type 2 diabetes. Participants also reportedly had risk factors for heart disease and were given either saxagliptin at 5 mg per day (or 2.5 mg daily in patients with reduced kidney function), or a placebo. Over more than two years, researchers found the patients who took the diabetes drug were at no greater risk for heart attack. The study also showed that cardiovascular death, heart attack, stroke, or hospitalization for unstable angina, coronary revascularization (angioplasty), or heart failure occurred in about 12.8% of patients who took the drug, compared to 12.4% of those in the placebo group. However, “our data also show an increase in hospitalization for heart failure in patients who received saxagliptin, which was not expected and deserves further study,” said cardiologist and study chairman Eugene Braunwald. But “patients who received saxagliptin also had better control of blood sugar levels and a reduced need for insulin therapy,” said physician Itamar Raz, co-principal of the study. Raz added that the diabetes drug also prevented the progression of microalbuminuria, a condition that occurs when a type of protein called albumin is spilling into the urine due to kidney damage. Additionally, two diabetes experts unconnected to the study said the findings should help ease the minds of patients and physicians.    “The treatment of patients with diabetes has been challenging in recent years,” said Sripal Bangalore, director of research in the cardiac catheterization laboratory at NYU Langone Medical Center, New York. “It is reassuring to see a mega trial…reassuring the cardiovascular safety of saxagliptin given for a median of two years.”   Physician Tara Narula, associate director of the cardiac care unit at Lenox Hill Hospital, New York, is hopeful the study’s investigators will publish more data from the trial showing improvement in microvascular events, according to the HealthDay report.

SteadMed Medical Names Chief Financial Officer

  Britt Ingebritson has been named the new chief financial officer at SteadMed Medical, an international provider of wound care medical devices and therapeutic products based in Fort Worth, TX. Ingebritson will be responsible for the company’s financial and operational departments, as well as strategic direction, according to officials.    “Britt comes to SteadMed Medical with an in-depth leadership background and expertise in streamlining the corporate finance function,” said Michael Steadman, president and CEO. “I am confident that his past experience and insight will greatly contribute to our growth strategies and sustained profitability.”   Ingebritson brings a wealth of experience to the company, including more than 20 years of association with Williamson-Dickie Mfg. Co. in Fort Worth, where he still serves as a member of the board of directors. Previously, he held titles of chief financial officer, vice president of supply chain management, vice president of marketing, and corporate controller. Ingebritson is a certified public accountant and holds a master of business from Southern Methodist University and a bachelor of business from the University of Texas at Arlington. He completed his postgraduate studies at the Massachusetts Institute of Technology.

Net Health Partners With Industry Leaders on EHR Software

  Officials at Net Health, Pittsburgh, PA, a developer of certified electronic health records, have announced a collaboration with Organogenesis Inc. and Soluble Systems® in relation to an update to its cell and tissue-based products module available through the WoundExpert® software.   The enhancement to the Net Health Connections program facilitates insurance verification, submission of supporting documentation, and automated ordering with order status updates completely electronically, while eliminating the need for paper order forms for cell- and tissue-based applications such as Apligraf® and TheraSkin,® officials said.    “Partnering with industry leaders like Organogenesis and Soluble Systems represents the next phase in connectivity for providers across the healthcare spectrum,” said Christopher Hayes, Net Health’s chief technology officer. “Combining our resources to make every step in the ordering process a direct, electronic exchange allows for better patient care by saving clinicians time and improving order accuracy.”   Updates will reportedly be available in fall 2013.

PA-Based Wound Center Earns Hyperbaric Accreditation

  The Advanced Wound Healing Center at Carlisle (PA) Regional Medical Center recently became one of a few centers in its region to receive accreditation through the Undersea Hyperbaric Medical Society (UHMS).   According to hospital officials, three hyperbaric chambers are in use at the facility, allowing for 9-12 patients to be treated per day.    “The rationale behind our UHMS accreditation was to set us apart from the other wound care centers in the area,” said program director Suzanne Peper. “UHMS is strictly quality and safety for hyperbaric medicine.”   Nancy Clawson works on staff as a certified hyperbaric technician who has helped the wound center’s staff earn a patient satisfaction rating near 97%, while the heal rate at the facility is 94% within 23 days, according to officials.

Ask the Board

  In this exclusive column, TWC offers readers the chance to ask industry-related questions to our expert editorial board members. Q: Why are my claims for debridement of multiple wounds denied? A: BY KATHLEEN D. SCHAUM, MS   This month, TWC received numerous questions pertaining to denied claims for both surgical and medical debridement. Most questions were similar to:     • “I surgically debrided subcutaneous tissue from wounds on both feet: 5 sq cm on the right foot and 10 sq cm on the left foot. I billed 2 units of 11042. I was paid for only 1 unit. How should I code this claim so that I get paid for the work I performed on both feet?”     • “I medically debrided devitalized epidermis and dermis from wounds on both feet: 8 sq cm on the right foot and 6 sq cm on the left foot. I billed 2 units of 97597. I was paid for only 1 unit. I even tried using modifier 50, but was only paid for 1 unit. How am I supposed to code this claim to receive payment for the bilateral work that I did?”   The answers to these questions, and to all similar debridement coding questions, point to a lack of knowledge/misunderstanding about the descriptions of these debridement codes.   Surgical debridement codes are described by and reported by the depth of tissue removed and by the surface area of the wound, not by the number of wounds debrided. If more than one wound is debrided to the same depth, qualified healthcare professionals (QHP) should add together the surface area of all debrided wounds. For example: The work described in the first question was debridement of a total of 15 sq cm of subcutaneous tissue. The QHP should have coded the claim as 1 unit of 11042 because the wound surface area did not exceed the code description of 20 sq cm. Therefore, the QHP was actually paid correctly. If the total wound surface area debrided had exceeded 20 sq cm, the QHP would have billed 1 unit of 11042 for the first 20 sq cm and 1 unit of 11045 for the additional 10 sq cm.   Medical debridement codes are reported by the total surface area of the wound(s) debrided, not by the number of wounds debrided. For example: The work described in the second question was debridement of a total of 14 sq cm of epidermis and dermis. The QHP should have coded the claim as 1 unit of 97597 because the wound surface area did not exceed the code description of 20 sq cm. Therefore, the QHP was actually paid correctly. If the total wound surface area debrided had exceeded 20 sq cm (for example 40 sq cm), the QHP would have billed 1 unit of 97597 and 1 unit of 97598.   QHPs should pay close attention to changes in codes, to their descriptions, and to the explanations for their use. Upon close review of the surgical and medical debridement codes, QHPs will understand that the location of the debrided wounds and the number of wounds debrided do not determine the selection of the debridement codes.   For an in-depth discussion of debridement codes and other wound-specific codes, consider attending a 2013 Wound Clinic Business seminar: www.woundclinicbusiness.com. For a full disclaimer regarding this information, please refer to Business Briefs in this issue.