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American Society of Interventional Pain Physicians News  | September 30, 2015

  1. Whitfield Not to Seek Re-election
  2. ICD10-CM Codes start Tomorrow! 
  3. Registration for ASIPP's November meetings is open  
  4. Scientific American PAIN MANAGEMENT with ASIPP Online Learning System 
  5. House Speaker John Boehner to Resign
  6. Inflammatory Back Pain Linked With Bone Loss
  7. ASIPP Call for Abstracts 
  8. ASIPP to Publish Monthly Podcast 
  9. How to Overcome Pain Resource Challenges: Part 1
  10. Staying Positive Can Alleviate Painful Conditions
  11. Do FDA's Fast-Track Reviews Skimp on Important Data?
  12. Time to Hang Up White Coats for Good? 
  13. State Society News 
  14. Physician Wanted 
Whitfield Not to Seek Re-election
ASIPP is sad to announce that our greatest friend in Congress, Representative Ed Whitfield, R-KY, has decided not to run for a 12th term representing Kentucky's First District. ASIPP is eternally grateful for all he has done for Interventional Pain Management and wish him all the best as he re-enters private life.
I have said before that without Congressman Whitfield, ASIPP and the interventional pain management specialty would have never achieved this status. This is not an exaggeration when you consider the following that he has done for us:
  • Advocated for IPM to have its own specialty designation, a MedPac study, a definition of IPM techniques, and our own practice expense.
  • Prevented IPM from being eliminated at ambulatory surgery centers.
  • Stopped or delayed physician fee cuts numerous times.
  • Was a tireless supporter and champion of NASPER (National All Schedules Prescription Electronic Reporting).
  • Was always willing to listen and then act on the concerns of ASIPP every time we needed him.
Ed Whitfield's influence will be sorely missed, not just by the people of Kentucky's First District, but also by patients suffering from chronic pain all across the country. ASIPP is grateful to the other representatives and senators in Washington who share our concerns for our patients, but no one will ever replace Ed Whitfield.
We wish him thanks and best wishes for the future.
tomorrowICD10-CM Codes start Tomorrow!
Tomorrow is the day. Medicare carriers have published ICD-10-CM codes which are approved for epidural injections and facet joint interventions. Please check your policies.
All carriers also have some irrelevant codes for various procedures; however, they may not allow them and they may also investigate if we use irrelevant codes.
These include all intervertebral disc disorder codes for facet joint interventions and lumbar epidural injections.
Lumbar Epidural Injections
For lumbar epidural injections, these codes include disc displacement codes substituting 722.10:
  •           M51.25 intervertebral disc displacement of thoracolumbar region
  •           M51.26 intervertebral disc displacement of lumbar region
  •           M51.27 intervertebral disc displacement lumbosacral region
However, other disc disorder codes (not included):
  •           M51.85 for thoracolumbar region
  •           M51.86 for lumbar region
  •           M51.87 lumbosacral region are not included.
If there is no disc herniation and you feel they do not fit into the disc displacement category, you may use disc degeneration even though other disc disorders will be the most appropriate one due to lack of coverage at the present time.
However, disc degeneration which was 722.52, now ICD-10-CM are included:
  •           M51.35 intervertebral disc degeneration - thoracolumbar region
  •           M51.36 intervertebral disc degeneration - lumbar region
  •           M51.37 intervertebral disc degeneration - lumbosacral region
Radiculopathy which was a nonspecific code of 724.4 now is covered with the following ICD-10-CM codes:
  •           M54.15 Radiculopathy, thoracolumbar region
  •           M54.16 Radiculopathy, lumbar region
  •           M54.17 Radiculopathy, lumbosacral region
Other new codes describing disc disorder with radiculopathy are approved as follows:
  •           M51.15 thoracolumbar disc disorder with radiculopathy
  •           M51.16 lumbar disc disorder with radiculopathy
  •           M51.17 lumbosacral disc disorder with radiculopathy
Sciatica is also covered with an old code of 724.3 with 4 new codes: 
  •           M54.31 right sciatica
  •           M54.32 left sciatica
  •           M54.41 lumbago with sciatica, right
  •           M54.42 lumbago with sciatica, left 
Spinal stenosis, 724.02 and 724.03 with claudication is covered without specification of claudication now, but including multiple codes.
  •           M48.06 Lumbar
  •           M48.07 Lumbosacral
  •           M99.23 Subluxation stenosis
  •           M99.33 Osseous stenosis
  •           M99.43 Connective tissue stenosis
  •           M99.53 Intervertebral disc stenosis
  •           M99.63 Foraminal: Osseous and subluxation stenosis
  •           M99.73 Foraminal: Connective tissue and disc stenosis
Post laminectomy syndrome is covered, which is M96.1 for all 3 regions.
Epidural fibrosis, now described as other disorders of meninges, ICD-10-CM code G96.12 and G96.19 (approved for some jurisdictions). You may want to look at your own region if it differs.
In reference to the facet joint interventions, the majority of the policies are appropriate with spondylosis without myelopathy or radiculopathy even though some of them include a large number of codes which are irrelevant for this purpose and they will never be reimbursing for those. It is best to stick to spondylosis codes for all facet joint interventions at all levels. Some have also included in the approval list multiple spondylosis and spondylolisthesis codes including those of cervical and thoracic regions even though the policy is limited to only lumbar region. Thus, the lumbar spondylolysis and spondylolisthesis codes are as follows:
  •           M43.06 Spondylolysis, lumbar
  •           M43.07 Spondylolysis, lumbosacral
  •           M43.16 Spondylolisthesis, lumbar
  •           M43.17 Spondylolisthesis, lumbosacral
Disc disorder with myelopathy is only approved in some states
  •           M51.06 lumbar
  •           M51.17 lumbosacral
Low back pain with M54.5 is approved for epidural injections as a diagnosis by all carriers.
Facet Joint Interventions
For facet joint interventions, the following codes are best and safest.
  •           M478.12 Cervical
  •           M478.13 Cervicothoracic
  •           M478.14 Thoracic
  •           M478.15 Thoracolumbar
  •           M47.816 Lumbar
  •           M47.817 Lumbosacral

