Drs. J. Mandume Kerina and Thomas Hatton McCoy Provide Access to Surgery with Medicare’s Approval of Outpatient Total Joint Procedures at Ambulatory Surgery Centers

September 15, 2021 – Total knee replacement became eligible for Medicare payment in the Ambulatory Surgery Center (ASC) setting in 2020, and Medicare added total hip replacements to its approved outpatient ASC list in 2021. Drs. J. Mandume Kerina and Thomas Hatton McCoy, orthopedic surgeons leading the UNOVA Hip & Knee Center in Lady Lake, Florida, are optimistic about this change and what it means for total joint replacement candidates. The team has developed several exclusive protocols that ensure “outpatient” truly means “outpatient” for their total joint replacement patients. These protocols have been developed over many years to improve outcomes for patients with minimal use of opioid pain killers both pre and post-operatively.

Left to Right – Dr. Thomas McCoy and Dr. J. Mandume Kerina of UNOVA Hip & Knee Center in Lady Lake, FL performing an outpatient total knee replacement

With the passage of Medicare’s new rules, many facilities offer “outpatient” total joint replacement to patients. Technically, the term “outpatient” can still include an overnight hospital stay. However, for 99.9% of Dr. Kerina and Dr. McCoy’s patients, “outpatient” means that they walk out and go home on the same day as surgery, ensuring true “outpatient” surgery. Additionally, their patients often recover without the use of prescription narcotic drugs, using only over-the-counter Extra-Strength Tylenol for pain relief.

“The opportunity for more Medicare patients to have access to total joint replacement surgery in an outpatient setting is an exciting development in our country’s efforts to provide more equitable healthcare,” said Dr. J. Mandume Kerina of UNOVA Hip & Knee Center. “Our Center’s approach to total joint replacement surgery is the result of years of analysis and listening to patients. Not every patient is the same, but every patient deserves the opportunity to live their life to the fullest,” he added.

A recent study in people with hip and knee osteoarthritis (Hawker GA, Croxford R, Bierman AS, et al.) revealed that a walking disability is associated with reduced life expectancy. Patients have an excess mortality risk as their disability progresses, and they become functionally dependent on medical therapy. In effect, a total hip replacement increases both the quantity and the quality of life by avoiding disease advancement.

Forward-thinking innovators dedicated to reimagining global health, Drs. Kerina and McCoy use a patient-centered, individualized, research-based approach in their work. By empowering patients and other practitioners to embrace outcomes-based healthcare, patients can spend less time in pain and experience much faster recovery than traditional in-patient total joint replacement patients.

“I think we will start seeing a larger percentage of total joint replacements performed in an outpatient setting. Outpatient joint replacement surgery tremendously increases the value of surgery as an option in the treatment of degenerative arthritis of the hip or knee,” said Dr. Thomas Hatton McCoy. “Over the past decade, tracking the outcomes of our outpatient total joint replacement patients, we have recorded a decrease in infection rate which is now less than 1 percent and an increase in recovery speed.”

To learn more about outpatient total knee replacement and outpatient total hip replacement in an ambulatory surgery setting, contact the experts at UNOVA Hip & Knee. Call the Center at 352-973-4070 or email appointment@UnovaHipAndKnee.com

About UNOVA Hip & Knee

The orthopedic surgeons at UNOVA Hip & Knee Center are an experienced and compassionate team of professionals utilizing a platform that provides technologically advanced, safe hip and knee surgery in the outpatient setting. With a goal of getting patients back to their favorite activities as quickly as possible, the team leverages proprietary protocols to provide outpatient total knee and hip replacements. www.unovahipandknee.com



Updates to medicine’s foundational data-sharing terminology describe COVID-19 vaccinations, tech-inspired services and chronic care

September 7 2021 – Innovative work to meet the urgent public health need for streamlined reporting and tracking of COVID-19 vaccinations is presented in today’s release of the 2022 Current Procedural Terminology (CPT®) code set published by the American Medical Association (AMA). The annual update to the CPT code set incorporates a series of 15 vaccine-specific codes that are the model for efficiently reporting and tracking immunizations and administrative services against the coronavirus (SARS-CoV-2).

Working closely with the Centers for Disease Control and Prevention to develop vaccine-specific CPT codes, the AMA introduced the first codes in the series for use in Nov. 2020 to clinically distinguish each coronavirus vaccine and dosing schedule for better tracking, reporting and analysis of patient vaccinations. These CPT codes were available prior to the public availability of the COVID-19 vaccines to facilitate updating of health care electronic systems across the U.S.

