THURSDAY | MAY 14, 2020

We are pleased to announce a series of online webinar review courses to fulfill your board review and credentialing needs. Registration will be opened next week! Schedules soon to follow.
  • Billing, Coding, and Compliance – June 13-14
  • Controlled Substance Management – June 27-28
  • ASIPP Comprehensive Review Course in Pain Medicine and Interventional Pain Management – July 17 -18 AND July 24-26 (Note* This course take place over two weekends (Friday evening through Sunday) in order to fulfill the necessary topics)
Pain Management
Workgroup to Hold Evidence Review Advisory Meeting
Please find the letter  addressed to American Society of Interventional Pain Physicians, along with other pain organizations from the Pain Management Workgroup Evidence Review advisory meeting with important updates.
There will be an evidence review advisory meeting for LCD policies on facet joint injections and medial nerve branch procedures on May 28, from 1pm to 3 pm CDT, inn Nashville and as a teleconference.  The meeting is a combined meeting with all Medicare Administrative Contractors (MACs), will take place A link to the meeting and registration information will be posted to each MAC’s website. Here is the link to the CGS Website announcement:

Some of the ASIPP members are already serving on this committee; however, it is crucial that each state contact their own carriers and try to represent them. We need as many people as you can participate.
It is very crucial that you participate and understand. If you register you should be able to ask questions and give opinions, etc.
Amol Soin, MD, ASIPP President-Elect, will hold a Zoom meeting on Wednesday, May 20 at 7 pm CDT, for all state society presidents and CAC members. If you would like to be included in this meeting for more information on the LCD policy meeting, please contact Melinda Martin at

Carriers and contact list:

Meredith Loveless, M.D., CGS Administrators, J15  
Neil Sandler, MD, CGS Administrators, J15

Leslie Stevens, M.D., First Coast Service Options, JN 

Jason Stroud, M.D. Palmetto GBA, JJ and JM

Marc Duerden, M.D., National Government Services, J6 and JK
Arthur Lurvey, M.D., Noridian Healthcare Solutions, JE and JF  

Eileen Moynihan, M.D., Noridian Healthcare Solutions, JE and JF  
ReaAnn Capehart, M.D., Novitas Solutions, Inc., JH and JL  
Robert Kettler, M.D., Wisconsin Physician Services Insurance Corporation, J5 and J8  
ASIPP® Update on COVID-19 News, Resources, and Activity
The second round of stimulus checks, approximately 65%, will arrive somewhat later than we first expected, due to a glitch in delivering these funds. Some people have already received the allocated funds. If you have not received your funds yet, please wait, funds are coming. HHS says that they are on their way.
As it stands now, it will be 14 to 21 days after the following Thursday the application has been filed. They process the applications only one day each week. For example, if you submitted your application last Wednesday after 11:00 EST, it will not be considered until the next week, which could mean it would take up to 4 weeks.
The Burnout Survey showed some startling findings about our issues, specifically related to COVID-19. Over 67% of the members who responded stated that one of the main reasons for stress and worry is "in-house billing." If billing is a stressor for you, you may want to consider ASIPP partnered Fedora Billing and Revenue Management , which may help your revenue cycle management and may even collect some of the old funds if you make an agreement with them.
Insurance has become a major issue. Consequently, once again, we would like to remind you of our partnership with NORCAL .
With costs of supplies skyrocketing, it may also be worthwhile to consider ASIPP partnered GPO with Henry Schein .
We continue to work on various other issues related to extension of Telehealth services, and more specifically, phone-only telehealth, through August 6 for Medicare Advantage Plans, other governmental services, and commercial insurers. We will update you on this as we gain more information. See May 1 letter to CMS Administrator Seema Verma AND May 5 letter to HHS Deputy Azar and Assistant Deputy Hargan .
Fraud and Abuse Investigations: We are also continuing to work on onerous fraud and abuse investigations. For more information, please read this April 8 letter to HHS Secretary Alex Azar and HHS Deputy Secretary, Eric Hargan. See HHS Letter
Checklist and Risk Stratification
for Opening of Interventional Pain Management Practices
There are several steps to take as you open your office to a full schedule, and range of procedures, during the coronavirus pandemic of 2020.

