THURSDAY | MARCH 19, 2020
We want to reassure everyone that we are still on the right page and nothing has changed regarding the expanded telehealth rules since yesterday’s announcements.
 
Update on Expanded Telehealth Rules
 
As more and more people become infected with coronavirus, keeping our practices open and caring for our patients is becoming increasingly difficult. CMS has responded to this issue by waiving the Medicare restrictions with new COVID-19 Telehealth Rules. Beginning on March 6, 2020, Medicare, administered by the Centers for Medicare & Medicaid Services (CMS), will temporarily pay clinicians to provide telehealth services for beneficiaries residing across the entire country.
Providing services virtually will help you treat more patients with fewer staff, prevent virus spread, and protect the health of your entire team. With these new rules, Medicare (and some private payers) are paying for non-face-to-face services (even in non-emergency areas). However, you must know how to accurately code for telemedicine (99213) and virtual care services (G2010, G2012). The following links provide current and trustworthy information to help you implement telehealth in your practice:
 
 
 
Billing and coding information from the AMA (click on the Policy, Coding, and Payment tab): https://www.ama-assn.org/practice-management/digital/ama-quick-guide-telemedicine-practice
 
General Info

 
 
 
Additional information and past updates from ASIPP:
 
Update on COVID-19 – March 17
 
If you have any questions, feel free to contact us at asipp@asipp.org
 
Be encouraged, stay positive, and do all you can to remain healthy!

ASIPP ® Members and Friends:
We want to thank you for your patience following the announcement of the postponement of the 2020 Annual Meeting due to Covid-19. We are pleased to report that the Dallas Hyatt Regency has been very gracious and has worked quickly with ASIPP to secure the same meeting space and same room rate for the new meeting dates of September 4-6.
 
What you need to know:
  • If you have already registered for the meeting, there is nothing more you need to do; your registration will remain as is. If you cannot attend the rescheduled meeting, please send a written request for full refund by April 2, 2020 to crogers@asipp.org or asipp@asipp.org. 
  • After April 2, the refund and cancellation policy will remain the same except with different deadlines.
  • If you have already booked your room at the Hyatt, there is no need to cancel your reservation. For your convenience, the Hyatt will be cancelling all rooms in our block that had been booked for the April meeting. We will announce when the new room block is ready to accept reservations for the new dates.
  • For information regarding rescheduling or cancelling your flight, CLICK HERE.
 
Click for the updated brochure. Visit  www.asippannualmeeting.com  for more details. We will update this site frequently with new information as it becomes available
UPDATES WILL BE POSTED TO | asippannualmeeting.com |
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.
 
For complete information about the examination requirements and to obtain an application packet, visit
www.abipp.org or call 270-554-9412 x4217 or by email at summer@asipp.org .
JUNE 27
ABIPP Part I  
  • Combined CSM/CCPM Exam for ABIPP Path
  • Competency Exam in Controlled Substance Management
  • Competency Exam in Coding, Compliance, and Practice Management
 
JUNE 27-28
ABIPP Part II  
  • ABIPP Competency Exam
  • Regenerative Medicine Competency Exam
  • Endoscopic Lumbar Decompression Competency Exam
 
939 Ridge Lake Blvd.,
Memphis, Tennessee 38120
JUNE 2020 ABIPP EXAMS AND COMPETENCY EXAMS
June 27 - June 28, 2020 | Hilton Memphis
LEARN MORE ABOUT ABIPP | EMAIL SUMMER WOODS |
Trump Signs Bill to Provide
Free Coronavirus Testing
$100-billion measure also to help people put out of work; much bigger economic relief package still to come

WASHINGTON — By a vote of 90-8, the Senate on Wednesday passed the second of several bills Congress has been considering to address various aspects of the COVID-19 epidemic, and President Trump quickly signed it.

The first was enacted March 6: an $8.3 billion measure known as the  Coronavirus Preparedness and Response Supplemental Appropriations Act  intended to temporarily increase federal Medicaid funding to states battling the virus outbreak, and expand unemployment benefits and provide grants to states for processing and paying claims.
READ MORE | MEDPAGE TODAY |
Announcing A New ASIPP ® Partnership - 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 ( https://www.ifedora.com ) 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:  https://www.asippbilling.com/  

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 
VIEW THE ASIPP ® BILLING PROGRAM | CLICK HERE |
Doctors Fear Bringing
Coronavirus Home: ‘I Am Sort
of a Pariah in My Family’
One doctor dreamed he was surrounded by coughing patients. “Most physicians have never seen this level of angst and anxiety in their careers,” a veteran emergency room doctor said. Dr. Stephen Anderson, an emergency room veteran, said there was a two-day supply of surgical masks at his hospital, MultiCare Auburn Medical Center near Seattle
                                                      
SEATTLE — After her shifts in the emergency room, one doctor in Utah strips naked on her porch and runs straight to a shower, trying not to contaminate her home. In Oregon, an emergency physician talks of how he was recently bent over a drunk teenager, stapling a head wound, when he realized with a sudden chill that the patient had a fever and a cough.

