American Society of Interventional Pain Physicians | August 1st, 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.
ASC & HOPD Proposed Payment Rates

The Centers for Medicare and Medicaid Services (CMS) released 2019 proposed payment rule for ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs) on July 25, 2018.
American Society of Interventional Pain Physicians (ASIPP) and the Society of Interventional Pain Management Surgery Centers (SIPMS) are proud to announce that CMS has addressed a number of long requested priorities effecting interventional pain management with increase in rates for multiple procedures.
Our longstanding work with CMS and congress for last 18 months has resulted in these changes effecting interventional pain management. We are very grateful to multiple chairs and members of the congress as we know our Bill 5804 even proposes further changes in calculation methodology that would be helpful in balancing payment rates to office settings also. In addition, appointment of an ASC member to Hospital Outpatient Payment panel is also major achievement, said Chairman of the Board of the American Society of Interventional Pain Physicians. (HR 6138)
1.        Percutaneous adhesiolysis procedure has been increased from a national rate of $350.20 to $400.09, a 14.2% increase, but still 13% lower than 2016 rate, and 50% less than 2015.
2.        Cervical and lumbar interlaminar epidural injections have been increased from $283.10 to $315.48, a 11.4% increase below 3.6% compared to 2016, and 14% less than 2015.
3.        Transforaminal epidural injections have seen an increase of 14.2% from $350.20 to $400.09.

4.   Multiple other procedures such as pudendal neurolysis, intercostal neurolysis, intercostal nerve blocks, axillary nerve block, brachial plexus block, also have seen increases.
5.      Among the other procedures seeing significant increases are removal of spinal electrode plate, removal of spinal electrode percutaneous array, and tunneling of intrathecal or epidural catheter, but offset by implant or replacement of subcutaneous reservoir with overall some increase.
   6.      Some of the major changes include the following:
●         Align update factors, moving the ASCs to hospital market basket that is used to update HOPD payments.
●         Under the proposal CMS would use the hospital market basket to update ASC payments for the 5-year period of calendar year (CY 2019 through CY 2013).
7.        The average update this year is 2% compared to no update of less than 1% in the past. Overall, ASCs would see an average overall covered procedures, an effective update of 2% - a combination of a 2.8% inflation update based on the hospital market basket and a productivity reduction mandated by the Affordable Care Act of 0.8 percentage points.
However, this may not apply across the board and there may be significant changes.
In addition, the statutory 2% reduction remains in effect until at least 2014 unless congress acts.
   8.     Lower Intensive Procedure Threshold:
CMS is also proposed to define ASC device-intensive procedures as those procedures with a device offset percentage greater than 30% based on the standard Outpatient Prospective Payment System (OPPS) Ambulatory Payment Classification (APC) rate-setting methodology. The current threshold is 40%.
   9.     Proposed Changes to List:
CMS is proposing to revise their definition of "surgery" in the ASC payment system to account for certain "surgery-like" procedures that are assigned codes outside the Current Procedural Terminology (CPT) surgical range.
   10.    Proposed Payment for Non-Opioid Pain Management Therapy:
CMS is also proposing to provide separate payment for nonopioid pain management drugs that function as a supply when used in a surgical procedure when a procedure is performed in an ASC.
   11.    Changes to the ASC Quality Reporting Program:
Implications of some of these changes are not known yet. We will be bringing these to you in the coming days.