1. Check with your state 
First, check with your state for when you can resume normal medical office visits and medical/surgical procedures. In some states, medical offices were never shut down. Elective procedures were banned, and emergent cases could only proceed at the physician's discretion in almost all states. Elective procedures can now resume in phase I, with variable dates during May and June 2020, if the patient can be discharged the same day. 
2. Prepare your office and staff for new safety measures
Prepare your office for the new paradigm of social distancing and required use of PPE. Every staff member should be screened on a daily basis for signs of illness and their temperature should be checked and logged. In some states, a ban on mass gatherings of more than 10 people remains in place. Restructure the office to minimize clustering of staff at break areas and patients in the waiting room or check out areas. All business offices can open, but all employees in the offices need to wear masks in most states. There are no clear guidelines that mandate visitors or patients in a doctor's office or hospitals have to wear masks, but it would be prudent to encourage your patients to do so. Only patients should be allowed in your office; drivers and/or family members should not be allowed in the office. Of course, if the patient needs assistance from a family member or the patient is a minor, then one person may accompany them. Patients should be screened for signs of illness, asked about their travel history to any area where COVID-19 is highly prevalent (not just to China or other foreign hotspots), questioned about any loss of smell, and have their temperature checked. Ideally, screening is done outside the building or at the entrance, and any staff member doing the screening would be wearing a mask. Patients may use their own personal mask in your office but if they don't have one, you should provide one. During surgery, they have to wear surgical or N95 masks, in some states.
The office should be prepared for social distancing. The chairs in the waiting room should be spaced 6 feet apart and all excess chairs should be removed from the waiting room. All surfaces in the office that would be expected to come in contact with people should be wiped down at the start of the day, the middle of the day, and the end of the day. Any chair or table used by a patient should be wiped down after each use. The restrooms should be monitored, cleaned and wiped down after each use. Hand sanitizer is required in high traffic areas.
Any work that can be done from home should be encouraged. This might include back office work such as accounting, bookkeeping, insurance authorizations and billing. Staff work hours could be staggered such that work that doesn't require the patient's presence can be done after clinic hours by staff coming in later in the day. Work stations in the office may need to be reconfigured to allow proper spacing between work staff. Telemedicine has gained much more acceptance and is now being used by most offices. This should be continued as offices open to a more regular schedule, as it will help to reduce patient traffic in offices.
Make sure you have an adequate supply of PPE for all medical and clerical staff in the office and for patients. Expect greater utilization of PPE than before due to increased use by staff and patients. You will need to maintain an adequate stock to remain open and be in compliance with Ohio Department of Health (ODH) recommendations. Each office will have to decide on the type of masks their staff will wear and whether face shields are needed.
3. Organize scheduling and maximize telemedicine
Telemedicine was encouraged by the US Government as a way to continue caring for the US population during this pandemic without exposing the patients or healthcare workers to the coronavirus. Just because the country is slowly opening up does not mean the virus is no longer a risk. Telemedicine involves communication with a patient who is not physically in the same room with the provider. The providers and patients who have used it have found it to be a nice way of delivering healthcare in the comfort of their own homes. Patients at home or work can take 15 minutes to do a follow up on the phone with the provider, rather than drive across town for a visit. We should continue to offer telemedicine for these reasons.
Right now, because of a waiver, the reimbursements for telemedicine visits that utilize audio or audiovisual communication can receive the same reimbursement. It is uncertain if this will continue after the waiver period ends, whenever this public health emergency is over. Until then, we should incorporate telemedicine to the fullest in our offices to take advantage of its benefits in terms of social distancing, safety and convenience to the patients and healthcare providers.
If patients will be brought to the office, then scheduled appointments will have to be spaced further apart so that social distancing can be accommodated in the office at least during Phase I and II. When they are checked out this should be done in a way that also minimizes patient crowding. The patient should also be allowed to leave the office quickly and then the follow up visit can be scheduled later over the telephone or by email. During pre-appointment reminder calls, patients should be pre-screened, notified of new in-office measures and encouraged to wear personal masks to their office visit. 
You may also want to consider the risks of performing interventional pain procedures based on the patient's age, medical history, physical condition and residence status (i.e. nursing home, assisted living). The attached American Society of Interventional Pain Physicians (ASIPP) toolkit contains recommendations on risk stratification.
4. Testing
Rules are highly variable for each state. Please look at the Department of Health posting.
If a patient is asymptomatic and has not had a reason to be tested for coronavirus before, what do you do? If the patient is coming in for a routine visit, then routine screening, including a temperature check, should suffice.
For IPM procedures in awake patients where the airway, face and neck are not involved, testing may not be necessary if they are asymptomatic and pass all standard coronavirus screenings, including temperature checks. Risk Stratification
If a person has a history of a positive coronavirus test, elective procedures should be delayed until the patient is considered no longer infectious and has recovered. The CDC uses both test-based and non-test based strategies. 

