American Society of Interventional Pain Physicians | July 25th, 2018
Neuromodulation Cadaver Workshop will be
limited to 4 physicians per station.
Minimum attendance of 4 physicians required thirty days prior to meeting or
course and workshop is subject to cancellation. Register early!

1 Day Review Course and 1.5 Day Cadaver Workshop.
1. Trial lead placement for low back pain
2. Trial lead placement for neck pain
3. Spinal cord stimulator permanent implant placement (conventional)
4. Wireless trial and permanent placement
5. Transforaminal trial and permanent placement
6. Placement of intrathecal infusion system
7. Intercostal nerve stimulation
8. Sacroiliac stimulation
9. Suprascapular nerve stimulation
10. Free forum

Procedures are subject to change.
On July 12, 2018, the Centers for Medicare and Medicaid Services (CMS) published the proposed physician fee schedule rule for 2019. It also includes provisions for the Quality Payment Program (QPP) for 2019 with physician fee schedule. Major breakthroughs in this schedule are as follows:
  1. Based on the budget neutrality adjustment to account for relative value  changes, as required by law, the proposed 2019 fee-for-service (FFS) conversion factor is $36.05, a slight increase from $35.99 for 2018.
  2. Change of payment modality for evaluation and management services similar to United Kingdom with one payment for most levels of services, avoiding the issues of upcoding, downcoding, etc.

  • CMS has proposed to collapse payment for office and outpatient visits 
  • New patient office visits (99202 - 99205) payments would be blended to be $135 instead of $76 for Level II to $172 to Level V.
  • For established patient office visits (99212 - 99215) would be blended to be paid at $93 instead of $45 for Level II and $148 for Level V.
  • CMS also will create new codes to provide add-on payments to office visits for specific specialties ($9) and for primary care physician ($5)

For interventional techniques there have been some changes; however, majority of the changes seem to be minor and small except for increases for hip joint injection and significant decreases for some of the codes for electronic analysis of programmable pump, occipital nerve blocks, suprascapular nerve blocks, etc. There are also some increases for spinal cord neuro-electrode placement, specifically in an office setting with 19% increase. Please see the enclose fee schedule which compares rates from 2017, 2018, to 2019 proposed payment rates. 

2018 Support our Success

As you must be aware, the American Society of Interventional Pain Physicians has long been at the forefront of the fight for the survival and practice of interventional pain physicians. So as we move into 2018, and continue to fight against challenges such as painful cuts to ASC reimbursement, Medicare Non-coverage policies, and continued payment cuts for interventional pain management procedures, we must look to you for help in realizing and taking advantage of the new possibilities. 
Our past advocacy efforts have reaped great benefits for interventional pain physicians, including the reversal of cuts for epidural injections, changes to the CMS MIPS ruling, and greater coverage for Percutaneous Image-guided Lumbar Decompression. 
But to continue our successful work, we must ask for the help of those who benefit most. 
If you haven't given the maximum $5000 to the ASIPP PAC in 2018, we urge you to give what you can. These donations must be made from personal funds. 

Should MIPS Be Saved? Depends on Who You Ask
Opinions vary among expert panel on the Medicare reimbursement program

WASHINGTON -- Medicare's Merit-based Incentive Payment System (MIPS) for physician reimbursement has serious flaws -- but whether it should be saved is open to debate, as seen at a  Brookings Institution briefing  on the topic.
"I would argue there is still some value in the program. The intent of program is really to streamline and tie together some existing, very disparate programs that were out there," Shari Erickson, MPH, vice president of governmental affairs and medical practice at the American College of Physicians, said at the Friday briefing.

Anthem partners with Samsung, American Well on telehealth offering

Anthem members will be able to access medical advice through a mobile telehealth app on their Samsung phone thanks to a new three-way partnership with the technology giant and American Well.
The collaboration will provide access to American Well physicians through an updated Samsung Health app that now offers access to LiveHealth Online, according to Monday’s  announcement .
The new partnership streamlines several existing contracts between the three companies. Samsung launched its Health Experts service last year, embedding American Well’s platform into its Samsung Health application. The addition of Anthem, which operates Blue Cross Blue Shield plans in 14 states, opens the service up to 74 million members.

ASIPP July Podcast Available

Join Dr. Hans Hansen with another great podcast. They get better ever time. This episode features Dr. Hansen interviewing Dike Drummond, physician and author of “Stop Physician Burnout.” The interview centers on how the Happy MD, Dike Drummond, words with Mr. Anonymous in identifying and addressing what causes burnout,m how to recognize it, and what you can do to cope with it. Learn more on how to avoid burnout.

Be Prepared: Provider-Based Mid-Build Audits Are Here

Hospitals with off-campus provider-based departments (“PBDs”) under construction (or “mid-build”) at the time of the Bipartisan Budget Act of 2015 – which limited Medicare payment to off-campus provider-based departments that were not operational prior to November 2, 2015– have been waiting years for Medicare to confirm the provider-based status of these locations. With mid-build audits underway, it appears hospitals are one step closer to that goal. 
Under the “mid-build” exception, an off-campus PBD is exempt from the Medicare payment limitation if the main provider (1) had a binding written agreement with an “outside unrelated party for the actual construction” of the PBD before November 2, 2015; and (2) submitted a written certification of its mid-build status, signed by its Chief Executive Officer or Chief Operating Officer, to the Medicare Administrative Contractor by February 13, 2017. By statute, CMS must audit compliance with the mid-build requirement by no later than December 31, 2018. 