To navigate your preparation, please print the specific tables as shown here:

Related Article:
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 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. 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 |
scientificScientific American PAIN MANAGEMENT with ASIPP Online Learning System
Decker Intellectual Properties Inc has signed a branding agreement with the American Society of Interventional Pain Physicians (ASIPP) to establish the comprehensive professional surgical online-learning database, Scientific American PAIN MANAGEMENT with ASIPP (SAPM). The subscription-based database, to launch in 2016, will be an inclusive, continuously updated modular resource for anesthesiologists, neurologists and other physicians in training and practice.
Decker is renowned for providing practicing clinicians and students with comprehensive and up-to-date medical and surgical information through Scientific American Medicine and Scientific American Surgery.  The new database will utilize the platform and unique educational features of these iconic publications to establish the new offering to physicians involved in the management of pain.
The module content for the SAPM resource will be based upon the new training curriculum used for the American Board of Anesthesiology, the American Board of Physical Medicine and Rehabilitation, the American Board of Psychiatry and Neurology, American Board of Emergency Medicine, American Board of Family Medicine, American Board of Radiology, and the American Board of Interventional Pain Physicians Exams in Pain Management. ASIPP has played an instrumental role in the development and refinement of the curriculum
Becker's newsletter published the following about this:
johnHouse Speaker John Boehner to Resign
WASHINGTON -House Speaker John Boehner (R., Ohio), long under fire from conservatives within his own party, will resign Oct. 30, according to GOP lawmakers and aides.

Mr. Boehner announced his plans to step down as speaker and resign from Congress at the end of next month at a closed-door meeting of House Republicans Friday morning. The announcement came one day after the 65-year-old welcomed Pope Francis for the first papal visit to Capitol Hill, fulfilling a decadeslong ambition for the speaker.
Mr. Boehner declined to comment to reporters as he left the closed-door meeting Friday.

