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American Society of Interventional Pain Physicians News  | November 4, 2015

  1. Few Spots Remain for ASIPP's November Meetings - Register for One Today
  2. ASIPP presents Comments on Cigna Musculoskeletal Precertification Program
  3. CMS Publishes Final Payment Rules 
  4. Payor, Coverage, and Policies: Denials & Appeals Webinar 
  5. Death Rates Rising for Middle-Aged White Americans, Study Finds 
  6. Jury convicts California doctor of murder in overdose deaths  
  7. Prescription Use Up and Here's Why, Say Researchers 
  8. The Search for a 'Safer' Ketamine  
  9. Antipsychotic Agent May Cause False-Positive Amphetamine Screens 
  10. Cognitive Behavioral Therapy Improves Insomnia from Chronic Pain 
  11. Counseling Patients About Balance in Their Lives is Key to Pain Treatment 
  12. ASIPP Call for Abstracts 
  13. Myofascial Pain Treated Faster with Lidocaine, Hyaluronidase Mix 
  14. State Society News 
  15. Physician Wanted 
novemberFew Spots Remain for ASIPP's November Meetings - Register for One Today

Regenerative medicine is a NEW and EVOLVING field for interventional pain management. Know if and when to offer these treatments.  
Choose to attend one of ASIPP's November meetings. You can attend the 2-day intensive Regenerative Medicine Workshop or the 1 day Hands-On Cadaver Workshop for IPM Techniques. 
Objectives for Regenerative Medicine Course
  • Attain understanding of regenerative medicine.
  • Attain eligibility for competency certification with the completion of both levels.
  • Incorporate regenerative medicine in treating your patients so that patients have better outcomes and reduced side effects.
  • Provide high-quality, competent, safe, accessible, and cost-efficient services to your patients.
Objectives for Cadaver Workshop for IPM Techniques 
Integrate multiple aspects of interventional pain management in treating your patients so that patients have better outcomes and reduced side effects.
  • Provide high-quality, competent, safe, accessible, and cost-efficient services to your patients.
  • Improve existing skills and/or develop new skills in the delivery of interventional techniques.
  • Review multiple areas of interventional pain management including fluoroscopic interpretation




3355 Las Vegas Blvd. South, Las Vegas, NV 89109
Hotel: 702.414.1000 | Reservations: 866.659.9643
Inform the agent that you are booking for American Society of Interventional Pain Physicians. We have secured a group rate of $159.
Cadaver Venue:
OQUENDO CENTER , 2425 E. Oquendo Road, Las Vegas, NV 89120
Phone: 702.739.6698 | Toll Free: 866.800.7326 |
ASIPP presents comments on Cigna Musculoskeletal Precertification Program 
We were contacted by e-mail on October 20 by Cigna regarding a precertification program that is to go into effect on January 1, 2016. Cigna is partnering with eviCore healthcare (formerly MedSolutions) to require prior precertification reviews performed by interventional pain management physicians. We were asked to review the medical necessity criteria in the policies.

We have prepared a comment letter to address our concerns about Cigna Musculoskeletal Precertification Program and various issues related to the coverage policies.
The letter was sent on behalf of American Society of Interventional Pain Physicians (ASIPP) and 51 state societies including Puerto Rico Society of Interventional Pain Physicians. We have corresponded with Cigna in the past requesting consideration of multiple coverage issues ( see letter )

CMS Publishes Final Payment Rules
The Centers for Medicare & Medicaid Services (CMS) has  issued a final rule updating payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2016. CMS finalized a number of new policies, including several that are a result of recently enacted legislation.
CMS released the final rules on Physician Payment Rates, Hospital Outpatient Departments (HOPD) payments, and Ambulatory Surgery Center (ASC) payments.

In reference to Ambulatory Surgery Center payments, there have been significant modifications including increasing facet joint interventions rates and reducing epidural rates. One item of good news is that CMS has increased payment for one-day percutaneous adhesiolysis, for which we have been struggling for a long period of time.
Following are the fee schedules for interventional pain management physicians, and for HOPDs and ASCs performing interventional pain management procedures.

Here are Fee Schedule links:
2016 Final Physician Fee Schedule - IPM Codes 

payorPayor, Coverage, and Policies: Denials & Appeals Webinar

Denials and Appeals Could Effect You Financially

Getting paid for services provided is essential to the financial success of your practice.  Key to getting paid is an understanding of the payor coverage policies that set forth the medical necessity, utilization and quality of care criteria as well as the coding requirements for provider services.  Failure to follow the mandates in these policies can lead to denial of payment and payor audits.

