CHEST Physician
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NPV vs NIPPV
Noninvasive ventilation (NIV) is a ventilation modality that supports breathing by using mechanically assisted breaths without the need for intubation or a surgical airway. NIV is divided into two main types, negative-pressure ventilation (NPV) and noninvasive positive-pressure ventilation (NIPPV). NPV NPV periodically generates a negative (subatmospheric) pressure on the thorax wall, reflecting the natural breathing…
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Responding to firearm violence in America
We think of disasters as sudden, calamitous events, but it does not take much imagination to recognize the loss of lives in America from firearm violence as a type of disaster. In 2020, 45,222 people died from gun-related injuries, an increase of 5,155 (14%) since 2019 (Kegler, et al. MMWR Morb Mortal Wkly Rep. 2022;71[19]:656). This is…
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Increasing primary care doctors’ knowledge of IPF could speed up diagnoses, suggests white paper
Prompt diagnosis of idiopathic pulmonary fibrosis is essential to reduce mortality, and improving education of primary care providers can help, suggests a new white paper. The nonspecific nature of the symptoms of idiopathic pulmonary fibrosis (IPF) especially in early stages, and the relative rarity of IPF compared with other conditions that have similar symptoms, may…
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ILD on the rise: Doctors offer tips for diagnosing deadly disease
Too often, when patients come to see Tejaswini Kulkarni, MD, with shortness of breath and cough and are diagnosed with interstitial lung disease (ILD), they are past the point when treatments would most benefit them. “There is definitely a delay from the time of symptom onset to the time that they are even evaluated for…
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Patients need Sep-1: Why don’t some doctors like it
Since its inception, the CMS Sep-1 Core Quality Measure has been unpopular in some circles. It is now under official attack by the American College of Emergency Physicians (ACEP) and the Infectious Diseases Society of America (IDSA), along with a handful of smaller professional societies. These societies appealed the National Quality Forum’s (NQF) 2021 recommendation…
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Nonphysician practitioner (NPP) billing for evaluation and management (E/M) and critical care services: A sea change now in effect!
In the 2022 Medicare Physician Fee Schedule, the Centers for Medicare and Medicaid Services (CMS) further refined E/M billing by addressing split/shared visits between nonphysician practitioners (such as nurse practitioners and physician assistants) (see https://www.govinfo.gov/content/pkg/FR-2021-11-19/pdf/2021-23972.pdf, pp. 65150-9). A split/shared visit is “an E/M visit in the facility setting that is performed in part by both a…
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Meet the new CHEST Physician Editor in Chief
Angel O. Coz Yataco, MD, FCCP, is a Pulmonary and Critical Care specialist at the Respiratory Institute at the Cleveland Clinic. He previously served as the Medical Director of the Intensive Care Unit at the Lexington Veterans Affairs Medical Center and was an Associate Professor of Medicine at the University of Kentucky. Dr. Coz received…
