Effective immediately, the AAOS Registry Program will begin collecting COVID-19 data through the capture of the ICD-10 code for COVID-19 confirmed diagnosis, U07.1. The new code is enabled across each of the AAOS registries, including: the American Joint Replacement Registry, the world’s largest national registry of hip and knee joint replacement data by annual procedural count; the Shoulder & Elbow Registry; the Musculoskeletal Tumor Registry, and the American Spine Registry, a collaborative effort between the American Association of Neurological Surgeons (AANS) and the AAOS.
WHY NOW?
The AAOS has taken swift action to understand COVID-19’s current and future impact on musculoskeletal care. With more than 1.97 million procedures across four registries, the AAOS Registry Program already collects clinical data to support orthopaedic surgeons, hospitals, health systems, and ambulatory surgery centers (ASCs) in providing the highest quality musculoskeletal care. Now more than ever, it is critical to collect data that will provide additional insights on the quality of care and outcomes of orthopaedic patients in the COVID-19 environment.
WHAT WILL THE DATA REVEAL?
By adding the ICD-10 code to the AAOS Registry Program, sites who contribute the data will have the ability to monitor the impact of COVID-19 on patients undergoing future joint replacement procedures. Tracking COVID-19 data will help analyze the impact of COVID-19 on outcomes, trends of surgery based on the pause in elective surgery, and the trends of patient-reported outcomes (PROMs) due to delayed procedures. It will also track the potential impact on CMS value-based payment models and coverage for patients recovering from COVID-19. On a broader scale, long-term data from the registries may allow for future insights into COVID-19 and its impact on clinical outcomes.
Key learnings from the AAOS Registry Program will be delivered to participants, the orthopaedic community, and the broader public throughout the coming years.
HOW ARE CURRENT AND NEW REGISTRY PARTICIPANTS IMPACTED?
Hospitals, health care systems, practice groups, and ASCs already participating in the registries will not need to join a new registry or engage in a new way to submit their data. Capturing this code will not change the site’s workflow since it was added as an accepted value for existing diagnosis or comorbidity code files. The ICD-10 code can be submitted as a pre-operative comorbidity or prior diagnosis present on admission and as a reason for readmission.
Participants who have questions about submitting the new code can reach out to AAOS Registry Support at RegistrySupport@aaos.org for assistance. To enroll in a Registry, contact an AAOS Registry Engagement Associate via email RegistryEngagement@aaos.org or phone 847-292-0530.
Our patients are finally getting the high-quality care they deserve as state and local governments continue to relax restrictions on surgical practices. Most importantly, this care is being provided in an environment that is safe for patients, staff, and society. All those involved in patient care—including the patients themselves—understand that certain aspects of our practices have changed. The need for social distancing requires that we see fewer patients and utilize telemedicine whenever possible. We are becoming accustomed to wearing masks during office hours and our patients welcome symptom screening before being seen. COVID-19 antigen testing is being required by many institutions prior to surgery and this has been well received by patients. Despite the inconvenience, they understand and appreciate the steps we are taking to protect them. In short, we are all getting used to the “new normal.”
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Under the Paycheck Protection Program (PPP) created by the CARES Act, loans may be forgiven if borrowers use the proceeds to maintain their payrolls and pay other specified expenses.
The Treasury Department and Small Business Administration recently released the application form and instructions for loan forgiveness. The forgiveness forms, instructions, and worksheets can be downloaded here.
PPP borrowers must apply for loan forgiveness with the lender that processed the loan.
This Guidance is directed at Ambulatory Surgery Centers (ASC) Office Based Surgery practices (OBS), and Diagnostic and Treatment Centers (DTC) that are located in counties without a significant risk of COVID-19 surge and are deemed eligible to perform Deferred Procedures, (i.e., elective surgeries and non-urgent procedures).
These centers and practices are required to meet the same provisions required of hospitals in these eligible counties that are also resuming deferred procedures.
Any ASC, OBS, or DTC that fails to comply with this Guidance may be subject to civil penalties.
The House of Representatives passed the Health and Economic Recovery Omnibus Emergency Solutions Act (H.R. 6800), which includes over $3 trillion in funding for state and local governments, hospitals and physicians, payments to individuals, and other assistance.