Another Win for Interventional Pain Management

American Society of Interventional Pain Physicians (ASIPP) and the Society of Interventional Pain Management Surgery Centers (SIPMS) are pleased to announce the successful passage of HR 6138 - ASC Payment Transparency Act of 2018 on 7/25/2018 in the House of Representatives. Due to nonrepresentation of pain physicians on many committees, including those of surgery centers on HOP Commission, ASIPP and SIPMS have worked with Congress. HR 6138 was sponsored by Congressman Devin Nunes (R-CA) and House Ways and Means Committee Chairman Kevin Brady (R-TX) over the past few years to support the bill. Specifically, ASIPP and SIPMS have regularly requested the congressional action to require the outside advisory panel that reviews the Medicare Prospective Payment System for hospital outpatient department services to include at least one ambulatory surgery center (ASC) representative. Representatives from ASIPP and SIPMS had several meetings with the House Ways and Means Committee staff during the past 3 years.
Here is the substance of HR 6138:
1.   The bill requires that at least one ASC representative would have to be included on the 15-member advisory panel that reviews the Medicare prospective payment system for hospital outpatient departments and ASCs. The law currently requires all members to be hospital- or health system-employed.

2.  H.R. 6138 also requires CMS to specify the criteria it uses to exclude certain ASC-based surgical procedures from Medicare coverage.
3.  The bill also stipulates CMS can't exclude a procedure because of a general concern. The procedure can only be reported using an unlisted surgical procedure code.
Now the bill has to go to the senate and after passage has to be signed by the President to become law.

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.

Brigham and Women's surgeon: Physicians aren't burning out; they're suffering from 'moral injury'

Physicians on the front lines of health care today are sometimes described as going to battle. It’s an apt metaphor. Physicians, like combat soldiers, often face a profound and unrecognized threat to their well-being: moral injury.
Moral injury is frequently mischaracterized. In combat veterans it is diagnosed as post-traumatic stress; among physicians it’s portrayed as burnout. But without understanding the critical difference between burnout and moral injury, the wounds will never heal and physicians and patients alike will continue to suffer the consequences.

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

Primary care office-based addiction treatment of opioid use disorder with buprenorphine is a realistic and scalable solution to address the overdose crisis in the United States, according to an opinion piece published in  The New England Journal of Medicine .
Citing that in 2016, for the first time since the 1960s, life expectancy in the United States dropped for the second consecutive year (partially because of  opioid overdoses ), the article's authors argued their case for wide-scale buprenorphine implementation by primary care physicians. They addressed the following myths regarding opioid use disorder treatment:
M yth #1 :   Buprenorphine treatment is more dangerous than other interventions for the management of chronic conditions.

The Unhealthy Business of Healthcare

Physicians are called to this profession to improve quality-of-life, if not save it. That is our calling and our oath. We pledge our time and resources to the betterment of others. Yet many of the administrators who have assumed the helm of our healthcare delivery system have not taken this oath nor committed themselves to this ideal. And for many physicians, other clinicians, nursing and support staff, this could not be more evident in the workplace than it is today. Put simply, physician burnout is the single biggest threat to the health and well being of both physicians and patients.

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

Michigan Physician Pleads Guilty to Conspiracy to Distribute Controlled Substances
A Detroit-area physician pleaded guilty today to conspiracy to distribute controlled substances for his participation in a scheme to unlawfully distribute more than 23,000 pills of Oxycodone. 
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Matthew Schneider of the Eastern District of Michigan, Special Agent in Charge Timothy Slater of the FBI’s Detroit Field Office, 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 Timothy J. Plancon of the U.S. Drug Enforcement Administration (DEA)’s Detroit Field Office made the announcement.
Alex Kafi, M.D., 70, of West Bloomfield, Michigan, pleaded guilty to one count of conspiracy to distribute controlled substances before U.S. District Judge Victoria A. Roberts of the Eastern District of Michigan. Sentencing has been scheduled for Jan. 9, 2019 before Judge Roberts.  
As part of his guilty plea, Kafi admitted that from 2013 through May 2017, he engaged in a scheme where he wrote medically unnecessary prescriptions for Oxycodone in exchange for cash. Kafi wrote these fraudulent prescriptions often without ever meeting or communicating with the patient. Instead, Kafi conspired with patient marketers, who provided lists of patients to Kafi, along with $300 per prescription of Oxycodone. Kafi admitted the scheme involved approximately 693,000 mg of Oxycodone and he agreed to forfeit $617,208.00, which were proceeds of his criminal activity.  


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