WEDNESDAY | NOVEMBER 25, 2020
Celebrating Thanksgiving
More than 1 million COVID-19 cases were reported in the United States over the last 7 days.
As cases continue to increase rapidly across the United States, the safest way to celebrate Thanksgiving is to celebrate at home with the people you live with.
Gatherings with family and friends who do not live with you can increase the chances of getting or spreading COVID-19 or the flu.
Things You Need To Know | CDC |
Findings showed a higher proportion of patients remained on treatment with erenumab compared with topiramate, demonstrating superior tolerability.
Pandemic Fuels Explosion in PPE and Tech Innovation
Nearly 20 years ago, David Bray, PhD, was working as the information technology chief for the CDC’s Bioterrorism Preparedness and Response Program, when he noticed a strange anomaly: In China, the price of garlic had risen nearly 10-fold. Since garlic is considered medicinal by many people in China, Bray and his team knew something had to be amiss. Working with people on the ground, they learned the country was experiencing a wave of an atypical febrile illness. Months later, China revealed it had been struck by a new coronavirus, SARS-CoV-1, also known as severe acute respiratory syndrome (SARS). “We knew about it five and a half months before the Chinese government said anything,” Bray said.

Today, as the world reels from the effects of another novel coronavirus, SARS-CoV-2 (COVID-19), Bray has been tracking innovations that rely on more than just garlic prices to quickly spot outbreaks, such as low-cost tools that analyze viral levels in wastewater. Other exciting developments that could help protect from and prevent future pandemics include medical devices that use artificial intelligence to guide treatment decisions and “smart” personal protective equipment (PPE). The possibilities are endless, said Bray, now the director of the Atlantic Council GeoTech Center, a think tank based in Washington, DC.
Read More | PAIN MEDICINE NEWS |
Modernizing and Clarifying the Physician Self-Referral Regulations Final Rule (CMS-1720-F)
On November 20, 2020, the Centers for Medicare & Medicaid Services (CMS) issued a final rule to modernize and clarify the regulations that interpret the Medicare physician self-referral law (often called the “Stark Law”), which has not been significantly updated since it was enacted in 1989. The final rule supports the CMS “Patients over Paperwork” initiative by reducing the unnecessary regulatory burdens on physicians and other healthcare providers while reinforcing the Stark Law’s goal of protecting patients from unnecessary services and being steered to less convenient, lower quality, or more expensive services because of a physician’s financial self-interest. Through the Patients over Paperwork initiative, the final rule opens additional avenues for physicians and other healthcare providers to coordinate the care of the patients they serve—allowing providers across different healthcare settings to work together to ensure patients receive the highest quality of care. In addition, as part of the Regulatory Sprint to Coordinated Care, CMS worked closely with the Department of Health and Human Services Office of Inspector General in finalizing policies that advance the transition to a value-based healthcare delivery and payment system that improves the coordination of care among physicians and other healthcare providers in both the federal and commercial sectors.
Read More | CMS |
According to the authors, outcomes such as adverse effects, cost, and patient preference should also be considered when selecting fibromyalgia therapy.
High-Quality Evidence Lacking for Most Fibromyalgia Therapies
The majority of treatment options for fibromyalgia are not supported by high-quality evidence, according to the findings of a systematic review and meta-analysis recently published in JAMA Internal Medicine.

To assess the effectiveness of these therapies on pain reduction and quality of life improvement, study authors searched various databases for randomized or quasi-randomized clinical trials that evaluated these outcomes in fibromyalgia patients. Pain intensity was assessed using the visual analog scale or numerical rating scales, while QOL was evaluated using the Fibromyalgia Impact Questionnaire.
Read More | Clinical Pain Advisor |
Tanezumab Shown to Reduce Low Back Pain In Comparison Study
Tanezumab, an investigational monoclonal antibody that inhibits nerve growth factor (NGF), was similar to tramadol in relieving the intensity of chronic low back pain (LBP), and the 10-mg dose of tanezumab was superior to placebo in improving function at four months, in a head-to-head placebo-controlled trial.

