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In response to letters from ASHA and a North Carolina speech-language pathologist, the Palmetto Medicare intermediary revised its speech-language pathology/dysphagia Local Coverage Determination (LCD) to allow performance of the fiberoptic endoscopic evaluation of swallowing (FEES) procedure without physician supervision. This is a significant step that will help ASHA achieve similar victories with other Medicare intermediaries.
ASHA's main argument was the safety record of almost 2000 consecutive FEESST procedures (documented in peer-reviewed journal articles) which indicated no complications other than self-limiting nosebleeds. Vicki Parker, an ASHA member, consulted with ASHA Government Relations and Health Services staff and composed a letter that focused on the need for the FEES in skilled nursing facilities. For further information, please contact Mark Kander, ASHA's Director of Health Care Regulatory Analysis, via e-mail at mkander@asha.org or by phone at 800-498-2071, ext. 4139.
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