Vicki Myckowiak will provide a practical guide to understanding payor policies and using these policies to ensure that the documentation in your medical record accurately reflects the services provided and meets the requirements of the payor policies.  Vicki will also provide valuable information on steps to take in the face of denials or audits including a primer on the best practices for responding to a payor audit.
WEBINAR FEE:   $175  
DATE: November 17, 2015
LENGTH: 90 minute session 
TIME: 11:00am - 12:30pm CDT

Vicki Mykowiak, Esq.
Vicki Myckowiak is a principal of MYCKOWIAK ASSOCIATES, P.C.  She is a graduate of Franklin and Marshall College and The National Law Center at George Washington University.  Ms. Myckowiak is a member of the State Bar of Michigan, the American Bar Association, the American Health Lawyers Association, and the Health Care Compliance Association.

Death Rates Rising for Middle-Aged White Americans, Study Finds
Something startling is happening to middle-aged white Americans. Unlike every other age group, unlike every other racial and ethnic group, unlike their counterparts in other rich countries, death rates in this group have been rising, not falling.

That finding was reported Monday by two Princeton economists, Angus Deaton, who last month won the 2015 Nobel Memorial Prize in Economic Science, and Anne Case. Analyzing health and mortality data from the Centers for Disease Control and Prevention and from other sources, they concluded that rising annual death rates among this group are being driven not by the big killers like heart disease and diabetes but by an epidemic of suicides and afflictions stemming from substance abuse:alcoholic liver disease and overdoses of heroin and prescription opioids.


Jury convicts California doctor of murder in overdose deaths

(CNN) A California doctor has been convicted of murder in connection with three prescription drug overdose deaths.
Prosecutors said this is the first time in the United States that a doctor has been convicted of murder for over-prescribing drugs.

Hsiu-Ying "Lisa" Tseng, 45, was found guilty of 23 counts, including 19 counts of unlawful controlled substance prescription and one count of obtaining a controlled substance by fraud.
Prescription Use Up and Here's Why, Say Researchers

Researchers report an increase in overall prescription drug use among adults in the United States between 1999-2012. Findings from the study are published in JAMA
Elizabeth D. Kantor, PhD, MPH, formerly of the Harvard T.H. Chan School of Public Health, Boston, and colleagues looked at trends in prescription drug use using data from the National Health and Nutrition Examination Survey (NHANES). A total of 37,959 study participants aged ≥20 years were included across seven NAHNES cycles (1999-2000 to 2011-2012). For each cycle, study authors analyzed use of prescription drugs in the past 30 days in general and by drug class. 

The prevalence of prescription drug use rose from 51% in 1999-2000 to 59% in 2011-2012. The prevalence of polypharmacy rose from 8% to 15%. Specifically, the use of hypertension treatments increased from 20% to 27%; hyperlipidemia treatments from 7% to 17%; and depression treatments from 7% to 13%. In general, an increased use was seen for 11 out of 18 drug classes consumed by >2.5% of the population at any point over the study duration.

ketamineThe Search for a 'Safer' Ketamine 
Can glutamate drugs treat the worst cases of depression -- and keep pharma in psychiatry?
For decades, depression has been seen as a problem of monoamines like serotonin and norepinephrine, and their activity is the target of the most commonly used antidepressants.
But there's now a growing interest in another neurotransmitter for its potential role in mood disorders: glutamate.
It's the most common excitatory neurotransmitter in the brain, and its theoretical role in neuroplasticity may hold the key to its effects on depression.

Glutamate has been able to excite researchers because of recent studies showing the anesthetic ketamine seems to ease treatment-resistant depression, and quickly -- within hours. Ketamine's action is thought to involve antagonism of NMDA (N-methyl-D-aspartate) receptors, one of the main binding sites for glutamate.

Antipsychotic Agent May Cause False-Positive Amphetamine Screens
(HealthDay News) - Urine drug screens (UDSs) can be false-positive for amphetamines after ingestion of aripiprazole, according to two case reports published online Nov. 2 in Pediatrics.
Justin Kaplan, Pharm.D., from the Hackensack University Medical Center in New Jersey, and colleagues present two cases of presumed false-positive UDSs for amphetamines after aripiprazole ingestion.