The study results at 16 weeks and at the completion of the 56-week, phase 3 trial, prior to a 24-week follow-up period, were reported at the 2020 American Academy of Neurology virtual meeting (abstracts P12002 and P11008, respectively).
Read More | PAIN MEDICINE NEWS |
ON-DEMAND COURSES

COURSE TITLE
Live Webinar
Attendees Price
New Registration
Price
Imaging Review Course
$ 100
$ 300
Controlled Substance Management
$ 100
$ 300
Documentation, Coding, Compliance,
and Practice Management
$ 100
$ 300
Board Review Course
$ 200
$ 500
Although research indicates cannabinoids may relieve pain, this study warned of issues with achieving adequate depth of anesthesia and advised they did not prevent postoperative nausea
and vomiting.
PAIN Panel Publishes Guidance on Perioperative Management of Cannabis Use
Given the paucity of evidence that suggests cannabis use can affect outcomes associated with surgery, the Perioperative Pain and Addiction Interdisciplinary Network (PAIN) has published consensus recommendations on the perioperative management of cannabis and cannabinoid-based therapies. PAIN outlined its recommendations in a recent online edition of the British Journal of Anaesthesia.

Rationale for the Recommendations
Increased legalization of cannabis across the globe has corresponded with an increase in both medicinal and recreational cannabis use. Research indicates cannabis may offer analgesic effects, but other data suggest cannabis may be associated with issues achieving adequate depth of anesthesia. However, clinical guidance is currently lacking on the perioperative management of cannabis use in patients who are undergoing surgery with anesthesia.
Read More | Clinical Pain Advisor |
Register to View ASIPP 2020 Annual Meeting Recordings
Free Access Window Closed
Free access for live meeting registrants was limited to 30 days following the close of the September 4-6 meeting. Please select the appropriate option under the payment section on the registration form if you want to extend your access to the meeting recordings. A significantly reduced add-on fee is available for those who pre-registered for the live meeting, as well as for fellows, residents and medical students.

If you did not register for the ASIPP Virtual Annual Meeting in September, you may still register to view the recorded version. All sessions from the September 4-6, 2020 meeting are available through June 2021 for a reduced fee. On-demand registration also provides access to all of the great resources available in the exhibit hall.

You will receive your new login credentials soon after completing the registration form.

CME Statement
Recorded sessions for this meeting are not eligible for CME credits.
Track COVID-19 Superspreader Clusters and Events
An interactive map with timeline and locations
From meat processing plants to dinner parties, from child care facilities to nursing homes, superspreader events appear to be driving renewed COVID-19 pandemic surges.

A project called Covid19settings seeks to track them across the globe. Many of those involved are based at the London School of Hygiene and Tropical Medicine (LSHTM) and other institutions. Below is an interactive data visualization of COVID-19 superspreader events in geographical locations keyed by chronological timeline.
Read More | MEDPAGE TODAY |
FILE - In this Saturday, July 18, 2020 file photo a general view of AstraZeneca offices and the corporate logo in Cambridge, England. AstraZeneca says late-stage trials of its COVID-19 vaccine were "highly effective'' in preventing disease. A vaccine developed by AstraZeneca and the University of Oxford prevented 70% of people from developing the coronavirus in late-stage trials, the team reported Monday Nov. 23, 2020.(AP Photo/Alastair Grant, File)
3rd Major COVID-19 Vaccine Shown To Be Effective And Cheaper
LONDON (AP) — Drugmaker AstraZeneca said Monday that late-stage trials showed its COVID-19 vaccine is highly effective, buoying the prospects of a relatively cheap, easy-to-store product that may become the vaccine of choice for the developing world.
The results are based on an interim analysis of trials in the U.K. and Brazil of a vaccine developed by Oxford University and manufactured by AstraZeneca. No hospitalizations or severe cases of COVID-19 were reported in those receiving the vaccine.