Test-based strategy

  • No fever without use of fever-reducing medicines.
  • Improvement of respiratory symptoms.
  • Negative results from two SARS-CoV-2 tests >= 24 hours apart.

Non-test-based strategy

  • Afebrile for 72 hours without use of fever-reducing medicines.
  • At least 7 days since the symptoms first appeared.

5. Risk Disclosure
Finally, as you open your offices, you should consider the use of a risk disclosure to explain the risks to your patients in this uncertain time. The risk disclosure should discuss the risks of leaving the safety of their own home to seek medical care and receiving medical treatments that might alter their response to the coronavirus should they get it (i.e., their infection may be more severe). An example risk disclosure can be found in the link below to the ASIPP toolkit for restarting your practice after the recent COVID-19 shutdown.

Surviving the COVID-19 Epidemic: Protecting Family and Employees and Managing Financial Issues and Burnout – PART 2

Surviving the Coronavirus Pandemic: Practical Advice Every Pain Physician Needs to Know – PART 1
ABIPP Recognizes Your Knowledge and Expertise
The  American Board of Interventional Pain Physicians  ( ABIPP )  has developed certification programs that recognize accepted levels of knowledge and expertise in the interventional pain management profession, with the goal of improved patient care. Hundreds of qualified physicians have made the commitment to become  ABIPP  certified.
ABIPP  now offers the only competency   certification program for regenerative medicine.

ABIPP Part I  - Theoretical written exam - October 3

ABIPP Part II   - Oral and Hands-on practical exam - October 3-4

ABIPP Competency Exam  - includes written, oral, and hands-on practical examinations October 3-4

Combined CSM/CCPM Exam for ABIPP Path   – October 3

Competency Exam in Controlled Substance Management – October 3

Competency Exam in Coding, Compliance, and Practice Management - October 3

Regenerative Medicine Competency Exam  - includes written, oral, and hands-on practical examinations – October 3-4
For complete information about the examination requirements and to obtain an application packet, visit  or call 270-554-9412 x4217 or by email at .
Doctor Devi Pens Book
Hospitals and healthcare workers struggle to keep up with the demand as the new coronavirus (COVID-19) spreads across the U.S. and throughout the world. 

Hundreds of millions of people are social distancing, quarantining, and sheltering in place to slow down the spread of the virus. The stock market is plunging and the global economy is heading into a recession because of the virus and because of the measures we are enforcing to stop it. Schools are closed. Restaurants, bars, and gyms are closed in many areas of the country. Major sports events, concerts and shows have been cancelled. Perhaps our greatest asset in this fight against the new coronavirus-- healthcare workers-- are becoming infected on the front lines. In the midst of this crisis, Doctor Devi explains what you need to know in a concise and easy-to-understand Question and Answer format.

Dr. Devi Nampiaparampil , a Harvard-trained doctor and a professor at NYU School of Medicine, breaks down the issues in this clear and compassionate handbook. What makes this virus so dangerous? How can I protect myself and my family? How did this happen?