“Data-driven planning and resource allocation is vital for effective immunization programs that will bring the coronavirus pandemic to an end,” said AMA President Gerald E. Harmon, M.D. “Correlating each coronavirus vaccine and dosing schedule with its own unique CPT code has provided necessary analytical advantages to help track, allocate and optimize resources for immunization programs across the United States.”

To help ensure accurate coding and reporting of COVID-19 vaccines and administration services, the AMA offers a vaccine code finder resource to help identify the appropriate CPT code combination for the type and dose of COVID-19 vaccine provided to each patient. The 2022 CPT code set also includes an appendix for one-stop access to all the codes for COVID-19 vaccine reporting.

Other Changes to the CPT Code Set
The COVID-19 vaccine and administration codes are among 405 editorial changes in the 2022 CPT code set, including 249 new codes, 63 deletions and 93 revisions. The CPT code set continues to see growth in new and novel areas of medicine with 43% of editorial changes tied to new technology services described in Category III CPT codes and the continued expansion of the Proprietary Laboratory Analyses (PLA) section of the CPT code set.

Changes to the CPT code set are considered through an open editorial process managed by the CPT Editorial Panel, an independent body convened by the AMA that collects broad input from the health care community and beyond to ensure CPT content reflects the coding demands of digital health, precision medicine, augmented intelligence, and other aspects of a modern health care system. This rigorous editorial process keeps the CPT code set current with contemporary medical science and technology so it can fulfill its vital role as the trusted language of medicine today and the code to its future.

Other important additions to the 2022 CPT code set respond to the fast pace of innovation in digital medicine services that can improve health care access and enhance outcomes for patients across the country. This is illustrated by the creation of five new CPT codes (98975, 98976, 98977, 98980, 98981) to report therapeutic remote monitoring, an increasingly important avenue of patient care especially during the COVID-19 pandemic. These codes expand on the remote physiologic monitoring codes that were created in 2020 (99453, 99454, 99457, 99458).

As innovative digital medicine services have quickly expanded in recent years, the CPT code set has responded with a unique educational guide. A new appendix included in the 2022 CPT code set provides a taxonomy for digital medicine services that supports increased awareness and understanding of approaches to patient care through the multifaceted digital medicine services available for reporting in the CPT code set.

The CPT Editorial Panel also created new codes for principal care management (99424, 99425, 99426, 99427), which allow physicians and qualified health care professionals to report care management services for patients with one complex chronic condition. Medicare policy for principal care management services has been evolving and the new CPT codes, along with revisions to existing CPT codes for care management, better align with Medicare guidelines. These CPT changes add to nearly a decade of coding content work that respond to the reporting needs of physicians and others who help manage the chronic conditions of America’s aging population.

CPT Content & Resources
To assist the health care system in an orderly annual transition to a newly modified CPT code set, the AMA releases each new edition four months ahead of the Jan. 1 operational date and develops an insider’s view with detailed information on the new changes in the 2022 CPT code set.

The AMA invites the health care community to stay up to date on the significant CPT code changes for 2022 by attending two virtual events this November, the Outpatient CDI Workshop and the CPT and RBRVS 2022 Annual Symposium. Meeting agendas and registration are available on the AMA website.

For more information, a special section for CPT education has been created for the AMA Ed Hub™, an online learning platform containing CME and education, including a module series covering an overview of CPT coding basics and other topics.

Coding books and products, including the CPT Professional 2022 codebook, are available from the AMA Storefront on Amazon. The 2022 CPT codes and descriptors can be imported straight into existing healthcare software solution using the downloadable CPT 2022 Data File. The file contains the updated code set’s complete descriptor package, including official descriptors for consumers and physicians, and the complete official CPT coding guidelines. The 2022 CPT coding content will also be included in an enhanced CPT/SNOMED CT map that links similar concepts shared by the two terminologies. The map is intended for use by organizations seeking to leverage both terminologies for research, population health, billing and analytics.



