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American Society of Interventional Pain Physicians News  | September 16, 2015

  1. Survival Strategies for the Tsunami of ICD-10-CM for Interventionalists: Pursue or Perish 
  2. Registration for ASIPP's November meetings is open 
  3. ASIPP Call for Abstracts 
  4. The Amount You Ate Likely Corresponds to the Size of Your Plate
  5. 5 Recent Hospital Closures
  6. FDA Panel Likes New Abuse-Deterrent Opioid
  7. Drug-Seeking Behavior Turns Deadly for Patient, Leads to Lawsuit for Provider
  8. Don't Fear Opioid Tapering
  9. Some Patients in Pain More Complicated to Treat Than Others
  10. Race May Play a Role in Treating Kids' Pain
  11. Prescription Drug Monitoring Programs: What to Do When There is a Red Flag
  12. How to Protect Your Practice From a Drug Diversion Investigation
  13. State Society News 
  14. Physician Wanted 
Survival Strategies for the Tsunami of ICD-10-CM for Interventionalists: Pursue or Perish
Members of ASIPP are publishing the survival strategies in the upcoming issue of Pain Physician. Since ICD-10-CM will be effective October 1, 2015, each and every physician has to be prepared. Consequently, we are providing you with the tables to assist you with the conversion.
Many of you have electronic medical records which you are hoping will convert automatically. As you see in this manuscript and also the codes converted, this will not be the case.
It is crucial that each condition be re-coded for accuracy and to avoid denials and subsequent cash crunch.
A single comprehensive table shows the conversion of commonly used spinal codes summarized into 2 pages. This can be carried on and put in the chart, even along with the other tables with modifications. You may not need to continue to use ICD-9 codes, however they are provided for your reference.
We have created 3 tables showing cervical, thoracic, and lumbosacral coding subsequently there are multiple tables with conversion of RSD, causalgia, and neuropathy,  headache and facial neuralgia, upper extremity joint coding, lower extremity joint coding, psychological coding,  and drug abuse coding.
I am quite certain you are all quite appreciative of these efforts. Please let us know your thoughts, even if you do not like our solutions. If you have found better solutions, please share them with us so we can share with the membership.
Above all, if you like these and appreciate the assistance, to help ASIPP diffuse some of the costs, please consider making an unrestricted donation to ASIPP which can be a tax deductible contribution from your business account. Click here for ASIPP Contribution Form.
novemberRegistration for ASIPP's November meetings is open
Regenerative medicine is a new and evolving field for interventional pain management. Know if and when to offer these treatments.

Choose to attend one or both of ASIPP's November meetings. You can attend the one day intensive Ultrasound for Regenerative Medicine Workshop or the 1 day Hands-On Cadaver Workshop for IPM Techniques or both. 
  • Attain the ability to understand ultrasound interpretation and regenerative medicine.
  • To incorporate ultrasound and regenerative medicine in treating your patients so that patients have better outcomes and reduced side effects.
  • To 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.


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. Register early, as all unbooked rooms will be  released on October 29, 2015 or until sold out, whichever occurs first.
Cadaver Venue:
OQUENDO CENTER , 2425 E. Oquendo Road, Las Vegas, NV 89120
Phone: 702.739.6698 | Toll Free: 866.800.7326 |
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.
We had tremendous success last year with our electronomic poster presentation area and we plan to continue this again for the 18th annual meeting.The top 20 posters will be selected to participate in the electronic poster presentations with Q & A time with poster presenters. These will also be published in Pain Physician journal. In addition the Top 8 posters will be presented for judging during Friday's session. The top three abstracts will receive cash prizes.
Posters will be on display during the meeting on both Thursday and Friday in the exhibitor hall.
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.
plateThe Amount You Ate Likely Corresponds to the Size of Your Plate
Eliminating larger-sized portions could reduce caloric consumption by up to 29% among adults in the United States, as a comprehensive review published in the Cochrane Library reports that portion, package, and tableware size influence food consumption patterns in adults.
A total of 61 randomized-controlled studies on 6,711 participants were evaluated to assess the impact of portion, packaging, and tableware on food consumption. The study authors found that overall, participants consistently consumed more food and drink if they were offered larger-sized portions, packages, or tableware compared to smaller-size versions. It is also suggested that the amount of daily energy consumed could be reduced by 12-16% among adults in the U.K. and 22-29% among adults in the U.S. with reductions in exposure to large sizes. The size of this effect did not significantly vary for men and women, or by body mass index (BMI), susceptibility to hunger, or tendency to consciously control eating behaviors.
closures5 recent hospital closures
Here are five hospitals that have announced plans to close in the past two months.

