American Society of Interventional Pain Physicians News | July 9, 2014
Reversal of Epidural Cuts: Two Steps Forward - One Step Backwards
CMS released the 2015 physician proposed payment rule July 3, 2013
On the eve of Independence Day, we sent you good news about the reversal of payment cuts for epidural injections for 2015; however, this is not all good news. As we have shown, this issue is taking 2 steps forward and one step backward.
Overall in the present health care atmosphere, this would be considered a hard-fought and historic achievement, since CMS admitted using inappropriate calculations.
Thus, we have gained substantially in principle in the change for office payments with an opportunity for further negotiations with CMS. When fluoroscopy was removed as a separate reimbursement from facet joint injections and sacroiliac joint interventions, the corrective action resulted in an increase in reimbursement by adding part of the fluoroscopy reimbursement to procedure codes.
We hope that CMS will apply a similar methodology and philosophy to the epidural decision and correct the epidural reimbursement in the same manner. They used the same philosophy at that time, with the Correct Coding Initiative claiming that they were component codes of the procedure and would not be reimbursable separately. We were able to reverse that decision several years ago. Click here to see impact.
Our next step is to advocate for addition of fluoroscopic component to the epidural codes and for reversal of the cuts this year, with retrospective reimbursement from January 2014.
Now again, this is the time to take your gloves off and provide as many opinions and comments as possible. We are hoping that each physician will send at least 100 letters from patients, colleagues, and staff. Based on our response to epidural injections, which facilitated in collecting over 1,000 signatures, we should be able to send at least 100,000 letters to CMS, at least 100 letters to each member of the House of Representatives from each physician and several hundreds of thousands per Senator.
Link for physician letter - Please place on your letterhead
Capwiz link for physician letter
2015 Proposed Physician Fee Schedule - IPM Codes
ASIPP plans cadaver workshop with basic and intermediate techniques, along with percutaneous disc decompression and vertebral augmentation and ultrasound for nonspinal interventions in Vegas
ASIPP has scheduled a Cadaver Workshop for Basic, Intermediate and Advanced (Disc Interventions) and an Ultrasound for Non-Spinal Injections Course. to be held Aug. 22-24 in Las Vegas. This is the last time this year that the ultrasound course will be offered.
This 2½ day review course and cadaver workshop includes interventional techniques (basic, intermediate, and advanced), Ultrasound for non-spinal
injections, and Disc Interventions (advanced). Participants experience a comprehensive and intense learning opportunity, focusing on interventional pain management techniques
After this course, participants should be able to:
- Describe the delivery of multiple aspects of interventional pain
- Review multiple areas of interventional pain management including
fluoroscopic interpretation and radiation safety
- Demonstrate skills through interactive review of images
3667 Las Vegas Boulevard South, Las Vegas, NV 89109
Reservations can be made through our block at group rate of $145 until 07/23/2014.
Click HERE to register for hotel.
Urine Drug Screen Testing Webinar Set for July 15
DATE: July 15, 2014
TIME: 11:00am-12:30am CST
LENGTH: 90 Minutes
SPEAKER: Marvel Hammer, RN, CPC
Marvel J. Hammer, RN, CPC
MJH Consulting, Denver, Colorado
Marvel J. Hammer RN BS CPC CCS-P ASC-PM CPCO, is a registered nurse with over twenty-five years' experience in a multitude of specialties.
Overview: Are you confused about how you should bill for the urine drug screen testing in your Interventional Pain Management Practice? Get the facts straight: steps to Urine Drug Screen Testing Compliance in your physician office
Are you performing point-of-care (POC) urine drug screen (UDS) testing in your interventional pain management practice? Does your office have the correct CLIA certification? Is the test you are using the correct test for your CLIA certification? Are you coding for your POC UDS compliantly? When should you report one of the HCPCS "G" codes for your POC UDS testing? Which of the HCPCS "G" codes should you report for your Medicare beneficiaries UDS testing? Are you reporting the correct units of service for the specific UDS test that you are using? Why is medical necessity important in POC UDS testing? Which ICD-9 code should you report? Is your UDS documentation up to snuff for a payer review?