In the study results presented by Dr. MichaelChuong, survival time for patients with inoperable pancreatic cancer was significantly longer when compared to standard radiation

September 7, 2021 ― Pancreas cancer is a leading cause of cancer-related death ― although an advanced type of radiation therapy at Miami Cancer Institute, part of Baptist Health South Florida, is offering patients the possibility of living longer. Michael Chuong, M.D., medical director of Radiation Oncology at the Institute, presented Miami Cancer Institute’s long-term results of MR-guided stereotactic ablative radiation therapy (SABR) at the European Society for Radiotherapy and Oncology (ESTRO) 2021 conference in Madrid on August 29. Typically given after chemotherapy, MR-guided SABR delivers about twice the radiation dose that can be safely delivered over five days with conventional radiation therapy machines and this may result in better treatment response. MR-guided SABR is an outpatient, painless and non-invasive procedure that is completed with little to no patient side effects.

Michael Chuong, M.D., medical director of Radiation Oncology at the Institute

In 2018, Miami Cancer Institute became the second institution in the United States to offer MR-guided SABR on the MRIdian Linac and has since been recognized as a global pioneer in the development of this novel technology. Real-time MRI scans throughout treatment permit continuous tracking of the pancreas tumor. This enables an unprecedented high dose of radiation to be delivered in only five days. This advanced imaging ensures millimeter accuracy and allows for daily treatment modification to account for changes in the patient’s internal anatomy, thus further improving treatment accuracy and safety.

“We were among the first to publish MR-guided SABR results for inoperable pancreas cancer in 2019 that demonstrated encouraging early results,” Dr. Chuong says. “Now, with longer follow up, we are encouraged that benefits of MR-guided SABR not only have been maintained over several years, but especially because they have been achieved without significant side effects in nearly all patients.”

The median survival time for inoperable pancreatic patients receiving chemotherapy and standard radiation therapy is only about 12 to 15 months. In the study results presented by Dr. Chuong, the median survival was significantly longer at 21 months. Many patients were still alive several years after SABR. “These exciting results provide additional support for ongoing and future clinical trials of MR-guided SABR for inoperable pancreas cancer, several of which are being developed at Miami Cancer Institute and will be opened at other institutions in the United States,” he says.

More than 60,000 people in the U.S. will be diagnosed with pancreatic cancer this year, according to the American Cancer Society. While the death rate for some cancers has dropped significantly in the last decade, it has not improved for pancreas cancer. With symptoms that mimic other ailments, it often goes undetected until it is in an advanced stage. Because pancreas cancer routinely involves important blood vessels in the abdomen it can be difficult to remove surgically. As a result, both chemotherapy and radiation therapy are important in the management of such patients, some who may eventually become candidates for surgery.

“We understand how devastating a diagnosis of pancreatic cancer can be for patients and their families,” Dr. Chuong says. “We are very excited that our work is advancing cancer care, possibly contributing to longer survival rates while maintaining a high quality of life for our patients. Our hope, as we conduct more trials, is that we see these targeted therapies having huge benefits to patients with many other types of cancer.”

About Miami Cancer Institute

Miami Cancer Institute brings to South Florida access to personalized clinical treatments and comprehensive support services delivered with unparalleled compassion. No other cancer program in the region has the combination of cancer-fighting expertise and advanced technology—including the first proton therapy center in South Florida, Latin America and the Caribbean, and one of the only radiation oncology programs in the world with each of the newest radiation therapies in one place—to diagnose and deliver precise cancer treatments that achieve the best outcomes and improve the lives of cancer patients. The Institute offers an impressive roster of established community oncologists and renowned experts, clinical researchers and genomic scientists recruited from the nation’s top cancer centers. Selected as Florida’s only member of the Memorial Sloan Kettering Cancer (MSK) Alliance, Miami Cancer Institute is part of a meaningful clinical collaboration that affords patients in South Florida access to innovative treatments and ensures that the standards of care developed by their multidisciplinary disease management teams match those at MSK.

Miami Cancer Institute is part of Baptist Health South Florida, the largest healthcare organization in the region, with 11 hospitals, more than 23,000 employees, 4,000 physicians and 100 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties. Baptist Health has internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences. In addition, it includes Baptist Health Medical Group; Baptist Health Quality Network; and Baptist Health Care On Demand, a virtual health platform. A not-for-profit organization supported by philanthropy and committed to its faith-based charitable mission of medical excellence, Baptist Health has been recognized by Fortune as one of the 100 Best Companies to Work For in America and by Ethisphere as one of the World’s Most Ethical Companies. For more information, visit BaptistHealth.net/Newsroom and connect with us on Facebook, Instagram, Twitter and LinkedIn.