The first case involved a 16-month-old girl who accidentally ingested 15 to 45 mg aripiprazole. The girl had one vomiting episode with no identifiable tablets. She was lethargic and ataxic at home and remained sluggish with periods of irritability. The patient was admitted for observation. On two consecutive days, UDS came back positive for amphetamines. The second case was a 20-month-old girl brought to the hospital after accidental ingestion of her father's medications, including aripiprazole. On the first day of admission, UDS came back positive only for amphetamines. Confirmatory testing with gas chromatography-mass spectrometry on the blood and urine samples was performed on presentation; in both patients these were negative for amphetamines. Both patients were discharged from the hospital after returning to baseline.


Cognitive Behavioral Therapy Improves Insomnia from Chronic Pain

Cognitive behavioral therapies may be effective in treating insomnia in patients with chronic pain, according to research published in the journal Sleep.

Nicole Tang, DPhil, CPsychol, from the Department of Psychology at the University of Warwick and colleagues found that cognitive behavioral therapies (CBT) were moderately or strongly effective in treating insomnia in patients with long-term pain. They found that patients also experienced benefits to pain, fatigue, and depression. However, the therapies reviewed needed to be administered in person to be effective; therapies delivered online or by phone were found to be less effective.

To examine the effects of non-drug treatments for insomnia in patients with chronic pain, the researchers examined 72 studies containing a total of 1066 patients ages 45-61 who experienced insomnia and chronic pain caused by a variety of conditions including long-term cancer, headaches, and arthritis.

Counseling Patients About Balance in Their Lives is Key to Pain Treatment
Counseling patients who have chronic pain about how to find balance in their lives is important, because patients in pain often seek pleasure and may go too far to find it, according to a speaker at a session here.

"You can go to too far in unregulated indulgence when seeking pleasure, which can lead to all sorts of issues including obesity and addiction," advised Michael R. Clark, MD, MPH, MBA, who is associate professor  and director of the Chronic Pain Treatment Program and the Department of Psychiatry and Behavioral Sciences at The Johns Hopkins Hospital.


Make your plans now to participate in the American Society of Interventional Pain Physicians abstract and poster presentation at the 18th Annual Meeting, April 15-17 in Dallas, Texas.
The abstract submission deadline will be February 9, 2016.
The annual meeting is a great opportunity to share your abstract with hundreds of physicians who specialize in interventional pain management.
Myofascial Pain Treated Faster with Lidocaine, Hyaluronidase Mix
HealthDay News - In patients with myofascial pain syndrome (MPS), trigger point injection (TPI) with lidocaine and hyaluronidase works more quickly on the first day following injection than lidocaine alone, but there are no significant differences between the methods after four days, according to a study published online Oct. 7 in Pain Practice.
Ji Won Choi, MD, from the Sungkyunkwan University School of Medicine in Seoul, South Korea, and colleagues randomized 61 adults (aged 25 to 75 years) with MPS affecting both trapezius muscles to treatment with either lidocaine (31 patients; 3.2 mL 0.5 percent) or hyaluronidase (30 patients; 3.2 mL 0.5 percent lidocaine + hyaluronidase 600 IU/mL). All patients received TPI. The verbal numerical rating scale (VNRS), the neck disability index (NDI), and the short form of brief paininventory (BPI-SF) were used to evaluate outcomes.

Mark your calendar for December 10th and view this live webinar 'Coding: IPM Guide to 2016'. Get up to speed with the coding changes that are coming in 2016 for Interventional Pain Management practices. You are responsible for reporting the services correctly so you don't risk delays, denials, or incorrect payments. Use this guide for coding, billing, and compliance changes in 2016 in this 90-minute webinar with coding expert Marvel J. Hammer, RN, CPC, CCS-P, ACS-PM, CPCO.
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State Society News

NY and NJ Societies to hold Pain Symposium Nov. 5-8
The New York and New Jersey Societies of Interventional Pain Physicians will host a Pain Symposium titled Evolving Pain Therapies on November 5-8, 2015 at the Hyatt Regency, Jersey City, NJ.  Click HERE for Schedule and more information.


Mark your calendar: GSIPP 12th Annual Pain Summit meeting set.
The Georgia Society of Interventional Pain Physician have set their meeting dates for 2016.
GSIPP 12th Annual Pain Summit
April 22-24, 2016
The Ritz Carlton Lodge Reynolds Plantation
Greensboro, Georgia

SAVE the DATE: FSIPP Meeting May 20-22, 2016
The Florida Society of Interventional Pain Physicians will hold its annual meeting in 2016 on May 20-22. The meeting will be held at the Orlando World Center Marriott in Orlando.
Watch FSIPP.org for more details.

Please send your State Society meetings and news to: Holly Long at hlong@asipp.org


Physicians Wanted


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