A doctor in Washington State woke up one night not long ago with nightmares of being surrounded by coughing patients.

“Most physicians have never seen this level of angst and anxiety in their careers,” said Dr. Stephen Anderson, a 35-year veteran of emergency rooms in a suburb south of Seattle. “I am sort of a pariah in my family. I am dipping myself into the swamp every day.”
READ MORE | NEW YORK TIMES |
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   http://pedspal.org/asipp/default.html   

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!
LEARN MORE ABOUT GROUP PURCHASING | CLICK HERE |
What Is This About Ibuprofen
in COVID-19?
Kerfuffle erupts over mysterious French health ministry announcement

 Is ibuprofen dangerous for COVID-19 patients? That's been a major topic of discussion this week but with no clear answer.

It started last Saturday, when France's health minister Olivier Véran  tweeted that NSAIDs including ibuprofen as well as cortisone  "could be an aggravating factor" in coronavirus infection and that "paracetamol" (acetaminophen in the U.S.) should be used to treat fever.

It was followed later in the day by an official health ministry  statement on COVID-19 management  that included the following (in Google translation):

"Serious adverse events related to the use of nonsteroidal anti-inflammatory drugs (NSAIDs) have been reported in patients with COVID19, possible or confirmed cases. We remind you that the treatment of a poorly tolerated fever or pain in the context of COVID19 or any other respiratory virosis is based on paracetamol, without exceeding the dose of 60 mg/kg/day and 3 g/day. NSAIDs should be banned."

"Conversely, patients on corticosteroids or other immunosuppressants for a chronic pathology should not interrupt their treatment, unless otherwise advised by the doctor who follows them for this pathology."
READ MORE | MEDPAGE TODAY |
Nation's opioid addiction treatment system during COVID-19 needs reform
Wash your hands. Practice social distancing. This often repeated and important public health messaging is critically important as the nation seeks to contain COVID-19.

Recently, CDC officials  encouraged  people to have a 2-week stock of their medications. Unfortunately, for people taking medications for opioid use disorder, this simply may not be possible — without critical federal intervention.
 
For people who use drugs or are in treatment for an opioid use disorder, the threat posed by COVID-19 may seem remote compared to the immediate risk of overdose, painful drug withdrawal, or the risk of HIV, viral hepatitis, or abscesses that can result from a disruption in harm reduction or effective treatment services.
READ MORE | THE HILL |
ALWAYS RETWEET ASIPP | @ASIPP |
Respiratory and GI Symptoms? Don't Rule Out COVID-19
Commentary also urges PPE use given potential
fecal shedding of virus

Given that COVID-19 may include stomach and bowel symptoms, gastroenterologists may consider the coronavirus illness when evaluating patients with GI complaints along with upper respiratory symptoms, researchers said.

Moreover, patients with inflammatory bowel disease (IBD) could be considered at high risk for COVID-19 if they are being treated with immunosuppressive agents, according to Ryan Ungaro, MD, of Icahn School of Medicine at Mount Sinai in New York City, and colleagues writing in  Clinical Gastroenterology and Hepatology .
READ MORE | MEDPAGE TODAY |
Hand Sanitizer Shortages Push FDA to Let Pharmacists Make It
The FDA is encouraging licensed pharmacists and physicians to create batches of hand sanitizer to cut back on spot shortages that, thanks to the new coronavirus, have pushed consumers to make their own.

People are encouraged to wash their hands for at least 20 seconds, or use hand sanitizer with at least 60% alcohol in it to help fight the virus, but stores around the country have run out of hand sanitizer and the agency is worried home-made concoctions aren’t as safe to use.

That’s why the agency  said Saturday  it won’t take any enforcement action against certain facilities or licensed professionals who make hand sanitizer for consumer use as long as they use high quality ingredients and follow a recipe laid out by the agency. That recipe includes suggested volumes of alcohol, glycerol, hydrogen peroxide, and sterile water.
READ MORE | BLOOMBERG |
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.
Essentials of Regenerative Medicine in Interventional Pain Management | ORDER |
Joint Statement Issued Addressing Concerns Over COVID-19 and ACE Inhibitor, ARB Use
Patients with cardiovascular disease diagnosed with novel coronavirus (COVID-19) are urged to continue taking their  angiotensin-converting enzyme inhibitor  (ACEi) and  angiotensin receptor blocker  (ARB) medications as prescribed, according to a statement jointly published by the American Heart Association (AHA), the Heart Failure Society of America (HFSA), and the American College of Cardiology (ACC). 

