American Society of Interventional Pain Physicians | October 4, 2017
2018 ICD-10-CM Codes Changes for Interventional Techniques

The Centers for Medicare & Medicaid Services (CMS) released the 2018 ICD-10-CM files recently, exciting many in the healthcare industry. The 2018 files contain information on the ICD-10-CM coding updates for the 2018 fiscal year. 
These 2018 ICD-10-CM codes are to be used for discharges occurring from Oct. 1, 2017 through Sept. 30, 2018, and for patient encounters occurring from Oct. 1, 2017 through Sept. 30, 2018. 
There is one change this year to ICD-10 for our most commonly used codes. M48.06 has been assigned a 6 th digit, 1=without neurogenic claudication, 2=with neurogenic claudication. Starting with dates of service 10/1/2017 and on the 6 th digit must be assigned to the medical record and to the claim.
M40.86 Spinal stenosis, lumbar region
M48.061 Spinal stenosis, lumbar region without neurogenic claudication
M48.062 Spinal stenosis, lumbar region with neurogenic claudication
All providers are being notified of the change.  If you come across M48.06 without the 6 th digit please question the provider as to which option should be used.
Physician-owned practices spend $19k per physician on health IT:
4 key statistics

The  National Interventional Pain Management – Qualified Clinical Data Registry (NIPM-QCDR), a new resource from ASIPP®, is specifically tailored for interventional pain physicians. Your practice can use the NIPM-QCDR to fulfill the 2017 requirements of the Centers for Medicare & Medicaid Services (CMS) Merit-based Incentive Payment System (MIPS). Specifically, you can meet MIPS mandates for  Qualityand  Improvement Activities, and receive credit toward  Advancing Care Information.
The NIPM-QCDR combines rich CMS reporting capabilities with the first-ever set of measures specifically designed for interventional pain medicine. Participating in the NIPM-QCDR will make quality reporting more meaningful to your everyday practice, and help you improve care and optimize results.
Upcoming deadlines:
Full reporting: Sign up before November 3 to avoid a downward payment adjustment (penalty), and potentially earn a neutral or positive payment adjustment (bonus), by submitting a partial year or a full year of data.
Minimal reporting: Sign up before December 15 to avoid a downward payment adjustment (penalty) by submitting the minimum amount of data (one measure).

To learn more and get started, visit .

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. 

We would like to invite you to submit research case reports, brief commentaries and reviews to Interventional Pain Management Reports Journal . Your article will be published FREE’ of charge. 

Led by Editor in Chief: Kenneth Candido, MD, Chairman and Professor, Department of Anesthesiology , Advocate Illinois Masonic Medical Center in Chicago, IPM Reports focuses on the promotion of excellence in the practice of interventional pain management and clinical research. 

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
Short Perspectives

Click HERE to submit
Start Planning NOW! ASIPP Abstract Submission for 2018 Annual Meeting is Open
The American Society of Interventional Pain Physicians will hold its 20th Annual Meeting March 15-17, 2018 in Orlando, Florida at Marriott Orlando World Center.
This year, we will be making significant changes to the Abstract and Poster Sessions. Submissions will be in two categories: Resident/Fellow and Physician.  Selected posters will be on display for all meeting participants during all breaks and meal times.
The Abstract Committee will select the top 25 for publication in Pain Physician and of those 10 will be selected for Abstract presentation and judging during the Annual Meeting. The top 3 will receive cash prizes.
Tenet CEO to exit with $22.9M in severance pay

Dallas-based Tenet Healthcare's longtime CEO Trevor Fetter is set to receive a $22.9 million severance package when the company secures a new leader.
Tenet announced in August it was replacing Mr. Fetter, who has led the 77-hospital chain since 2003. He will step down by March 15, 2018, or when Tenet appoints a successor, whichever occurs first.
According to proxy materials filed earlier this year, Mr. Fetter will receive a $22.9 million severance package when he leaves the company. That amount includes: $10.85 million in cash payments; accelerated equity awards of $8.29 million; $3.74 in supplemental executive retirement plan and executive retirement account benefits; health and welfare benefits of $42,273; and $25,000 in outplacement services.

