American Society of Interventional Pain Physicians | July 18th, 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. 

7 ways the CMS wants to change the Medicare physician fee schedule

HHS and the CMS released its proposed changes to the 2019 physician fee schedule in a 1,473-page  proposed ruleon July 12. The modifications included some indications of where the agencies are headed with future Medicare regulations. Here, Modern Healthcare highlights seven ways the physician fee schedule could change.
1) Targeting high-cost procedures

CMS physician payment proposal nudges open the door for telehealth

elehealth advocates are rejoicing over last week’s physician payment proposal that would reimburse physicians for certain virtual interactions, a move that some see as a significant first step in overcoming the telehealth payment obstacle.
Buried in the 1,473-page proposed rule released last week by the Center for Medicare & Medicaid Services are several new proposals to pay physicians for virtual check-ins and reviewing patient photos or videos using asynchronous or “store-and-forward” transmission.
CMS also proposed adding new billing codes for “prolonged preventative services,” along with three new remote monitoring reimbursement codes recommended by ACT, The App Association.

FDA Outlines Plan for Increasing Nonprescription Drug Availability

The Food and Drug Administration (FDA) has released new guidance for drug developers that could potentially lead to the approval of a wider range of nonprescription drug products, allowing patients to "self-treat" some acute conditions and possibly chronic ones as well.
"Select types of drugs are appropriate for nonprescription use if we are able to ensure access to resources that will help patients determine if the medicine is right for them," said FDA Commissioner Scott Gottlieb, MD. Resources such as mobile applications, suggested Gottlieb, could be used by an individual to determine whether a certain treatment is appropriate for them prior to being able to actually purchase it. 

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.

Anti-Terror Tech to Fight Rx Fraud
Palantir can spot wrongdoing, but there may be a cost

Palantir, a data-mining technology developed by Peter Thiel and funded by a venture capital firm closely connected with the CIA, gained its foothold in government contracting during the "War on Terror" by finding terrorist cells and predicting improvised explosive device (IED) attacks on U.S. forces. As a young captain deployed to Helmand Province, Afghanistan, I saw the effectiveness of Palantir and its ability to spot patterns amongst seemingly random sets of data first hand. Palantir gave us the ability to see the frequency and location of IED attacks, identify the location of terrorist cells, and monitor information about high-value targets and detainees. This data was used to influence battlefield decisions in real time so that effort could be expended in areas that would cause the highest impact.
After its success on the battlefield, Palantir Technologies heavily marketed its Palantir Platform to government programs and landed big government contracts with federal agencies, the Department of Defense, and local law enforcement, including a recent $876 million Army contract. It was not long before Palantir caught the attention of the Department of Health and Human Services (HHS) as a tool to combat rising prescription drug fraud.

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

Reefer Madness
Colorado legalized marijuana in 2014 and the Pot Rush is on—but the ERs are filling up and a generation of kids is at risk.

Pueblo, Colo.
Colorado is the national pioneer of legalized marijuana. In 2014, it became the first state to allow any adult over 21 to buy weed or grow it without fear of prosecution. Since then, eight others and the District of Columbia have legalized the drug, and, with a momentum that feels irreversible, more are heading that direction. Public opinion is rapidly shifting in favor of legalization. Coloradans approved marijuana sales in a referendum, with state leaders musing that it would be a grand experiment and an exercise in federalism that could be instructive for the rest of the country.
Nowhere are the results of this experiment being felt more than in Pueblo, a small city of 108,000 about two hours south of Denver. Pueblo is an old working-class steel town largely left out of the prosperity of Denver and the state’s famous ski resorts. With nearly 200 legal marijuana farms, Pueblo is at the forefront of the state’s rapidly expanding pot industry. Marijuana has become big business. It is creating jobs, harnessing the energies of young entrepreneurs, raising millions in new tax revenues, attracting visitors to town, and giving residents more personal freedom.

Growing Array of Street Drugs Now Laced with Fentanyl
Physicians, officials spotlight grim trends and possible solutions

WASHINGTON -- Fentanyl is increasingly appearing in commonly abused drugs including heroin, cocaine, and marijuana, creating new challenges for physicians, said healthcare officials and emergency room doctors at an event here Tuesday.
While doctors have known for some time that patients frequently overdosed on a combination of opioids and alcohol, or opioids and benzodiazepines, there has been a new trend emerging: "Fentanyl is being used to lace a wide variety of drugs, including marijuana," said Nora Volkow, MD, director of the National Institute on Drug Abuse, speaking at a  Politico Pro 2018 Summit panel.

Fentanyl Deaths Double in 10 States, CDC Reports
Drug present in 21% of deaths

The number of opioid overdose deaths in which fentanyl was detected in 10 states doubled during the first half of 2017 compared with the second half of 2016, according to the CDC's  Mortality and Morbidity Weekly Report -- putting numbers to a trend already known qualitatively.
The number of deaths from carfentanil nearly doubled, too.

Fentanyl analogs were present in 21% of 11,045 opioid overdose deaths in 10 states during a 1-year period ending July 2017, the CDC reported. Carfentanil was found in 11.2% of those cases. The largest numbers and most substantial increases in fentanyl-related deaths were in Ohio.

Centivo Raises $34 Million to Create Primary Care-Focused Health Plan

Centivo Corporation has raised $34 million in Series A funding to develop a novel type of employer-sponsored health plan centered on primary care.
Bain Capital Ventures led the round in the New York-based company, with participation from F-Prime Capital, Maverick Ventures, Bessemer Venture Partners,  Rand Capital and others. Bain Capital Ventures Managing Director Yumin Choi will join Centivo’s board.
Founded in 2016, Centivo aims to reduce health-care costs for mid-to-large employers and their employees.

Access to this article may be limited.
Pain Physician
May/June 2018 Issue Features

Systematic Reviews
  • Role of Unilateral Balloon Kyphoplasty for OVCSF
Comprehensive Review
  • Patters, Changes, and Trends in Prescription Opioid Dispensing in Canada
  • Stem Cells for the Treatment of Knee Osteoarthritis
Randomized Trials
  • Effect of Different Volumes on Pain Relief in Patients Receiving Fluoroscopic Guided Interlaminar Lumbar Epidural Steroid Injections
  • Noninferiority Trial Comparing Upper and Lower One-Third Joint Approaches for SI Join Injections
  • Efficacy and Safety of Bone-filling Mesh Container and Simple Percutaneous Balloon Kyphoplasty

State Society News 
July 19-22, 2018
FSIPP 2018 Annual Meeting, Conference, and Trade Show
Florida Society of Interventional Pain Physicians
One South County Road, Palm Beach, FL 33480
Click Here for more information

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