Observations over the past several months have indicated that cardiovascular disease patients are at a higher risk of serious complications and death from COVID-19. The statement was issued in order to “dispel misinformation” on whether patients currently prescribed an ACEi or ARB for indications such as heart failure, hypertension, or ischemic heart disease should continue therapy after being diagnosed with COVID-19. 
READ MORE | MPR |
Clinical Challenges: Test Your Knowledge on These Pain Topics
Recent series looked at pain and pain management

Pain and pain management are complex for both physicians and patients. The following three-question quiz tests one aspect from each article in our "Clinical Challenges" series on pain about  opioid tapering pain and cognition , and  women and pain . Correct answers and explanations appear after completing the quiz.
CLICK | HERE | TO TAKE QUIZ
No evidence of vertical transmission of COVID-19, challenges in diagnosing COVID-19 in those with respiratory co-infections, and detection of SARS-CoV-2 in stool specimens from an asymptomatic child
NEW YORK -- Today’s DG Alert covers mother-to-child transmission of coronavirus disease 2019 (COVID-19), the challenge of diagnosing COVID-19 if a patient is co-infected with another respiratory illness, and detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in stool specimens from an asymptomatic child in China.

There is no evidence that COVID-19 could be transmitted vertically to the fetus from the pregnant mother and cause a clinically significant infection, according to a  case study  published in Frontiers in Pediatrics.

Four full-term, singleton infants were born to pregnant women who tested positive for COVID-19 in Wuhan, China. Of the 3 infants for whom consent to be diagnostically tested was provided, none tested positive for the virus. None of the infants developed serious clinical symptoms such as fever, cough, diarrhoea, or abnormal radiologic evidence.
READ MORE | DG ALERT |
Goodbye, Benadryl
It's time to retire the old-line antihistamine,
says Roy Benaroch, MD

Sometimes, old ideas and time-tested treatments remain the best. Newer doesn't always mean better. Except in the case of one of our oldest antihistamines, tried-and-true Benadryl. It is time for that old drug to be retired, sent off to pasture, and never used again. Goodbye, Benadryl. Fare thee well, adieu, and don't let the door hit you on the way out.

Benadryl (diphenhydramine) was introduced in 1946. The top single that year was Perry Como's "Prisoner of Love," and, with all due respect, neither has aged well. Back in 1946, medicines like Benadryl didn't have to pass the stringent safety and efficacy standards now required. And there's zero chance, today, it would have been approved for over-the-counter sale. Even if it made it as a prescription medicine, it would be plastered with warning labels.
READ MORE | MEDPAGE TODAY |
Pain Physician January/February
2020 Articles Available Online Now
The January/February issue of Pain Physician features two surveys: one on prescription drugs in the workplace, and another on patient-reported outcome demographics. The issue also features randomized trials on pulsed radiofrequency on thoracic dorsal root ganglion, and the effects of intraoperative, low-dose ketamine on postsurgical pain after breast cancer.
Analysis/Survey
Prescription Drugs and the US Workforce: Results from a National Safety Council Survey
Alaa Abd-Elsayed, MD, Mathew Fischer, MD, Jonathan Dimbert, MS, and Kenneth James Fiala,BS

Demographic Factors Associated with Patient-Reported Outcome Measures in Pain Management
Jihad Abdelgadir, MD, Edmund W Ong, PhD, Salma M Abdalla, MD, John C Hunting, MPH, Mohamed Mustafa Diab, MD, Michael M Haglund, MD, PhD, C Rory Goodwin, MD, PhD, and Padma Gulur, MD

Randomized Trials
Pulsed Radiofrequency on Thoracic Dorsal Root Ganglion versus Thoracic Paravertebral Nerve for Chronic Postmastectomy Pain, A Randomized Trial: 6-Month Results
Diab Fuad Hetta, MD, Sahar Abdel Baky Mohamed, MD, Kawser Hofny Mohamed, MD, Taha Abd Elrazek Mahmoud, MD, and Hanan Ahmed Eltyb, MD

Effects of Intraoperative Low-Dose Ketamine on Persistent Postsurgical Pain after Breast Cancer Surgery: A Prospective, Randomized, Controlled, Double-Blind Study
Christine Kang MD, Ah-Reum Cho MD, PhD, Kyung-Hoon Kim MD, PhD, Eun-A Lee MD, Hyeon-Jeong Lee MD, PhD , Jae-Young Kwon MD, PhD, Haekyu Kim MD, PhD, Eunsoo Kim MD, PhD, Ji-Seok Baik MD, PhD, and Choongrak Kim MD, PhD
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.
GET YOUR OWN LOBBY TV CHANNEL | CLICK HERE FOR ASIPP-TV |
STATE SOCIETY MEETINGS
Send in your state society meeting news to Holly Long , hlong@asipp.org
ASIPP ® | Pain Physician Journal | Phone | Fax | Email