Get the answers to these questions and much more in this 90 minute webinar.
Click here to register.
White House Ramps Up Opioid Offense
Today the Obama administration will release its 2014 National Drug Control Strategy, the fourth since its inaugural report in 2010. This year's report notes the growing toll that abuse of opioids (including prescription painkillers and heroin) is taking on the country, with around 110 Americans dying of overdose each day in 2011. The report emphasizes prevention and treatment rather than law enforcement and incarceration by increasing support for state prescription drug monitoring programs, expanding opportunities for disposing extra medications, bolstering support for opioid treatment and increasing access to the overdose reversal drug naxolone.
NHS 'defies the law' to deny pensioners vital operations, warns Royal College of Surgeons
Elderly people are being denied life-saving operations because of age discrimination within the NHS, the Royal College of Surgeons has warned.
New data reveal for the first time that across large areas of the country, almost no patients above the age of 75 are receiving surgery for breast cancer or routine operations such as gall bladder removal and knee replacements.
Charities said it was "alarming and inexcusable" that pensioners could be left to die prematurely because of a lack of surgery while others were left immobile and in pain.
Jeremy Hunt, the Health Secretary, said such discrimination was "unacceptable and illegal" while health officials pledged to tackle variations in care.
The study by the Royal College and the charity Age UK analysed rates of surgery in England for six of the most common operations among different age groups.
When the Doctor Knows Best
I still remember the day my father told me the story of how, in 1996, he had single-handedly prevented other physicians from performing CPR on a woman whose heart had just stopped. He had actually laid his body on top of hers to ensure they couldn't try.
I was stunned and, frankly, appalled. As someone who taught medical ethics, I knew that interfering with CPR for a patient who had not given a do-not-resuscitate order wasn't only illegal but unethical.
Or was it? Several years ago, in preparing to write a biography of my father, an infectious diseases specialist, I began reviewing the personal journals that he had kept for decades. Reading his version of what he did that day, in the context of his larger medical career, led me to rethink some of my own basic assumptions about patient autonomy-a concept at the center of contemporary medical ethics.
I began to wonder if recent legal and ethical reforms in medi
Wall Street Journal
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Paper or Power: Nothing Cut and Dried About Hand Washing in Restrooms
After washing up, professed germaphobe Stacy Hafeman eyed hand dryers in a Costco restroom and decided the only acceptable way to dry her hands was with her black T-shirt.
"It looked like I had been sprayed with a water gun," she said. On her way out, Ms. Hafeman, a 41-year-old former nursing assistant from West Bend, Wis., used her damp shirt again-to pull the door handle.
Bathroom experiences like Ms. Hafeman's are the cause of much hand-wringing in the high-tech dryer industry.
Over the past decade, dryers have become faster and cheaper. But despite technological advances, hand dryers leave millions of Americans unsatisfied.
Wall Street Journal
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Sign-Ups Not the Only Way to Gauge Health Law's Success
In April, after enrollment for Obamacare had closed, the president announced that 8 million people had signed up-a boast he delivered to Republicans like a rhetorical dope slap. And he was right: Enough people enrolled in the health-care marketplace to declare the rollout itself a success.
But enrollment is only one number that ultimately will determine how well the Affordable Care Act works. While sign-ups exceeded expectations, other measures are more important and, at this point, uncertain. For example, relatively few young people signed up. Significantly more females, who are pricier to insure, enrolled than males. And little is known about the overall health of the sign-up group, although early studies suggest they are older and sicker than other insured Americans.
To keep up with enrollment projections, twice as many people must sign up next year. More healthy people of all ages must enroll to offset the expenses of the very sick. And premiums must remain low to retain this year's enrollees, attract new participants, and check the cost of subsidies, which will grow as enrollment and premiums rise.