Sept. 7, 2021 – Golisano Children’s Hospital of Southwest Florida, in partnership with Ronald McDonald House Charities® of Southwest Florida, offers a free monthly autism spectrum disorder screening for toddlers 18 months to five years of age.

The next screening will be held on Sept. 24, 2021, from 9 a.m. to 2 p.m. at the Pediatric Specialist Office, 15901 Bass Rd, Suite 102, Fort Myers.

It is estimated that one in every 59 children is diagnosed with some form of Autism Spectrum Disorder, making it more common than childhood cancer, juvenile diabetes and pediatric AIDS combined.

Medical consultants for the project stress that an early diagnosis can make a vast difference for toddlers and their families. They say early intensive behavioral intervention can make an immense difference not just in the development of the child, but in their families as well.

The ASD screening is conducted by the Golisano Children’s Hospital of Southwest Florida. The screenings are administered by an Advanced Practice Registered Nurse, who has extensive training and experience in typical child development and developmental disorders.

A physician referral is not required. To schedule a screening, please call 239-343-6838.

About Golisano Children’s Hospital

Established in 1994, Golisano Children’s Hospital of Southwest Florida has been named a “Top Hospital” three consecutive years by The Leapfrog Group. It is the only recognized children’s hospital between Tampa and Miami. Lee Health opened the new 134-bed Golisano Children’s Hospital in May 2017, relocating the children’s hospital from the adjacent HealthPark Medical Center. It includes comprehensive pediatric services including a 24-hour pediatric emergency department, hematology-oncology unit, milk lab, Regional Perinatal Intensive Care Center, and Level II and Level III NICU with 70 private rooms. Golisano Children’s Hospital is proud to have been named Soliant’s 2018 Most Beautiful Hospital in the U.S., a recognition determined by popular vote For more information, visit GolisanoChildrensSWFL.org

About Ronald McDonald House Charities®

Ronald McDonald House Charities® (RMHC®), is a non-profit, 501 (c) (3) corporation that creates, finds, and supports programs that directly improve the health and well-being of children and their families. Through its global network of nearly 290 Chapters in more than 64 countries and regions, and its three core programs: the Ronald McDonald House®, the Ronald McDonald Family Room® and the Ronald McDonald Care Mobile®, keeps families with sick children close to each other and the medical care their child needs at leading hospitals worldwide. RMHC programs not only provide access to quality health care, they enable family-centered care ensuring families are fully supported and actively involved in their children’s care. For more information, visit www.rmhcswfl.org



September 7 2021 – CareMax, Inc. (“CareMax”) (NASDAQ: CMAX; CMAXW), a leading technology-enabled provider of value-based care to seniors, today announced that Dr. Vincent Omachonu has been appointed as an independent member of the CareMax board of directors.

“We are very pleased to have Dr. Omachonu join our board of healthcare industry veterans,” said Carlos de Solo, CEO of CareMax. “Dr. Omachonu has extensive expertise in managed care and process improvement, and has helped to create replicable and measurable workflows in the industry, resulting in better patient experience and outcomes. We look forward to leveraging Dr. Omachonu’s expertise as we work to bring CareMax’s value-based model nationwide.”

Dr. Omachonu is a Professor and Chair of the Department of Industrial Engineering at the University of Miami and President of Vintex International, Inc., a Miami-based training and consulting company. He is the author of five books that are widely used in the healthcare industry and the field of Quality Improvement. Dr. Omachonu’s work was instrumental in the early adoption of the TQM methodology by hospitals in the United States, Central and South America, as well as the Caribbean.

Dr. Omachonu received his Ph.D. in Industrial Engineering from the New York University Tandon School of Engineering. He has two master’s degrees ‑ one in Operations Research from Columbia University, New York, and the other in Industrial Engineering from the University of Miami, Florida. His B.S. degree is also in Industrial Engineering from the University of Miami. He is a Master Black Belt in Lean Six Sigma Quality Methodology, and a Registered Professional Engineer (P.E. License) in the State of Florida.

“CareMax’s value-based healthcare model has been proven to help patients improve their health, reduce the effects and incidence of chronic disease and live healthier lives,” said Dr. Omachonu. “I look forward to working with the leadership team to expand the CareMax footprint throughout the country.”

To learn more about CareMax, please visit www.caremax.com.