1. Springfield, Ill.-based Hospital Sisters Health System announced it is discontinuing healthcare services at St. Mary's Hospital in Streator, Ill., and transferring ownership of the hospital and its related facilities to Peoria, Ill.-based OSF Healthcare System. The health systems expect the transition to begin in early 2016, but a firm date has not been set for St. Mary's closure. OSF already has a physician office building in Streator and plans to initially use the former hospital building to provide outpatient services. However, OSF has plans to build a new outpatient center in Streator, and it is uncertain what would happen to the St. Mary's building at that point.
2. Chesterfield, Mo.-based Mercy health system announced it will close Mercy Hospital  Independence (Kan.) next month. The hospital's inpatient services, emergency department and ambulatory surgery services will close on Oct. 10. Some outpatient clinic services will remain open past that date, but are expected to close no later than Dec. 31.
3. Boston-based Partners HealthCare announced it will close its Union Hospital in Lynn, Mass. The system had originally intended to close the hospital and consolidate inpatient services at North Shore Medical Center Salem (Mass.) Hospital over the next 18 months. However, Partners subsequently extended that timeline to three years.

4. Nye Regional Medical Center in Tonopah, Nev., closed it doors Aug. 21 due to financial troubles. The hospital had been struggling financially for years, and those troubles forced the facility to file for chapter 11 bankruptcy in December 2013.
5. Cheverly, Md.-based Dimensions Healthcare System announced plans to close 106-bed Laurel (Md.) Regional Hospital and replace it with an ambulatory services center. The ambulatory care center, which will offer emergency services, outpatient surgery and diagnostic imaging, is expected to open on the hospital site by 2018.

Related stories:
panelFDA Panel Likes New Abuse-Deterrent Opioid
WASHINGTON -- In a second joint meeting of two FDA advisory committees, all 23 panelists voted unanimously to approve an abuse-deterrent formulation of extended-release oxycodone (Xtampza).
Panelists felt that the new formulation, which is comprised of tiny microspheres of drug collected inside a capsule, would pose a significant advantage for the large number of chronic pain patients who have difficulty swallowing pills -- without any additional safety risk posed by the need to take the drug with food.
Giving dysphagia patients opioids has been a challenge with other abuse-deterrent products because these properties prevent crushing, a common route of abuse. The new capsule, on the other hand, can be opened and sprinkled into food or delivered via feeding tube.
deadlyDrug-Seeking Behavior Turns Deadly for Patient, Leads to Lawsuit for Provider
Pain management is a growing problem across the country, often forcing clinicians into the awkward position of trying to determine if a patient is legitimately seeking pain relief or just seeking drugs. This month's case focuses on a vital issue in making that determination - communication. Whether it's communication between providers or between a provider and a patient, the old adage "knowledge is power" holds true, as does the opposite. Without proper communication, and the information that comes from that communication, a clinician may not be able to make the best decision for a patient.