Wall Street Journal
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As Jobs Surge, Hurdles Linger
The U.S. economic expansion is entering its sixth year with the best stretch of job growth in almost a decade. Beneath the shiny exterior, however, lurk soft patches that worry economists and policy makers.
Investors on Thursday seized on robust jobs numbers-not lingering soft spots-and drove the Dow Jones Industrial Average past 17000 for the first time. The Dow closed up 92.02 points, or 0.5%, at 17069.26 in holiday-shortened trading.
Overall job growth in June showed businesses gaining confidence and shedding the caution that has defined the labor market in the five years since the recession ended. Employers added 288,000 jobs during the month and unemployment fell to 6.1%, the lowest level since September 2008, the Labor Department said Thursday, pushing the rate closer to what many economists consider full employment.
Wall Street Journal
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New York Healthcare Premiums Are About To Explode
Insurance companies operating in New York State's marketplace are expected to ask for double-digit premium hikes next year, according to new filings from the companies.
Capital New York reports the average requested increase was 13%. The New York Post reports that number at about 12%. But the bigger insurers are seeking a bigger premium hike - according to Capital, the six most popular plans in New York are requesting an average increase of almost 15%.
The Post reports that Excellus Health Plan, which has about 24,000 customers, is requesting a 19.7% hike. MVP Health Plan, which has nearly 33,000 customers, is seeking a 19% increase. New York's largest insurer on the exchange - Health Republic Insurance of New York, which has 68,000 customers - is requesting a 15% increase.
Stay Informed: Articles published on Interventional Techniques this Year in Other Journals
Hirsch JA, Leslie-Mazwi TM, Nicola GN, Oklu R, Schoppe KA, Silva III E, Manchikanti L. The ICD-10 system: A gift that keeps on taking. J Neurointerv Surg Published online first 21 June 2014.
Hirsch JA, Schaefer PW, Romero JM, Rabinov JD, Sanelli PC, Manchikanti L. Comparative effectiveness research. AJNR Am J Neuroradiol 2014 May 29 [Epub ahead of print].
Manchikanti L, Helm S II, Pampati V, Racz GB. Cost utility analysis of percutaneous adhesiolysis in managing pain of post-lumbar surgery syndrome and lumbar central spinal stenosis. Pain Pract 2014 March 26 [Epub ahead of print].
Hirsch JA, Donovan WD, Barr RM, Nicola GN, Rosman DA, Schaefer PW, Manchikanti L. The Independent Payment Advisory Board. AJNR Am J Neuroradiol 2014 35:1066-1069.
Manchikanti L, Cash KA, McManus CD, Damron KS, Pampati V, Falco FJE. A randomized, double-blind controlled trial of lumbar interlaminar epidural injections in central spinal stenosis: 2-year follow-up. Int J Phys Med Rehab 2014; 2:179.
Manchikanti L, Cash KA, Pampati V, Malla Y. Two-year follow-up results of fluoroscopic cervical epidural injections in chronic axial or discogenic neck pain: A randomized, double-blind, controlled trial. Int J Med Sci 2014; 11:309-320.
Hirsch JA, Turk AS, Mocco J, Fiorella DA, Jayaraman MV, Meyers PM, Yoo AJ, Manchikanti L. Evidence-based clinical practice for the neurointerventionalist. J Neurointerv Surg 2014 Mar 6. [Epub ahead of print]
Hirsch JA, Leslie-Mazwi TM, Nicola GN, Barr RM, Bello JA, Donovan WD, Tu R, Alson MD, Manchikanti L. Current procedural terminology: A primer. J NeuroIntervent Surg 2014; Published online first 4 March 2014.
Hirsch JA, Manchikanti L. The sustainable growth rate: A 2014 update. J NeuroIntervent Surg 2014; 6:411-412.
Manchikanti L, Benyamin RM, Falco FJ, Kaye AD, Hirsch JA. Do epidural injections provide short- and long-term relief for lumbar disc herniation? A systematic review. Clin Orthop Relat Res 2014 Feb 11. [Epub ahead of print].
