News Briefs: Week of March 28-April 1

This roundup includes the following news briefs:

Accurate physician payment depends on the selection of appropriate CPT billing codes, and now, the AMA has created a new technology application that will help physicians determine appropriate evaluation and management, or E/M codes, from their handheld devices.

According to a March 29 AMA press release, the "CPT E/M Quick Reference" product is an on-the-go reference guide that is compatible with the Apple iPhone, iPod Touch and iPad. The app features both decision-tree logic and quick search options and allows users to digitally track and e-mail CPT codes. The application also will save frequently used codes by location or type of service.

The free application contains nearly 130 codes and will give physicians quick access to accurate information that they use daily, the AMA said. The application will be updated throughout the year, and users may be charged for future upgrades.

The FDA is warning consumers about the potential risks associated with Soladek, a vitamin-solution product that has not been approved by the agency.

The product cannot be marketed legally in the United States, but the FDA said in a March 28 news release that it had received adverse event reports related to the product, including decreased renal function, elevated levels of calcium in the blood, fatigue, heart arrhythmias, vomiting and diarrhea.

FDA officials said Soladek contains levels of vitamins A and D that far exceed the recommended daily allowances for those vitamins. Signs and symptoms of vitamin D toxicity include weakness, fatigue, headache, nausea, vomiting, diarrhea, changes in mental status, increased blood pressure, abnormal heart rate or rhythm, kidney damage, and coma. Signs and symptoms of vitamin A toxicity include anemia, anorexia, alopecia, joint pain, bone weakness, bulging eyes, liver abnormalities and birth defects.

Consumers who have been using Soladek and are experiencing any of the above symptoms should see a physician immediately, said the agency. All consumers in possession of Soladek are advised to stop using the product.

The product is marketed by Indo Pharma S.A. of the Dominican Republic and is packaged with Spanish language labeling.

Health care professionals and consumers should report adverse events associated with the product to the FDA's MedWatch program.

Time is running out on the only OTC asthma inhaler sold in the United States. Primatene Mist, which contains epinephrine, will not be sold after Dec. 31 under the terms of an international agreement to stop the use of ozone-depleting chlorofluorocarbon propellants.

Badrul Chowdhury, M.D., Ph.D., director of the FDA's Division of Pulmonary, Allergy and Rheumatology Products, said in a March 16 consumer update that people using the OTC inhaler should consult a physician.

"If you have breathing problems but have not been diagnosed by a health care professional, it's important to see one," Chowdhury said. "Not all breathing problems are asthma, so you need to get an accurate diagnosis and the proper medicine."

The FDA also pointed out that there are assistance programs for patients who cannot afford prescription inhalers. Many manufacturers have changed their inhalers to replace chlorofluorocarbon with hydrofluoroalkane, or HFA, but there is no HFA version of the Primatene Mist inhaler.

McNeil Consumer Healthcare is again recalling product because of a musty or moldy odor thought to be caused by the presence of trace amounts of the chemicals 2,4,6-tribromoanisole and 2,4,6-trichloroanisole. The company said in a March 29 news release that it was recalling one lot -- ADM074 -- of 150-count bottles of Tylenol 8 Hour Extended Release Caplets.

The lot was manufactured in April 2010 at the company's Fort Washington, Pa., plant before it was closed as part of an FDA investigation.

McNeil said consumers who purchased product from the affected lot should stop using it and contact McNeil Consumer Healthcare for instructions about receiving a refund or product coupon.

Consumers who have concerns or questions should contact their healthcare professional. Adverse reactions should be reported to the FDA's MedWatch program.

The CMS Center for Medicare & Medicaid Innovation, or CMMI, has launched an updated website that provides new details about applying for grant funding from the center and submitting recommendations for new payment models to be tested by the CMMI.

Richard Gilfillan, M.D., M.B.A., acting director of CMMI, said in a recent conference call that the center will issue several requests for proposals, or RFPs, in the coming months. These RFPs will focus on medical home models, accountable care organizations, chronic care models of care and payment bundling models. CMMI officials also said the innovation center's initial RFP focus will focus on six points contained in the HHS National Strategy for Quality Improvement in Health Care:

The U.S. Drug Enforcement Administration, or DEA, has scheduled a National Prescription Drug Take-Back Day for April 30.

"This will be an opportunity for the public to prevent pill abuse and theft by ridding their homes of potentially dangerous expired, unused and unwanted prescription drugs for safe disposal," the agency said on its website. "Many Americans are not aware that medicines that languish in home cabinets are highly susceptible to diversion, misuse and abuse."

The service is free and anonymous, said the DEA. People interested in organizing an event in their community should contact their local police or sheriff's office to see if that office will operate a collection site in the area.