For the latest guidelines, please always check:

Senators Quiz Federal Health Officials on Testing, Vaccines
Development of a vaccine is "more likely than not," says Fauci

WASHINGTON -- Members of the Senate Health, Education, Labor & Pensions (HELP) Committee appeared to have varying agendas at Tuesday's hearing on getting people back to work and school during the COVID-19 pandemic, but most of them agreed that testing would be a vital component of any reopening strategy.

"Staying at home indefinitely is not the solution to this pandemic," said committee chairman Lamar Alexander (R-Tenn.) who, like all of the witnesses and many of his fellow senators, appeared via a video hookup. "There's not enough money available to help all of those hurt by a closed economy. All the roads back to work and back to school lead through testing, tracking, isolation, treatment, and a vaccine. This requires widespread testing."
Call for COVID-19 Submissions: 
Manuscripts related to COVID-19 and interventional pain management are now being solicited for a special issue of Pain Physician .   
We will publish articles on prevention, diagnosis, treatment, including epidemiology, pathophysiology, pharmacology. Plus articles risks of interventional techniques, risks of anesthesia, precautions, and preventive measures.  
Pain Physician , the official journal of the American Society of Interventional Pain Physicians is and open access journal listed in Embase, SCOPUS, PubMed, and Medline. 
Pain Medicine Case Reports journal is also requesting submissions. PMCR is the sister journal to Pain Physician that focuses solely on Case Reports and Case Series. Articles submitted to PMCR will need to be Case Reports or Case Studies only that relate to COVID-19. 
Pain Medicine Case Reports is an open access journal, available online with free full manuscripts. It is listed in SCOPUS, Embase, ScienceDirect, Evolve, and Clinical Key. 

Articles for both journals will go through rapid review and rapid publication.  
Pain Physician March/April 
2020 Articles
Available Online
The March/April issue of Pain Physician  features 

Position Statement
Laxmaiah Manchikanti, MD, Christopher J. Centeno, MD, Sairam Atluri, MD, Sheri L. Albers, DO, Shane Shapiro, MD, Gerard A. Malanga, MD, Alaa Abd-Elsayed, MD, MPH, Mairin Jerome, MD, Joshua A. Hirsch, MD, Alan D. Kaye, MD, PhD, Steve M. Aydin, DO, Douglas Beall, MD, Don Buford, MD, Joanne Borg-Stein, MD, Ricardo Buenaventura, MD, Joseph A. Cabaret, MD, Aaron K. Calodney, MD, Kenneth D. Candido, MD, Cameron Cartier, MD, Richard Latchaw, MD, Sudhir Diwan, MD, Ehren Dodson, PhD, Zachary Fausel, MD, Michael Fredericson, MD, Christopher G. Gharibo, MD, Myank Gupta, MD, Adam M. Kaye, PharmD, FASCP, FCPhA, Nebojsa Nick Knezevic, MD, PhD, Radomir Kosanovic, MD, Matthew Lucas, DO, Maanasa V. Manchikanti , R. Amadeus Mason, MD, Kenneth Mautner, MD, Samuel Murala, MD, Annu Navani, MD, Vidyasagar Pampati, MSc, Sarah Pastoriza, DO, Ramarao Pasupuleti, MD, Cyril Philip, MD, Mahendra Sanapati, MD, Theodore Sand, PhD, Rinoo Shah, MD, Amol Soin, MD, Ian Stemper, MS, Bradley W. Wargo, DO, and Philippe Hernigou, MD

Health Policy Review
Laxmaiah Manchikanti, MD, Mahendra R. Sanapati, MD, Amol Soin, MD, Maanasa V. Manchikanti, BS, Vidyasagar Pampati, MSc, Vanila Singh, MD, and Joshua A. Hirsch, MD

Systematic Reviews
Jianwei Wang, MS, Zifeng Xu, MD, Zhou Feng, MS, Rui Ma, BS, and Xiaoyu Zhang, MS

Felipe Araya-Quintanilla, MSc, Hector Gutierrez-Espinoza, PhD, Maria Jesus Munoz-Yanez, MSc, Ursula Sanchez-Montoya, MSc, and Juan Lopez-Jeldes, MSc
A National Standard for Diagnosing COVID-19
Accurate statistics should guide America's re-opening

It's been more than a month since most states issued shelter-in-place mandates and ordered businesses to close. These actions were crucial -- and they've saved lives. Now most Americans are eager to see the country re-open, but we have to be smart about how we do it. One of the big challenges is that re-opening criteria are dependent on the data of new diagnoses and deaths attributable to COVID-19. But the numbers that are often reported are based on the subset of people who were tested and tested positive. In reality, most people with the infection and some who even die from it are never tested. That results in skewed infection and fatality rates.

