Columns

From the Board: My Perspective

By Kenneth A. Liss, DO Ironically, the request from the editorial staff for 250 to 500 words coincides with day five of our electronic records being disabled. We have been informed that a “ransomware attack” has forced our service provider to block access to our digital records in the name of privacy and security. Unable to get medication lists, labs, ... Read More »

From the Field: Reimbursement for Parsabiv™ and Sensipar®

Sarah Tolson For the first time since the inception of the End-Stage Renal Disease (ESRD) Prospective Payment System, two drugs qualify for payment outside of the dialysis base rate. The renal community is buzzing with questions about reimbursement, purchasing, clinical protocol, and supply chain logistics for Parsabiv™ (etelcalcetide) and Sensipar® (cinacalet). I’ve been speaking with clients to discuss their plans ... Read More »

From the Chair: Partial versus Radical Nephrectomy for Kidney Cancer: Comparative Effect on Kidney Function

Ajay K. Singh, MBBS, FRCP, MBA Brigham and Women’s Hospital and Harvard Medical School  Boston, Massachusetts In 2017, there were approximately 64,000 new cases of kidney cancer in the United States1, representing nearly 4% of all cancer cases. Patients with kidney cancer are usually evaluated for surgical management unless the cancer is advanced. The traditional surgical approach has been a ... Read More »

From the Field: More Frequent Dialysis Appears Dead for Now

I still remember the excitement expressed by our company’s first client that purchased new, smaller home dialysis machines nearly 20 years ago. While the machines were expensive and would require patients to receive more frequent treatments, the patients’ quality of life would improve significantly, according to the company’s sales representative. Instead of being tied to a standard hemodialysis machine for ... Read More »

From the Chair: Predicting the Risk of Kidney Failure among Kidney Donors

One can only donate if this act doesn’t put one’s own health and identity in serious danger.1 While kidney donation markedly improves the lives of recipients, recent studies have shown that the long-term risk of end- stage renal disease (ESRD) among donors is about 11 times greater than that in matched healthy nondonors2. That said, the absolute 15-year risk of ... Read More »

From the Field: Cheap Billing Can Be Costly

Rick Collins “We can do your billing for much lower fees than you’re paying now!” While this is a tantalizing phrase for physicians, management, ownership, and accountants, paying for “cheap” billing frequently costs you much more than any savings you realize from the cheaper billing rate. To illustrate this point, following are personal experiences from our company’s 20 years in ... Read More »

From the Chair: Home Dialysis Takes a Big Step

Ajay K. Singh, MBBS, FRCP, MBA Brigham and Women’s Hospital and Harvard Medical School  Boston, Massachusetts From the early days of hemodialysis, many, including the late Dr. Bernard Scribner at the University of Seattle, worked tirelessly to promote home hemodialysis. In the early 1970s, the use of home hemodialysis peaked, with nearly 40% of all patients in the United States ... Read More »

From the Field: New Bill Cuts Facility Certification Delays and Expands Telehealth Options

Rick Collins Ridiculously lengthy delays in getting new dialysis facilities certified might finally be going away. H.R. 3178, sponsored by ten members of the House of Representatives, would allow new facilities to be certified by government-approved agencies other than Medicare. In this age of few agreements between political parties, this bill appears to have great appeal to both parties as ... Read More »

From the Chair: The New Mineral and Bone Disorder Guideline Update: Osteoporosis and Fracture Risk

Ajay K. Singh, MBBS, FRCP, MBA Brigham and Women’s Hospital and Harvard Medical School Boston, Massachusetts Fractures in chronic kidney disease (CKD) patients, particularly those that are elderly, have substantial morbidity and mortality. The Kidney Disease Improving Global Outcomes 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (KDIGO CKD-MBD)1, ... Read More »

From the Field: AKI Billing Update and Insurance Refund Limitations

Rick Collins and Sarah Tolson Recognizing that key differences exist in the reimbursement of services for acute kidney injury (AKI) patients, the Centers for Medicare & Medicaid Services (CMS) issued important clarifications in June that significantly impact physician and outpatient dialysis facility claims. End-stage renal disease (ESRD) Conditions for Coverage, the Low Volume Payment Adjustment, home dialysis, physician services, payment for ... Read More »