 Access to this article may be limited.
boneInflammatory Back Pain Linked With Bone Loss
More than four in 10 patients having inflammatory back pain suggestive of early axial spondyloarthritis (SpA) and followed for 2 years experienced bone loss in the lumbar spine and hip, according to findings published in Rheumatology.
Furthermore, even a short duration of anti-tumor necrosis factor (TNF) therapy had a positive effect on bone mineral density (BMD) in the lumbar spine and hip, while baseline use of nonsteroidal anti-inflammatory drugs (NSAIDs) and an increase in BMI were associated with protection at the hip.

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.
podcastASIPP to Publish Monthly Podcast
ASIPP will soon be publishing a monthly podcast! Podcasts are becoming more and more popular. You can listen to a podcast on your computer or download it onto your iPod or other MP3 player. The ASIPP podcast will feature news about upcoming ASIPP meetings and didactic courses as well as general medical news and news of interest to interventional pain physicians.  Each episode will also have one or more interviews.

The premiere episode will have an interview with Devi Nampiaparimpil, MD. Dr. Devi is an ASIPP board member and published author. She has made numerous national television appearances and will have tips on how to use media to promote your practice. The podcasts will be produced and hosted by ASIPP staff member and sponsor relations coordinator Tom Prigge. The podcasts will be available on the ASIPP Web site.
How to Overcome Pain Resource Challenges: Part 1
A challenge frequently encountered at pain management clinics is the need to deliver an abundant amount of resources for patients. To meet this need, clinicians are expanding staff, services, and establishing new facilities to accommodate the growing number of individuals in need of treatment for pain.
Peter Learned Barelka, MD, graduated from the University of Colorado at Boulder, majoring in molecular biology, biochemistry, and Russian language. He attended Georgetown University Medical School and completed the Georgetown Transitional Medical Internship. He then completed his residency in anesthesiology and a pain medicine fellowship at Stanford University.
positiveStaying Positive Can Alleviate Painful Conditions
Being a pessimistic might not only alter one's mental state, it may also increase painful conditions if any are present.
Published in the Journal of Spirituality in Mental Health, a new report revealed that individuals who blame karma for their poor health have more pain and even worse physical and mental health. Counteracting negative spiritual beliefs could assist some individuals with limiting pain and improving overall health, researchers noted in the study.
fastDo FDA's Fast-Track Reviews Skimp on Important Data?
Accelerated and expedited FDA reviews of drug marketing applications have been awarded primarily to "me too" products and usually not with trials using active comparators or clinical outcome measures, according to two evaluations of these programs conducted by academic researchers and published in The BMJ.
A group led by Aaron Kesselheim, MD, JD, MPH, of Harvard's T.H. Chan School of Public Health, examined records of FDA's fast-track reviews going back to 1987. Not only have the number of such reviews grown steadily over that time (by about 3% per year), but this trend was driven mainly by applications involving drugs that were not first-in-class and/or were for expanded indications of already approved products (supplemental NDAs).
whiteTime to Hang Up White Coats for Good?
On a warm August 2004 day in Philadelphia, I joined 150 first-year medical students on stage at the University of Pennsylvania to celebrate the start of our medical careers. The dean called our names and, one by one, draped short white coats around our shoulders. We then stood together as a class and recited the Hippocratic Oath, reflecting on the importance of becoming humanistic physicians. My parents had driven up from Kentucky and proudly sat in the audience. It was a powerful ritual and a memorable day.

During my four years of medical school, I wore that short white coat on the hospital wards. After graduation, I moved to California and traded in the short white coat for a long one. Residency was exhausting. I was on call for 30 hours every few nights, my coat became sullied, and it was difficult to keep it pristine even with frequent washing. Once, after rounds in the intensive care unit, the attending physician took me aside. "Do a better job washing that coat," he admonished me. "Patients and their families shouldn't see you like that." But even with bleach, my coat never regained its original luster.
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State Society News


CASIPP Meeting set for October 16-18
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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