> Access the AAOS Summary
In this pre-recorded webinar, the Joint Commission provides an overview of COVID-19 routes of transmission and focuses on prevention strategies for freestanding surgical centers to consider prior to resuming elective procedures: Preventing Coronavirus Transmission in Ambulatory Surgery Centers
As the world’s largest medical association of musculoskeletal specialists, AAOS announced in November 2019 a strategic investment in the field of biologics and future disruptive technologies. Over the next five years, AAOS will prioritize research and development for a biologics-focused competency addressing issues of unreliable information and patient receipt of substandard care from nonorthopaedists, as well as continuing to be the trustworthy source of information for patients, members, and external providers and payers. This reprioritization is an expansion of previous work of many members on previous committees who also worked in this space.
The Centers for Medicare & Medicaid Services (CMS) issued another round of regulatory waivers and rule changes with the goal of increasing diagnostic testing and access to medical care during the COVID-19 pandemic.
The AAOS Office of Government Relations has developed an overview for members with high-level key points
Executive orders are a method for the state government to ensure all actions can be taken to respond effectively and efficiently to a state emergency without being impeded by state laws and regulations that ordinarily serve a purpose but during the emergency can often hinder the fastest and best response to an emergency. The executive order accomplishes this goal by suspending or modifying certain laws or regulations that are listed in the order.
This Executive Order authorizes, through May 25, licensed pharmacies to administer the tests to detect COVID-19 or its antibodies in patients suspected of having COVID-19 or of having recovered from COVID-19.
This executive order suspends and modifies various public health law and education law provisions and regulations, until May 16, to maximize the pool of health care professionals available to assist the State in the response to COVID-19. Among those of particular note are the following:
This executive order suspends or modifies certain laws through May 12, 2020. Among this order’s provisions are the following with an impact on health care:
This executive order broadly continues the directives in previous executive orders issued since March 7 regarding the COVID-19 outbreak to May 7. Among the provisions that regard health care and malpractice liability are the following:
This Executive Order contains one health care matter directing hospitals and health care facilities to permit one person to be present who is a support person for a patient giving birth.
Continuing the State’s efforts to ensure sufficient numbers of healthcare professionals, nursing graduates (RN and LPN programs) may be employed for 180 days with supervision of a registered professional nurse and endorsement from the employing hospital or nursing home, and midwives licensed and in good standing from any state or Canada may practice in New York State without penalty. Also, physicians assisting the State’s response in a SUNY facility are provided with the defense and indemnification, as if a state employee. This Order also declares a modification of EO 202.10 on the dispensing of hydroxychloroquine or chloroquine by pharmacist and declares that COVID-19 guidance issued by DOH are immediately effective and supersede any prior conflicting guidance issued, including local health departments.
This Executive Order ensures that New York State has adequate hospital bed capacity, supplies, and providers to treat patients affected with COVID-19, as well as patients afflicted with other maladies. To assist in this goal, the Governor has provided immunities to licensed healthcare individuals through April 22, 2020.
New York’s Governor declared a state of disaster emergency for the entire State of New York on March 7, 2020, which authorizes him to temporarily suspend or modify, to the extent necessary, any statute, local law, ordinance, order, rule, or regulation of any agency and authorizes him to issue directives to cope with the disaster.
This executive order primarily mandates that most New York businesses reduce their in-office workforce by 50 percent. The order makes an exception for essential businesses providing essential services. The following is a list of essential health care operations:
This executive order contains numerous suspensions and modifications of New York laws and regulations. Among those of particular note are the following:
This Executive Order directed local and state employees whose position is non-essential to either work from home or take leave. In addition, the Order mandated closure of all New York State schools until April 1.
This Executive Order limited gatherings in any one location to no more than 50 persons. The Order also required food service establishments to no longer serve food on premises but only via delivery or pick up and it closed all gyms, fitness centers and movie theaters in the state.
This Executive Order concerned suspension and modification of law governing elections in New York State. It also imposed certain requirements on school districts closing due to a local state of emergency.
This Executive Order suspends various laws and regulations in order to permit expansion of services and temporary facilities for health and human service providers. Also, the order suspended laws and regulations relating to child care to allow flexibility for providers while continuing to protect children’s health and safety.
This Executive Order suspended or modified a variety of New York Education Law and Public Health Law provisions in order to accomplish the following:
The US Health and Human Services (HHS) has indicated that the application portal is open for physicians to avail themselves of a portion of the $20 billion allocation from the CARES Act Provider Relief Fund.
The AMA has also put together this guide to help physicians pull together the information they need to submit to the portal. Here is additional information from HHS regarding the distribution.
Advocating for the orthopaedic surgeon, patients and musculoskeletal health in New York.
info@nyssos.org 1-518-439-0000 Address: PO Box 38004, Albany, NY 12203