Dr. P, 49, was a physician specializing in pain management. Over her twenty year career, she had worked in various practice settings, but for the past three years she had been working in a pain management clinic. Dr. P's patients were referrals from other practitioners, and Dr. P was highly regarded as a pain management specialist.
fearDon't Fear Opioid Tapering
As the outcry against opioid use and abuse continues to increase in intensity, more  prescribers are becoming increasingly reluctant to write a prescription for opioid analgesics for their patients with pain symptoms. With the opioid abuse epidemic now featuring prominently in news media, patients are becoming more knowledgeable on the topic and some will look to their physician to provide an alternative treatment for their chronic or acute pain. However, weaning patients off opiates can be a challenging task for any medical professional.

"Opioid tapering is always met with dread and anxiety, both by patients and by providers," said Lee A. Kral, PharmD, BCPS, CPE, Clinical  Pharmacy Specialist and Adjunct Assistant Professor in the Department of Anesthesia at the University of Iowa Hospitals & Clinics, Center for Pain Medicine, in Iowa City, Iowa.
Some Patients in Pain More Complicated to Treat Than Others
There are several considerations when managing patients with pain, but some patients present greater challenges to the clinician than others.
Brett Badgley Snodgrass, MSN, APRN, FNP-C, a family nurse practitioner specializing in pain management and palliative care, spoke about the "complex" patient with pain and discussed 3 types of patients who may pose particular challenges for clinicians: those who are at risk of becoming addicted to their pain medications, obese patients, and the elderly.
raceRace May Play a Role in Treating Kids' Pain
Compared to white children, black children were less likely to receive opioids for the treatment of appendicitis in the ED, according to a retrospective cross-sectional analysis of hospital survey data.

After adjusting for pain score, insurance status, age, and sex, black children with appendicitis were markedly less likely to receive opioid analgesia than white children (adjusted odds ratio 0.2, 95% CI 0.06-0.8). Some 34% of white children with appendicitis were treated with opioid analgesia compared to 12% of black children, Monika K. Goyal, MD, MSCE, of Children's National Health System in Washington, D.C., and colleagues reported in JAMA Pediatrics.

PMPPrescription Drug Monitoring Programs: What to Do When There is a Red Flag
Incorporating prescription drug monitoring programs (PDMPs) into daily practice is an integral step in assisting physicians who prescribe controlled substances, according to Matthew Foster, PharmD, who spoke on this subject during a session this week.
PDMPs are important, Dr. Foster noted, because patients have been shown to misuse these medications. A senior clinical pharmacy manager with Helios, Dr. Foster cited Centers for Disease Control and Prevention data that state:  "Nearly 15,000 people die every year of overdoses involving prescription painkillers," and "In 2010, 1 in 20 people in the U.S. (age 12 or older) reported using prescription painkillers for nonmedical reasons in the past year."
PDMPs give clinicians "access to legitimate medical use of controlled substances," Dr. Foster noted, adding that they can help clinicians "identify, deter, or prevent drug abuse and diversion."
How to Protect Your Practice From a Drug Diversion Investigation
LAS VEGAS - Healthcare providers got an insider's look at how law-enforcement officials conduct drug diversion investigations, learning how to avoid unintentional mistakes that may garner unwanted scrutiny from regulatory bodies and how to better protect their practices.
Two members of the National Association of Drug Diversion Investigators, Marc Gonzalez, PharmD, and Steven Louie, JD, hosted an interactive session detailing actual cases in which "pill mills" were busted, letting clinicians enact scenarios in which they assume the role of the drug diversion investigator. 
"There are a lot of things that are done in the background that regulatory and law enforcement do that practitioners have no clue about. If you know this, you'll be better able to protect yourself and know what red flags will get their attention," Gonzalez said. 
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State Society News


Save The Date! CASIPP Meeting set for October 2015
The California chapter of the American Society of Interventional Pain Physicians   will hold its 6th Annual Meeting in Monterey, CA at the Monterey Plaza Hotel Resort over the weekend of October 16-18. Agenda and registration can be found online at www.casipp.com or by calling 661-435-3473. 


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.


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



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