Pictured left to right: Deborah Tracy, MD; Sunny Jha, MD; Annu Navani, MD; Rep. Larry Bucshon, MD; Vanila Singh, MD; Laxmaiah Manchikanti, MD; Joshua Hirsch, MD; Devi Nampiaparampil, MD; Rep. Ed Whitfield; Sheri Albers, DO; Amol Soin, MD; and Rep. James Comer. Honored faculty in the Manchikanti Distinguished Lecture Series during the general session on Friday, May 6. |
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ASIPP 24th Annual Meeting a Tremendous Success!
The American Society of Interventional Pain Physicians (ASIPP) 24th annual meeting was held last week in Las Vegas. The meeting boasted a new record number of attendees with an attendance that exceeded 1000 registrations –our largest Annual Meeting attendance ever. Those who attended the meeting in Las Vegas are still buzzing about what a great success it was.
The meeting was supported by 80 exhibitors, 14 sponsors, two Breakfast Symposiums (Legally Mine and Averitas Pharma), three Lunch Symposiums (Medtronic, Boston Scientific, and Stimwave), one Meet and Greet, one Resident Fellow Reception (Medtronic), two Fundraisers, and one post-session/meeting reception (NALU).
We offered our attendees three days of lively and informative general session talks, with a total of 43 presentations and five afternoon breakout sessions with a total of 71 presentations. We provided several hours of time allotted to visit the exhibit hall to interact with our exhibitors and learn more about their exciting products and services.
There were a total of 11 awards presented this year.
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The League of Presidents Awards went to immediate past president Dr. Amol Soin;
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Outstanding State Society Leadership Award – Dr. Ripu Arora;
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Distinguished Service Award – Dr. Deborah Tracy;
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Rising Star Award – Dr. Sunny Jha and Dr. Michael Lubrano;
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Raj Excellence Award – Dr. Sairam Atluri; Racz Excellence Award – Dr. Alan Kaye;
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Manchikanti Excellence Award – Dr. Mahendra Sanapati;
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and the final and the most prestigious award given by ASIPP, The Lifetime Achievement Award, was given to Dr. Sudhir Diwan, Dr. Hans Hansen, and Dr. Francis Riegler.
Please follow us on social media for the many meeting posts and post-meeting updates, as well as information on the ASIPP 25th Annual Meeting and Celebration where we return to Washington, DC at the Gaylord National Resort & Convention Center!
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Why You Should Have a Specialty Designation of 09 for Interventional Pain Physicians |
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Specialty codes are used by CMS for programmatic and claims processing purposes Medicare and commercial payers use the primary specialty designation in processing claims. Physicians in a group of the same specialty must bill and be paid as if they were one physician. Appropriate use of specialty codes helps reduce inappropriate suspensions and improves the quality of utilization data.
Physicians should monitor their specialty status to ensure that they are enrolled in the specialty type that most accurately represents their practice. This is particularly important as physicians change the focus of their practice and become more specialized. Failure to notify Medicare of specialty changes can affect reimbursement. If you are performing interventional pain procedures but your primary designation is Anesthesiology (5) or Pain Management (72) this will negatively affect the reimbursement for pain procedures. Interventional pain physicians’ primary designation should be 09 – Interventional Pain Management, a designation that ASIPP fought for and gained to assure more representation and reimbursement.
You may check your current specialty designation and/or to change it to Interventional Pain Management (09) on the following CMS website: https://nppes.cms.hhs.gov/#/please
Before doing so, CLICK HERE for a step-by-step instructional guide created by ASIPP member Dr. Rohit Choudhary to assist members in this process.
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The American Society of Interventional Pain Physicians (ASIPP) and Louisiana Society of Interventional Pain Physicians (LSIPP) actively opposed Louisiana HB 941 which would restrict access to minimally invasive spine procedures performed by appropriately trained interventional pain management physicians.
The bill would restrict access to care, prevent new minimally invasive techniques from being accessed in LA which are currently readily available across the country, and ultimately harm patient care by forcing patients to have much larger and more invasive procedures completed by surgical specialists who only seek to protect their financial well-being by restricting access only to themselves to complete more invasive procedures.