AstraZeneca is the third major drug company to report late-stage data for a potential COVID-19 vaccine as the world waits for scientific breakthroughs that will end a pandemic that has pummeled the world economy and led to 1.4 million deaths. But unlike the others, the Oxford-AstraZeneca vaccine doesn’t have to be stored at freezer temperatures, making it potentially easier to distribute, especially in developing countries.
Read More | AP NEWS | View The | YouTube Video |
As individuals we have undergone many changes in our day-to-day life in 2020. Changes are also coming to our professional lives. Major changes impacting Evaluation and Management (EM) coding in 2021 are around the corner as well as the addition of items to the Office of Inspector General (OIG) Workplan that may impact pain management providers. 

Effective training and education as well as conducting monitoring and auditing are elements of an effective compliance plan.  Now is the time to develop and maintain a proactive auditing program. 

We will discuss the benefits of monitoring and auditing as related to in-person EM encounters and forecasting revenue changes in 2021 as well as telemedicine visits.

Documentation of medical necessity remains an area requiring ongoing focus by means of education and training to match the ever-changing payer regulations. Other topics include recent reports related to facet procedures and, of course, urine drug testing documentation and the relationship of these issues to ongoing monitoring of auditing.
P R E S E N T E R :
Amy Turner,
RN BSN MMHC CPC CHC CHIAP

Amy Turner has a widespread background in clinical operations, revenue cycle, internal audit, risk management and health care administration.
*This program has been approved by the American Academy of Professional Coders (AAPC) for 1.5 continuing education hours.
Granting of prior approval in no way constitutes endorsement by the AAPC of
the program content or the program sponsor.
A Comprehensive Update on Aspirin Management During Noncardiac Surgery
Aspirin is considered critical lifelong therapy for patients with established cardiovascular (CV) disease (including coronary artery, cerebrovascular, and peripheral arterial diseases) and is consequently one of the most widely used medications worldwide. However, the indications for aspirin use continue to evolve and recent trials question its efficacy for primary prevention. Although one third of patients undergoing noncardiac surgery and at risk for a major adverse CV event receive aspirin perioperatively, uncertainty still exists about how aspirin should be optimally managed in this context, and significant practice variability remains.
Read More | MEDSCAPE |
The Treatment of Topical Drugs for Postherpetic Neuralgia: A Network Meta-Analysis
Postherpetic neuralgia (PHN), a neuropathic pain syndrome, is the persistent complication that follows an outbreak of acute herpes zoster and it typically begins after 1 to 6 months of lesion crusting. PHN occurs in approximately 10% to 20% of patients who are aged 50 years or older after the 3 months of zoster onset. Additionally, the number of patients with PHN greatly increases with age. The incidence rate of PHN is up to 75% in patients who are aged 70 years or older after the acute episode of herpes zoster. The quality of life of patients is affected by this persistent symptom, which may even persist for years. The underlying mechanisms have been explored in these 2 aspects: the persistent vesicular stomatitis virus exists after the acute episode of herpes zoster, and its level is higher than incubation, and as a result, it makes sustaining pain; and the infection of acute zoster may cause neural damage, which changes pain perception and enhances neuronal excitability.
Read More | Pain Physician Journal |
There are disparities in access to the internet among those with chronic health conditions.
Disparities Seen in Internet Access for Those With Chronic Conditions
HealthDay News — There are disparities in access to the internet among those with chronic health conditions such as hypertension and diabetes, according to a research letter published online Nov. 2 in Diabetes Care.

Vardhmaan Jain, M.D., from the Cleveland Clinic Foundation, and colleagues analyzed data from the 2016 to 2017 Behavioral Risk Factor Surveillance System to assess disparities in access to the internet among individuals with chronic medical conditions (diabetes and hypertension) and minority patients (Blacks and Hispanics versus Whites).
Read More | Clinical Pain Advisor |
Spinal Cord Stimulation for Chronic Pain Syndromes: A Review of Considerations in Practice Management
Up to approximately 8% of the population in the United States suffers from chronic pain. Unfortunately, this pathological phenomenon remains incompletely characterized, poorly understood, and challenging to treat. Extensive data has shown that opioid medications are inappropriate and ineffective in treating chronic pain and are burdened with numerous detrimental adverse effects ranging from addiction to mortality. Across the past decade, neuromodulation with spinal cord stimulation (SCS) has been utilized increasingly for treating chronic pain refractory to standard-of-care management with good efficacy.