Interventional Pain Management Reports is an Open Access online journal, a peer-reviews journal dedicated to the publication of case reports, brief commentaries and reviews and letters to the editor. It is a peer-reviewed journal written by and directed to an audience of interventional pain physicians, clinicians and basic scientists with an interest in interventional pain management and pain medicine. 

Interventional Pain Management Reports is an official publication of the American Society of Interventional Pain Physicians (ASIPP) and is a sister publication of Pain Physician . Interventional Pain Management Reports Interventional Pain Management Reports is an open access journal, available online with free full manuscripts.  

The benefits of publishing in an open access journal that has a corresponding
print edition journal are:  
  • Your article will have the potential to obtain more citations.
  • Your article will be peer-reviewed and published faster than other journals.
  • Your article can be read by a potentially much larger audience compared with traditional subscription-only journals.  
  • Open Access journals are FREE to view, download and to print.

So submit today your:
  • Case Reports
  • Technical Reports
  • Editorials
  • Short Perspectives

The Overlooked Opioid Crisis
Cancer care hindered by chronic shortages of IV drugs

An overlooked opioid crisis threatens legitimate pain management and overall care of patients with cancer, oncologists and palliative care specialists asserted in a perspective article on the issue.
Chronic, often severe shortages of intravenous (IV) opioids affect the care of patients with a variety of conditions, particularly those with cancer. The resulting crisis created by the shortage will only worsen unless the problem receives appropriate recognition and attention, said Andrew Hantel, MD, Stacie Levine, MD, and Mark Siegler, MD, all of the University of Chicago.

CMS Plugs Changes to E/M Coding
Agency argues that streamlined billing codes will reduce physician burden

WASHINGTON -- Administration officials sought to explain the nuts and bolts of proposed changes to evaluation and management (E/M) codes during an online panel discussion on Wednesday.
Last week, the Centers for Medicare and Medicaid Services (CMS) proposed several major changes to the  Medicare physician fee schedule  that the agency believes will greatly reduce some of the paperwork burden physicians face each day.

2 surgeons indicted in $950M kickback scheme in California

A federal grand jury indicted two surgeons July 17 for their alleged roles in a kickback scheme that resulted in the submission of more than $950 million in fraudulent claims, mostly to California's worker compensation system, according to the Department of Justice .
The surgeons, Jacob Tauber, MD, and Serge Obukhoff, MD, were indicted in relation to the government's investigation into kickbacks physicians received for patient referrals for spinal surgeries performed at Pacific Hospital in Long Beach, Calif. They are among dozens of physicians and other medical professionals allegedly involved in the scheme.
In June, nine other defendants were charged for their alleged involvement in the kickback scheme, which the government has dubbed Operation Spinal Cap. Michael Drobot, former owner and CEO of Pacific Hospital, ran the 15-year-long kickback scheme. He was  sentenced  to more than five years in prison in January.

Spinal Cord Stimulation for Disk Degeneration: Pain Medicine News Report

Researchers have found that  spinal cord stimulation can reduce pain  in patients with lumbar degenerative disk disease.
The type of provider a patient sees influences whether that patient receives an opioid prescription to treat low back pain, a new  study  found.
Experts discuss the challenges of understanding and treating  headaches in children .
Should central nervous system depressants and opioids be prescribed together?  Douglas C. Throckmorton, MD,  explores the issue.
An  FDA committee recently decided  not to approve the use of extended-release oxycodone to help deter opioid abuse.

Pain Physician
July/August 2018 Issue Features

Health Policy Review
  • Reframing the Prevention Strategies of the Opioid Crisis: Focusing on Prescription Opioids, Fentanyl, and Heroin Epidemic
Systematic Reviews
  • Is Unilateral Percutaneous Kyphoplasty Superior to Bilateral Percutaneous Kyphoplasty for Osteoporotic Vertebral Compression Fractures? Evidence from a Systematic Review of Discordant Meta-Analyses
  • Prevalence of Recurrent Herniation Following Percutaneous Endoscopic Lumbar Discectomy: A Meta-Analysi
Randomized Trials
  • Thermal Versus Super Voltage Pulsed Radiofrequency of Stellate Ganglion in Post-Mastectomy Neuropathic Pain Syndrome: A Prospective Randomized Trial
  • Evaluation of an Experimental Pain Model by Noncompartmental Analysis of Results from a Randomized Placebo Controlled Trial
  • Transforaminal vs Interlaminar Epidural Steroid Injection for Acute-Phase Shingles: A Randomized, Prospective Trial

State Society News 

Aug 17-19, 2018
Ohio and Kentucky SIPP Meeting
Click HERE for more information

July 12-14, 2019
GSIPP 2019 - 15th Annual Meeting & Pain Summit
The Cloister Hotel at Sea Island
Sea Island, GA
For more information, contact Karrie Kirwan at or Tara Morrison at or 770-613-0932.

Send in your state society meeting news to Holly Long,
ASIPP | Pain Physician Journal | Phone | Fax | Email