It was to be acted upon last week, Tuesday, May 2, but because of the ASIPP/LSIPP lobbying and opposition, this onerous bill has been tabled at this time. LSIPP Executive Director and President, Paul Hubbell, was set to testify our opposition when the bill was tabled in the final hour. We must keep this issue in our sights as it may be reintroduced with edits in the future.
Please keep in mind that bills such as these can occur in all states, and often are introduced quietly without much notice. This is an example of the importance of the ASIPP affiliate state societies! If you are not a member of your state society, please consider joining today. https://asipp.org/join-us-renew-2/
Click here to see ASIPP/LSIPP letter to the Louisiana House of Representatives, Health and Welfare Committee.
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NEXT EXAM DATES:
Part I
May 28, June 18, July 30, August 27, September 17, October 22, November 19 & December 17
Part II
July 15 & September 23
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There must be a better way to sort out which portal messages actually need our urgent attention
Extending the care of our patients beyond the confines of the office visit has never been easier -- which has its good points and its bad ones.
Many years ago, for the most part the only interactions we had with our patients occurred when they came to see us in the office for their annual physical examination. There were occasionally sick visits in between, and many conditions that patients had required more regular follow-up and longitudinal office visits every few months. But long ago I can recall as a resident admitting patients from attendings in the community for evaluation and workups for anemia or fatigue, the easiest way for follow-up to occur.
Many Forms of Care
Ongoing care today takes many forms, and we can expedite care and make so much more happen with better systems. Video visits and interim care from other members of the team can enhance the course of managing a condition, and e-consults and chatting with colleagues can help move things along as well. Home monitoring and testing at local labs near home can further enhance care and lead to swifter diagnoses. And with the advent of the electronic health record, the ease with which our patients are able the reach us, and we are able to reach them, seems to have increased exponentially.
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Burnout is having strong impacts on physicians in many specialties — and is hitting female doctors particularly hard. Meanwhile, about 1 in 5 physicians say they experience depression. Half the physicians suffering from burnout and depression think they can deal with their issues without consulting a professional.
The following infographic highlights the extent of these physician mental health challenges. If you're interested in delving deeper into the data, check out the Medscape Physician Burnout & Depression Report 2022: Stress, Anxiety and Anger, and other Medscape reports.
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A crossover trial has found that open-label placebo (OLP) significantly reduced pain and the use of rescue medications for pain in children and adolescents with functional abdominal pain or irritable bowel syndrome (JAMA Pediatr 2022 Jan 31. doi:10.1001/jamapediatrics.2021.5750).
“There is evidence that the placebo effect is very powerful for disorders of gut–brain interaction,” said principal investigator Samuel Nurko, MD, MPH, the director of the Motility and Functional Gastrointestinal Disorders Center at Boston Children’s Hospital, and a professor of pediatrics at Harvard Medical School, also in Boston. “Typically, when you conduct a clinical trial in disorders of gut–brain interaction, you need to take into account there is going to be a high placebo rate, which makes showing efficacy of the drug being tested harder.”
But instead of minimizing the placebo effect, Nurko wondered whether there might be a way of harnessing advantages of placebo in the clinical realm, due to lack of side effects and high cost.
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Cedars-Sinai Scientists Are Establishing In-Space Production of Stem Cells on the International Space Station to Advance the Next Generation of Cell Therapies
Already pioneers in regenerative medicine, scientists at Cedars-Sinai are launching their expertise into space to see if they can elevate the next generation of stem cell and gene therapies by harnessing the near-zero gravity conditions of spaceflight.
The two-year mission, funded by a $2 million grant from NASA, will help investigators determine if the microgravity conditions in space can improve stem cell production. The lack of gravity may make it easier to produce large batches of stem cells more efficiently.