Opioid Policy Steering Committee; Establishment of a Public Docket; Request for Comments
The Food and Drug Administration (FDA or Agency) is establishing a public docket to solicit suggestions, recommendations, and comments from interested parties, including patients and patient representatives, health care professionals, academic institutions, regulated industry, and other interested organizations, on questions relevant to FDA's newly established Opioid Policy Steering Committee (OPSC). Opioid addiction and the resulting overdoses and deaths have created a national crisis, which requires action by federal agencies that may in some instances be unprecedented in order to address the situation and attempt to turn the tide on the crisis. As a public health agency responding to the crisis, FDA seek public input as it considers how its authorities can or should be used to address this crisis. This information will help the Agency understand areas of focus important to the public and identify and address opioid product and policy issues that need clarification. FDA is especially interested in hearing from interested parties in three key areas: What more can FDA do to ensure that the full range of available information, including about possible public health effects, is considered when making opioid-related regulatory decisions; what steps can FDA take with respect to dispensing and packaging ( e.g.,  unit of use) to facilitate consistency of and promote appropriate prescribing practice; and should FDA require some form of mandatory education for health care professionals who prescribe opioid drug products, and if so, how should such a system be implemented?
Submit either electronic or written comments by December 28, 2017.
CMS Puts Brakes on Part B Drug Payment Demo
Demonstration project would have included a flat fee for drug administration
WASHINGTON -- The Centers for Medicare & Medicaid Services (CMS) on Tuesday  formally withdrew  its controversial proposed demonstration project that would have changed the way Medicare pays for drugs under the Part B program.
When the project was  first proposed  in March 2016, "some commenters signaled their support for the proposed rule," the agency said in a three-page  Federal Register  notice scheduled for publication on Wednesday. "However, a number of commenters expressed concerns about the proposed model. As we worked to address these concerns, the complexity of the issues related to the proposed model design and the desire to increase stakeholder input led us to the decision to withdraw the March 11, 2016 proposed rule."
FDA Drug Market Exclusivity Periods: Time for a Change?
Most new drugs receive about 12 to 16 years of market protection from the time of US Food and Drug Administration (FDA) approval, according to a paper published in  JAMA Internal Medicine .
These monopoly periods are usually defined by patents and regulatory exclusivity earned at the time of FDA approval.
Aaron Kesselheim, MD, JD, MPH, of Brigham and Women's Hospital and Harvard Medical School in Boston, Massachusetts, and colleagues reviewed laws and regulations that protect brand-name manufacturers from competition. They also examined policy proposals intended to adjust exclusivity periods to help make drugs more affordable to patients.
FDA: Manufacturers of Immediate-Release Opioids Must Provide Clinician Prescribing Training
In an effort to halt the ongoing opioid addiction crisis, US regulators are requiring manufacturers to provide extensive training to doctors, according to a report published by the Associated Press.
Scott Gottleib, MD, commissioner of the US Food and Drug Administration, noted in a recent blog post that the FDA had informed 74 manufacturers of immediate-release opioids, including hydrocodone/acetaminophen and oxycodone/acetaminophen, that their drugs would be subject to these requirements. However, physicians will not be required to undergo training.
DOJ News
Doctor Pleads Guilty to Health Care Fraud Conspiracy for Role in $19 Million Detroit Area Medicare Fraud Scheme
A physician pleaded guilty today to conspiracy to commit health care fraud for his role in an approximately $19 million Medicare fraud scheme involving three Detroit area providers.
Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting U.S. Attorney Daniel L. Lemisch of the Eastern District of Michigan, Special Agent in Charge David P. Gelios of the FBI’s Detroit Division, Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Chicago Regional Office and Special Agent in Charge Manny Muriel of Internal Revenue Service Criminal Investigation (IRS-CI) made the announcement.
Abdul Haq, 72, of Ypsilanti, Michigan, pleaded guilty to one count of conspiracy to commit health care fraud before U.S. District Judge Denise Page Hood of the Eastern District of Michigan. Sentencing has been scheduled for May 29, 2018 before Judge Hood. 
Reducing the  P -Value for Statistical Significance to Improve the Quality of Research?
In a controversial and divisive article posted July 22, 2017 on the preprint server PsyArXiv, a group of 72 well-established researchers from the same number of institutions across the United States, Europe, Canada, and Australia in departments as diverse as psychology, statistics, social sciences, and economics, led by Daniel J. Benjamin, PhD, from the Center for Economic and Social Research and Department of Economics, University of Southern California, Los Angeles, propose to improve "statistical standards of evidence," by lowering the  P- value for significance from  P  <.05 to  P  <.005 in the fields of biomedical and social sciences. 1  This article was published in September 2017 as a comment in  Nature Human Behavior. 2
Statistical significance set at  P  <.05 results in high rates of false-positives, note the authors, "even in the absence of other experimental, procedural and reporting problems," and may underlie commonly encountered issues of lack of reproducibility.
Capsaicin 8% Patch Safe for Peripheral Neuropathic Pain