Based on a few limited population antibody testing studies, it is estimated that approximately 10-85 times more people have been infected than are entered into most public health tracking systems. In addition, some doctors and hospitals were observing spikes in influenza-like illnesses in March, before testing was widely available, likely causing many early cases to be missed in the reporting. Another reason for under-diagnosing patients is that a patient may present to a hospital late in their illness or have a rapid decline too urgent to make testing a priority since it had minimal impact on patient management prior to the  remdesivir trial .
High SARS-CoV-2 Attack Rate Following Exposure at a Choir Practice — Skagit County, Washington, March 2020

What is already known about this topic?
Superspreading events involving SARS-CoV-2, the virus that causes COVID-19, have been reported.

What is added by this report?
Following a 2.5-hour choir practice attended by 61 persons, including a symptomatic index patient, 32 confirmed and 20 probable secondary COVID-19 cases occurred (attack rate = 53.3% to 86.7%); three patients were hospitalized, and two died. Transmission was likely facilitated by close proximity (within 6 feet) during practice and augmented by the act of singing.

What are the implications for public health practice?
The potential for superspreader events underscores the importance of physical distancing, including avoiding gathering in large groups, to control spread of COVID-19. Enhancing community awareness can encourage symptomatic persons and contacts of ill persons to isolate or self-quarantine to prevent ongoing transmission.

White House pushes states to test 2 percent of their populations for Coronavirus
New York City data show dramatic imbalance

President Donald Trump boasted Monday that the United States has “prevailed on testing” — despite public health experts’ warnings that millions more tests per week are needed to safely reopen the country.

"If people want to get tested, they get tested," he said at a Rose Garden briefing where he and other federal health officials revealed a plan to help states test at least 2 percent of their populations for the coronavirus in May.

That would amount to at least 12.9 million tests, according to Brad Smith, director of the Center for Medicare and Medicaid Innovation. To meet that goal, the federal government is providing states with 12.9 million swabs and nearly 10 million tubes of chemicals used to transport samples.

The White House also revealed how it plans to distribute $11 billion from the CARES Act to support state coronavirus testing plans. The money will be distributed to states based on a formula that considers the prevalence of the coronavirus in states and their overall populations.
App Data May Sniff Out Early Symptoms of COVID-19
Smartphone app data reports loss of smell and
taste may be a key indicator

People who tested positive for COVID-19 infection were more than six times more likely to report loss of smell and taste as early symptoms compared with people who tested negative, according to data from a smartphone-based app.

Among more than 18,000 participants using a  smartphone-based app  to report COVID-19 symptoms in the U.K. and the U.S. and who had undergone a test for SARS-CoV-2, 65% of those with a  positive test result reported loss of smell and taste  versus 21% of those with a negative test result (OR 6.74, 95% CI 6.31-7.21), reported Christina Menni, PhD, of King's College London, and colleagues.
We are currently looking for reviewers for Pain Physician  
We would like to take this opportunity to ask if you would be interested in a position as a Reviewer on the Editorial Board for Pain Physician or if you have a recommendation for someone who might be interested.  
Editorial Board responsibilities are as follows: 
  • Review a minimum of 6 manuscripts per year.  
  • Failure to review 2 manuscripts consecutively or 60% of the manuscripts sent will disqualify one from Editorial Board Membership. 
For more information or to submit your letter of interest, please e-mail: 
Holly Long at or call 270.554.9412 ext 4230.
ASIPP ® Partners with Fedora Billing And Revenue Cycle
Management Company 
After long discussions, in addition to our NorCal liability program for ASIPP ® members, now we are able to offer unique benefits for revenue cycle management with billing, etc.