“Cedars-Sinai has already established a world-class biomanufacturing center here in Los Angeles, and now we want to leverage our specialized expertise to try to expand the production of stem cells in space," said Clive Svendsen, PhD, executive director of the Cedars-Sinai Board of Governors Regenerative Medicine Institute and co-principal investigator on the mission.
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"These data should not be interpreted as vaccines not working," one expert said.
A growing proportion of COVID-19 deaths are occurring among the vaccinated, a new ABC News analysis of federal data shows.
In August of 2021, about 18.9% of COVID-19 deaths occurred among the vaccinated. Six months later, in February 2022, that proportional percent of deaths had increased to more than 40%.
Comparatively, in September 2021, just 1.1% of COVID-19 deaths occurred among Americans who had been fully vaccinated and boosted with their first dose. By February 2022, that percentage had increased to about 25%.
Experts said the increase in breakthrough deaths is expected with more Americans reaching full vaccination status.
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- ASIPP Members Only Site Information - |
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To log in for the first time you will need to click “forgot password” at the bottom of the login window.
- Check your email and then log in as directed.
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If you have problems logging into your account, click here.
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Pain Medicine Case Reports (PMCR) and Editor-in-Chief Alaa Abd-Elsayed, MD, PhD would like to invite you to submit case reports and case series to the PMCR journal. Your article will be published free of charge.
Open access journals are freely available online for immediate worldwide open access to the full text of published articles. There is no subscription fee for open access journals. Open access journals are no different from traditional subscription-based journals: they undergo the same peer-review and quality control as any other scholarly journal.
Interested in becoming a member of the PMCR Editorial Board?
Editorial board members are asked to review 2-6 manuscripts per year. Please submit your most up-to-date CV to sgold@asipp.org for consideration.
For more information or to submit your articles, click here.
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| CASE REPORT |
Owais Qureshi, MD, Thomas Cheriyan, MD, Daniel Atkinson, MD, Joshua B. Stevens, MD, PhD, Paramvir Singh, MBBS, Anterpreet Dua, MBBS, and Zhuo Sun, MD
Abstract
BACKGROUND: Seromas, an uncommon complication of spinal cord stimulator (SCS) implants, can result in patient distress, increased office visits, and infection with eventual system explantation. Due to the rarity of this condition, diagnostic and treatment strategies are rather limited within the interventional pain field.
METHODS: A retrospective chart review was performed on patients who underwent SCS implant, from January 2014 to June 2019, at our academic center. Management of SCS implantation complicated by a seroma is described.
RESULTS: Out of 215 SCS implanted patients, 4 (1.9%) were complicated by a seroma. Seroma severity varied widely. Management varied from conservative management without intervention to evacuation, to moving the generator pocket, and to explantation due to a seroma infection and later replacement of the SCS.
CONCLUSIONS: The management strategy of a post-SCS implant seroma varies based on the progress of the seroma formation. Close follow-up with evolving treatment is necessary to prevent further complications.
KEY WORDS: Spinal cord stimulator, pain management, chronic pain, seroma, complication
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| PROSPECTIVE STUDY |
Alp Eren Celenlioglu, MD, Savas Sencan, MD, Serhad Bilim, MD, Mert Sancar, MD, and Osman Hakan Gunduz, MD
Abstract
Background: Epidural fibrosis (EF) is one of the leading causes of post lumbar surgery syndrome (PLSS). Although there are studies in the literature suggesting that lumbar epidural steroid injections are an effective method in the pain management of PLSS caused by EF, no study is available comparing the effectiveness and safety of caudal and transforaminal approaches.
Objectives: To investigate the efficacy of caudal epidural steroid injection (CESI) versus transforaminal epidural steroid injection (TFESI) in patients with PLSS.
Study design: A prospective, randomized, assessor-blind study.
Setting: Interventional pain management center at a tertiary care center.
Methods: Patients with low back and radicular pain related to EF following single-level lumbar discectomy were included. The patients were randomly divided into 2 groups: a CESI group and a TFESI group. All patients were assessed before the procedure (baseline) and at one hour, 3 weeks, and 3 months after the procedure using the Numeric Rating Scale (NRS-11) and at baseline, 3 weeks, and 3 months using the modified Oswestry Disability Index (mODI). Treatment success was defined as a >= 50% decrease in the NRS-11 scores compared to baseline.