The use of capsaicin 8% patch repeat treatment is well tolerated and may provide effective long-term benefit in patients with peripheral neuropathic pain, according to an open-label, prospective, observational study published in The Clinical Journal of Pain.1
Investigators analyzed treatment-emergent adverse events (TEAEs) and drug-related TEAEs in nondiabetic patients receiving up to 6 capsaicin 8% patch treatments over a 52-week period for  post-herpetic neuralgia , HIV-associated distal sensory polyneuropathy, posttraumatic or postsurgical nerve injury, and peripheral neuropathic pain. The average daily pain score was ≥4, and retreatment occurred at 9- to 12-week intervals, depending upon clinical need.
Geisinger's operating income tumbles 34%
Danville, Pa.-based Geisinger recorded an operating surplus of $109.6 million in the fiscal year ended June 30, down 34.6 percent from an operating surplus of $167.5 million in the year prior, according to recently released bondholder documents.
Geisinger's revenues climbed 14.3 percent year over year to $6.3 billion in fiscal year 2017. The growth was primarily due to a 13.9 percent increase in patient service revenue and a 15.8 percent increase in premium revenue. Geisinger's health plan membership climbed 5.8 percent year over year. 
The system's expenses also grew in the most recent fiscal year. Geisinger's expenses totaled $6.2 billion in the most recent fiscal year, compared to expenses of $5.5 billion in the year prior.
Temple University Health's $5.7M operating loss anchored by Epic installation
Philadelphia-based Temple University Health System reported an operating loss in the 12 months ended June 30, largely due to costs associated with the implementation of an Epic EHR system, according to recently released bondholder documents.
Temple University Health System reported revenues of $1.75 billion in fiscal year 2017, up from $1.64 billion in the year prior. Although the system reported revenue growth, rising expenses offset those gains.
The increase in expenses was largely attributable to higher than expected staffing costs related to the Epic EHR implementation. The health system spent $15.1 million on staffing needs related to the Epic go-live.
Wisconsin health system blames Cerner software for $16M in losses
Fond Du Lac, Wis.-based Agnesian Healthcare is suing Cerner, claiming issues with its revenue cycle management software caused the system to lose $16 million.
In its complaint, filed Sept. 15, Agnesian alleges it began experiencing "pervasive errors" in patient billing immediately after going live on Cerner's RCM system in August 2015. Agnesian says the problems caused it to spend time and money to manually process patient billing statements and resulted in a significant backlog of patient claims for reimbursement.
Although Cerner allegedly told Agnesian officials in 2016 that all major issues with the billing software were resolved, Agnesian claims it discovered additional coding errors this year, which resulted in a large amount of undetected write-offs. Cerner then determined the billing software needed to be rebuilt.
Brigham and Women's mandatory flu shot policy prompts nursing suit: 7 things to know
A union representing nurses at Boston-based Brigham and Women's Hospital is standing up against the facility's new policy mandating flu vaccines for employees, reports The Boston Globe .
Here are seven things to know.
1. Brigham's new policy mandates employees receive annual flu vaccines.
2. Employees may opt out of the new policy for health or religious reasons, although those who do opt out must put on face masks around patients, according to the report.
3. The Massachusetts Nurses Association, which represents thousands of Brigham nurses, is suing the hospital over the new policy. The union claims nurses who opt out of the new policy for reasons unrelated to health or religion are unfairly and unlawfully penalized, according to the report. The union also claims nurses should be the decision-makers when it comes to flu vaccines.
State Society News 

October 7, 2017: New York
The 2017 The Art and Science of Pain Management: A Clinical and Research Update will be Oct. 7, 2017 at The Gideon Putnam, 24 Gideon Putnam Road, Saratoga Springs, NY 12866
The meeting is sponsored by Albany Medical College’s Department of Neuroscience and Experimental Therapeutics and the Office of Continuing Medical Education and the Albany Medical Center Provider Unit for Continuing Nursing Education. Registration Deadline is October 2, 2017.
For information regarding the conference, contact the Office of Continuing Medical Education by phone at (518) 262-5828, fax at (518) 262-5679 or e-mail at

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