Fedora is a company known to many of our board members and others. ASIPP ® has reached an agreement with Fedora to provide exclusive discounts on billing or revenue cycle management that will decrease practice costs and promote growth, or at least stop deterioration. It is not just a billing company; they streamline the billing and receivable process and constantly update payor regulations keeping your practice up to on date on a daily basis. 

You may view the ASIPP ® billing program website at the following link:  

Some of the ASIPP ® Billing Program highlights are below:
Up to 50% savings for ASIPP ® members for their billing or revenue cycle management for their offices and surgery centers:
  • Expertise in interventional pain management billing for all types of services
  • 99% Clearing House Rate
  • 95% First-Time Claim Passage
  • 23.4 Average Days in A/R
  • Eligibility and Benefits Verification 
  • Pre-Certification/Prior Authorization
  • Denials and A/R Management 
Join The Group Purchasing Organization Today
ASIPP ® has formed a partnership with Henry Schein and PedsPal , a national GPO that has a successful history of negotiating better prices on medical supplies and creating value added services for the independent physician. Working with MedAssets, PedsPal provides excellent pricing on products like contrast media that alleviate some of the financial pressures you experience today. While the cost of contrast media has skyrocketed due to the single dose vial issue, because we have partnered with Henry Schein, this could enable you to purchase Omnipaque 240mg/50mL for slightly above $4.50.

It will be easy for  ASIPP ® members in good standing to enroll today and begin to realize the savings this partnership can bring. Members can join or see sample prices by going to    

Click on “view our discounted supplier prices” (Username:ASIPPmember and Password: Save) or click on the words "join for free now" and begin saving today!
Portable, Reusable Test for COVID-19
“Testing, testing, testing.” It’s a mantra that health officials have been constantly promoting because screening people for COVID-19 is the best way to contain its spread. In the US, however, that crucial necessity has been hampered due to a lack of supplies.

But University of Utah electrical and computer engineering professor Massood Tabib-Azar has received a $200,000 National Science Foundation Rapid Response Research (RAPID) grant to develop a portable, reusable coronavirus sensor that people can always carry with them. The sensor, about the size of a quarter, works with a cellphone and can detect COVID-19 in just 60 seconds.

“It can be made to be a standalone device, but it can also be connected to a cellphone,” says Tabib-Azar. “Once you have it connected either wirelessly or directly, you can use the cellphone software and processor to give a warning if you have the virus.”
We are currently looking for reviewers for Pain MedicineCase Reports  
We would like to take this opportunity to ask if you would be interested in a position as a Reviewer on the Editorial Board for Pain Medicine Case Reports or if you have a recommendation for someone who might be interested.  
Editorial Board responsibilities are as follows: 
  • Review a minimum of 6 manuscripts per year.  
  • Failure to review 2 manuscripts consecutively or 60% of the manuscripts sent will disqualify one from Editorial Board Membership. 
For more information or to submit your letter of interest, please e-mail: 
Holly Long at or call 270.554.9412 ext 4230.
Essentials of Regenerative Medicine in Interventional
Pain Management
Essentials of Regenerative Medicine in Interventional Pain Management is a book to bring concise, collective, and comprehensive information to interventional pain physicians practicing regenerative medicine in managing chronic pain. Regenerative medicine is an integral part of interventional pain management within the definitions of interventional pain management and interventional techniques.

Each chapter contains an introduction of the subject, historical context,pathophysiology, applicability of regenerative medicine with its evidence base, indications, anatomy, technical aspects, complications, and precautions for each topic when available and applicable. This comprehensive book consists of 35 chapters, more than 350 figures, and 50 tables.
| ORDER | Essentials of Regenerative Medicine in IPM
Control Your Waiting Room TV

Customized waiting room TV exclusively for ASIPP ® members. Create your own ad-free television broadcasts using our videos, custom informational slides and your own YouTube videos. Even add local weather reports, news and live messages.
Send in your state society meeting news to Holly Long ,
ASIPP ® | Pain Physician Journal | Phone | Fax | Email