Results: A total of 56 patients (n = 26 CESI group; n = 30 TFESI group) were included. NRS-11 and mODI scores showed a significant decline in both groups at all follow-ups (P < 0.001). At 3 weeks, the improvement in the mODI scores was significantly higher in the TFESI group (P = 0.020). In all follow-ups, the NRS-11 scores were similar between the groups. At 3 weeks, the rates of patients with a >= 50% decrease in NRS-11 scores were 53.8% and 60% in the CESI group and TFESI group, respectively, while these rates were 30% and 26.7%, respectively, at 3 months.
Limitations: This study had no placebo-control group and a relatively short follow-up.
Conclusion: Both CESI and TFESI are effective and safe methods in the treatment of PLSS caused by EF following lumbar discectomy. These methods can reduce pain and disability. Although both methods have similar treatment success rates, TFESI seems to be a more effective treatment method in reducing disability at 3-week follow-up.
Keywords: back pain; caudal; epidural fibrosis; epidural steroid injections; failed back surgery syndrome; post laminectomy syndrome; radiculopathy; transforaminal; Post lumbar surgery syndrome.
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| RANDOMIZED CONTROLLED TRIAL |
Seoyon Yang, MD, Sang Gyu Kwak, PhD, Gyu-Sik Choi, MD, and Min Cheol Chang, MD
Abstract
Background: Approximately half of the patients with long-standing diabetes are known to have diabetic peripheral neuropathy (DPN). Pain from DPN deteriorates quality of life and hinders activities of daily living.
Objectives: This study aimed to evaluate the short-term effect of high-frequency (10 Hz) repetitive transcranial magnetic stimulation (rTMS) on the left primary motor cortex (M1) for neuropathic pain in the lower extremities due to DPN.
Study design: A randomized controlled trial.
Setting: The outpatient clinic of a single academic medical center.
Methods: In this randomized trial, 22 patients with DPN were randomly assigned to the rTMS group (10 Hz stimulation, 5 sessions) or the sham group. A numeric rating scale (NRS) was used to measure pain intensity before treatment and after one day and one week of treatment. Physical and mental health status were evaluated using the Short Form 36-Item Health Survey (SF-36), comprising 2 subscales (physical and mental component scores [PCSs and MCSs]), at one-week posttreatment. Of the 22 included patients, 20 (10 patients in each group) completed the study.
Results: In the rTMS group, the NRS score at one day and one week posttreatment was significantly lower than that at pretreatment. The SF-36 PCS and SF-36 MCS were significantly increased one week after the rTMS sessions. However, in the sham group, the NRS score, SF-36 PCS, and SF-36 MCS did not significantly change after the rTMS sessions.
Limitations: The small number of included patients and no long-term follow-up.
Conclusion: High-frequency rTMS on the left M1 may be useful for managing pain in the lower extremities due to DPN and may improve a patient's quality of life.
Keywords: diabetes; pain; quality of life; repetitive transcranial magnetic stimulation; Diabetic peripheral neuropathy.
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Since this malpractice insurance program officially launched in November 2018, ASIPP has signed up hundreds of providers with an average savings of 30%. This is professional liability insurance tailored to our specialty and will stand up for us and defend our practices.
Norcal Mutual is A-Rated by AM best and is licensed in all 50 states. To read a few important points to keep in mind about the program, including discounts, administrative defense, cyber coverage, aggressive claims handling, and complimentary award-winning risk management CME activities, click here.
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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 independent physicians. Working with MedAssets, PedsPal provides excellent pricing on products like contrast media that alleviate some of the financial pressures you experience today.
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ASIPP® is now offering our members the benefit of a unique revenue cycle management/ billing service.
We have received a tremendous amount of interest in the ASIPP® billing and coding program.
Click here to learn more about the negotiated rate for practices and more!
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up-to-date news related to you, your practice, and your patients!
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