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  • Open Door Forum on Manual Medical Review Scheduled for October 22

    The Centers for Medicare and Medicaid Services (CMS) will hold a special open door forum (ODF) on October 22, 2:00 pm-3:30 pm ET, to allow providers to ask questions about the manual medical review of therapy services that exceed $3,700. 

    During this special ODF (conference call only), CMS will discuss therapy documentation requirements and answer any questions providers may have. CMS requests that providers who order or provide therapy services nationally participate in the call. The therapy cap applies to all Part B outpatient therapy settings and providers in:

    • private practices
    •  Part B skilled nursing facilities
    •  home health agencies hospital
    • outpatient departments rehabilitation agencies (outpatient rehabilitation facilities)
    • comprehensive outpatient rehabilitation facilities

    Participants may submit questions prior to the special ODF to therapycapreview@cms.hhs.gov. To participate, call 866/ 501-5502 and enter conference ID 44803009.

    New Adult Fitness Exam Tool Promotes Continuum of PT Care for Adults

    APTA's newest publication, Adult Fitness Examination: A Physical Therapy Approach, brings together a series of tests and measures that enables physical therapists to build lifelong health and wellness plans with their asymptomatic adult clients.

    Written by APTA member Dan Millrood, PT, MEd, and Charlotte Chua, PT, DPT, this groundbreaking assessment tool contains the ready-to-use instructions and resources PTs need to identify, quantify, and qualify key components of physical health and wellness.

    For educators, it's a textbook that addresses educational objectives related toprevention, health promotion, fitness, and wellness.

    Adult Fitness Examination includes:

    • preparticipation health screening overview
    • 16 ready-to-use examinations, complete with step-by-step instructions and full color photos; normative data, charts, flowcharts, illustrations; and notes and warnings (when to terminate testing)
    • equipment supply checklist
    • clinician workbook to promote easy, accurate record-keeping
    • client take-home form to help clients follow treatment plans, track results, and stay motivated to achieve health and fitness goals

    Order Adult Fitness Examination (AFE-001, $34.99 for APTA members) from APTA's online bookstore.

    Diabetic Foot Ulcers Linked With Higher All-cause Mortality

    Diabetic foot ulceration (DFU) is associated with a nearly 2-fold increased risk for all-cause mortality above that of diabetes alone, says a Medscape Medical News article based on a meta-analysis published in Diabetologia.   

    The authors included 8 studies in their analysis. The studies were published between 1996 and 2011 and reported on a total 17,830 patients with 81,116 patient-years of follow-up. Patients with both type 1 and type 2 diabetes were included in all but 1 study, in which all patients had type 2 diabetes.

    The 3,095 patients with DFU had a significantly longer duration of diabetes (12.72 years) compared with the 14,735 patients without DFU (7.19 years). The prevalence of coronary artery disease was significantly higher among patients with DFU (31.4% vs 14.7%), as was that of both hypertension (57.6% vs 35.7%) and hypercholesterolemia (47.6% vs 11.1%).

    During follow-up, there were a total 3,619 deaths from any cause. The population with DFU had a 1.89 pooled relative risk for all-cause mortality compared with the patients with diabetes without DFU. Unadjusted rates of all-cause mortality were 99.9 per 1,000 person-years for the population with DFU vs 41.6/1,000 in the group with diabetes only.

    Further analysis of 3,138 patients in 4 studies for whom information on cardiovascular mortality was available showed that rates of fatal myocardial infarction and fatal stroke also were higher among patients with DFU. However, the overall proportion of deaths resulting from cardiovascular causes was almost the same in the DFU and non-DFU groups—43.6% of the 117 DFU patients and 44.2% of the 952 diabetes-only patients.

    The higher mortality rate in patients with DFU may also "relate to their more advanced stage of diabetes, with greater overall disease burden and noncardiovascular complications of foot ulceration such as sepsis," Medscape says.