Now is the Time to Prepare for Board Examinations
Order these IPM Board Review materials which are designed to prepare physicians seeking board certificatin, re-certification, or an in-depth review of the specialty of interventional pain medicine.
Comprehensive and Timely Books
This three-volume set from ASIPP Publishing was created to give clinicians a complete study course to prepare for pain medicine board certification exams, based upon the curriculum of the American Board of Medical Specialties pain medicine examinations. These books take clinicians on a journey through the specialty of pain medicine and interventional pain management, from their origins and history, to the science and research behind methods and techniques, to pharmacology, types of pain, complementary therapies, and interventional and surgical techniques, and much, much more. Culminating with a comprehensive resource of 1,500 sample board exam questions, complete with thorough explanations of the answers, these books will not only help prepare clinicians for their board examination, they will become valuable resources that will be consulted for years to come.
Comprehensive and Convenient eBooks
The three-volume set from ASIPP Publishing created to give clinicians a complete study course to prepare for pain medicine board certification exams, based upon the curriculum of the American Board of Medical Specialties pain medicine examinations is now available in ebooks. Now you will be able to download the ebook version of these books to hand held devices for easy accessiblity for the mobile world we work in. These books take clinicians on a journey through the specialty of pain medicine and interventional pain management, from their origins and history, to the science and research behind methods and techniques, to pharmacology, types of pain, complementary therapies, and interventional and surgical techniques, and much, much more. Culminating with a comprehensive resource of 1,500 sample board exam questions, complete with thorough explanations of the answers, these books will not only help prepare clinicians for their board examination, they will become valuable resources that will be consulted for years to come.
Videos on DVD
Order the Videos and receive 5 days of course video on a set of five DVDs. You can watch them on your computer, save them to your computer, or transport them with you to view somewhere else. And you will be able to load this on your iPad for viewing or just to listen to when you're driving
Order the online videos and receive 5 days of course video via the Internet. You can watch them on your computer or any computer with Internet access. You will be given a password to access the high quality streaming video of each day.
SELECT FROM BOOKS, EBOOKS, DVD VIDEOS, OR ONLINE VIDEOS
VA whistleblowers to detail retribution
House lawmakers will hear testimony on Tuesday from whistleblowers who accuse the Department of Veterans Affairs of retaliating against them for exposing shoddy medical care.
The VA would often force whistleblowers into administrative leave after they raised concerns about lagging health care quality stemming from overworked nurses or under-staffed medical centers, according to testimony from four witnesses set to testify before the House Committee on Veterans' Affairs.
Survey finds that 15% of returning soldiers use opioids
The results of a new survey, published in JAMA Internal Medicine, show that 44% of soldiers returning from deployment report chronic pain and more than 15% report recent use of opioids for pain relief.
A quarter of people seeking primary health care are affected by chronic pain, for which opioids are a commonly prescribed medication. However, rates of opioid use and misuse are rising, which has led to significant numbers of hospitalizations and deaths caused by overdosing on these painkillers.
The extent of opioid use among soldiers returning from deployment has not previously been measured, so the Walter Reed Army Institute of Research in Silver Spring, MD, conducted the new study to investigate this.
Medical News Today
|State Society News
CASIPP to Hold Annual Meeting on September 12-14
The California Society of Interventional Pain Physicians will hold its 2014 Annual Meeting September 12-14 at the Terranea Resort (www.terranea.com) in Rancho Palos Verdes, CA.
For more information, go to www.casipp.com
Save the Date: NY/NJ Chapters Schedule Pain Medicine Symposium
The New York and New Jersey Societies of Interventional Pain Physicians' 2014 Pain Medicine Symposium will be held on November 6 - 9, 2014 at the Hyatt Regency Jersey City in New Jersey.
More information will be available soon.
* Please send your State Society meetings and news to:
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