Surgical vs non-surgical interventions for basal cell carcinoma
A Cochrane Review published in November 2020, which reviewed 52 studies with 6,690 participants, compared surgical and non-surgical interventions for the treatment of basal cell carcinoma (BCC).
The review found that surgical interventions are the most effective treatment for BCC. For adults with high-risk facial BCC, Mohs micrographic surgery (MMS) may lead to slightly fewer recurrences compared to surgical excision, although there may be little to no difference regarding improvement of cosmetic outcomes between MMS and SE judged by participants and observers 18 months post‐operatively (low certainty of evidence).
Imiquimod cream most likely leads to more recurrences than surgical excision at three years (16.4% vs. 1.6%, respectively) and five years (17.5% vs. 2.3%), but it has the best evidence of the non-surgical treatments, and it may result in good or excellent cosmetic outcomes compared to surgical excision when observer-rated (low certainty of evidence).
DermWorld Insights and Inquiries: Pigmented onychomatricoma — Avoid getting nailed by misdiagnosis
Rightfully, monodactylous linear melanonychia should make any dermatologist nervous, with or without a Hutchinson sign. No nail unit melanoma should be left behind. Despite the long differential diagnosis for monodactylous linear melanonychia, including the rare pigmented onychomatricoma, it is incumbent on the dermatologist to consider the diagnosis of a nail unit melanoma first and foremost. Keep reading!
Derm Coding Consult: Coding for preventive skin examination in 2021 and beyond
An established patient presents for his annual skin examination pursuant to a history of basal cell skin cancers, squamous cell skin cancers, and melanoma. A complete skin examination is performed. No other concerns are identified today. Sun protection, including the use of broad-spectrum SPF 15 or higher sunscreen and self-skin exams are recommended treatments. Patient is advised to follow up in one year or if he sees any changes. Using medical decision making, how would you code this encounter?
MIPS dates and deadlines: What you need to know
The 2020 MIPS reporting year is coming to a close, which means it’s time to note important dates and deadlines on your calendars, and make note of what needs to be accomplished — whether you’re simply avoiding the 9% penalty, or trying for an incentive.
Dec. 31 – 2021 virtual group election period closes. Solo practitioners and groups with 10 or fewer clinicians (including at least one MIPS-eligible clinician) who want to participate in MIPS as a virtual group for the 2021 performance year must submit their election to CMS. Learn more about how to elect a virtual group.
Jan. 4, 2021 – 2020 MIPS performance year data submission window opens.
March 1, 2021 – Deadline for CMS to receive 2020 claims for the Quality performance category. Claims must be received by CMS within 60 days of the end of the performance period.
March 31, 2021 – 2020 MIPS performance year data submission window closes.
For a complete guide to 2020 MIPS reporting, including determining whether you are exempt, follow the Academy’s 5-step reporting guide.
If you’re still mulling over which quality measures are the best fit for your practice, try the Academy’s quality measures selection tool.
If you’re using the Academy’s DataDerm™ registry to report, there’s still time to purchase the 2020 MIPS Reporting Module.
How thoroughly are biosimilar products tested?
In a recently published article inJAMA Internal Medicine, study authors evaluated publicly available FDA review documents, disclosures from ClinicalTrials.gov, and peer-reviewed literature to assess the quality of testing for 23 FDA-approved biosimilar agents. For 21 (91%) of these drugs, comparative efficacy was tested in at least one phase 3 clinical trial in patients with an approved reference product indication. Efficacy studies also included a follow-up period in which a subset of patients was switched between the biosimilar and reference drugs.
There were 29 clinical trials for biosimilar comparative efficacy, and these studies were often larger (median 504 patients), more costly (median estimated cost USD $20.8 million), and longer (median duration 52 weeks) than the pivotal trials done for the reference drugs. The study authors concluded that studies conducted for biosimilar drugs appear to be as rigorous as those done for new biologics.
What is keeping biosimilars out of reach and when will they be available? Find out in DermWorld.
Hurricane Laura, wildfires qualify as national disasters, receive neutral payment adjustment
In response to the Federal Emergency Management Agency (FEMA) designation of Hurricane Laura and the California and Oregon wildfires as national disasters, CMS has determined that the automatic extreme and uncontrollable circumstances policy will be applied to Merit-based Incentive Payment System (MIPS)-eligible clinicians in FEMA-identified areas under sections PA-A and PA-B in Louisiana, California, and Oregon.
MIPS-eligible clinicians in these areas will be automatically identified and receive a neutral payment adjustment for the 2022 MIPS payment year (2020 performance year). During the data submission period for the 2020 performance year (Jan. 4, 2021 to March 31, 2021), all four performance categories for these clinicians will be weighted at 0%, resulting in a score equal to the performance threshold.
However, if MIPS eligible clinicians in these areas choose to submit data on two or more performance categories, they will be scored on those categories and receive a 2022 MIPS payment adjustment based on their 2020 MIPS final score.
The automatic extreme and uncontrollable circumstances policy will not apply to MIPS eligible clinicians in MIPS Alternative Payment Models (APMs) who are subject to the APM Scoring Standard for the 2020 performance year, or to those participating in MIPS as groups or virtual groups.
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