There exist numerous high-level and high-quality studies supporting the use of SCS in various chronic pain syndromes. These studies have not only demonstrated superiority of SCS over comprehensive medical management in delivering analgesia and improving functional outcomes, but have also shown that SCS may confer significant reduction in systemic opioid intake. Notably, SCS itself has also been shown across several longitudinal studies to be a relatively safe intervention.
Read More | Pain Physician Journal |
Patients Expected Better Outcomes Than Surgeons After Lumbar Spine Surgery, Study Says
Surgeons more accurately predicted patient-reported outcomes two years after lumbar spine surgery than patients, according to a study published in Spine.

Researchers had 402 patients and their surgeons predict patient-reported surgical outcomes on the New York City-based Hospital for Special Surgery Lumbar Spine Surgery Expectations Survey before their procedure and two years post-procedure. The researchers used the results to evaluate how the surgery fulfilled patient expectations on a 1-100 scale, where 100 was the highest.
Read More | BECKER'S SPINE REVIEW |
ASIPP Membership Special
During these hard times, ASIPP would like to help out our members by offering a special dues payment benefit! When you renew before December 31, 2020, we are offering the following benefits:
One-year renewal by December 31 – Two (2) complimentary on-demand two-day review courses, or one (1) board video, which is conducted in 6-day sessions, or the on-demand version of our 2020 Annual Meeting. Additionally, to further express our gratitude to you for your continued support, we will also provide you with the Opioid and Regenerative Medicine Guidelines.
Two years dues renewal by December 31 – Four (4) on-demand review courses and your choice of either the on-demand Board Review course or the Annual Meeting. You will also receive the Opioid and Regenerative Medicine Guidelines.
 
Three years dues renewal by December 31 - Four (4) on-demand review courses and either the on-demand Board Review course or the Annual Meeting. You will also receive the Essentials of Regenerative Medicine in IPM book, the Opioid Guidelines, and Regenerative Medicine Guidelines.
 
Join as a Lifetime Member by December 31 - Four (4) on-demand review courses and both the on-demand Board Review course and the Annual Meeting. Additionally, you will receive the Essentials of Regenerative Medicine in IPM book, the Opioid Guidelines, and Regenerative Medicine Guidelines.
 
Your contribution to ASIPP through your membership dues renewal is crucial. Member dues allow ASIPP to continue our advocacy efforts with legislatures, administration, and various other bodies on your behalf.
 
Already a life member? Make a tax deductible year-end contribution to ASIPP of $500 or greater to receive a complimentary demand review course. Each $500 contribution is worth a one (1) two-day on-demand review course and a $1000 contribution = Board Review or Annual Meeting on-demand. The more you contribute the more you earn! 
           
This offer is also open to those who are joining ASIPP for the first time, paying 2020 dues, and paying future dues (2021 and beyond). By paying for multiple years, you will benefit from these tax deductions before taxes go up in 2021. Please share this great offer with others and encourage them to join ASIPP.
ASIPP® Partners with Fedora Billing And Revenue Cycle Management Company
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. One question we continue to receive is what the negotiated rate is for practices. The rate is 3% for ASIPP members and includes all the following services:

  • Reporting
  • Credentialing
  • Charge and Payment Posting
  • Credentialing 
  • Pre-certification/Prior Authorization
  • Denials and A/R Management 
  • And more!

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. 
The American Society of Interventional Pain Physicians (ASIPP) is pleased to announce a partnership with Willow Risk Advisors to create an exclusive policy available to ASIPP members. In an effort to further increase value to its physician members, the American Society of Interventional Pain Physicians (ASIPP) has endorsed Willow Risk Advisors as their professional liability insurance broker. Teaming up with the NORCAL group, Willow Risk has developed an exclusive Medical Malpractice Insurance Program tailored specifically to serve interventional pain physicians. This new program will offer necessary benefits including risk management, premium discounts, consent to settle, aggressive claims handling, and administrative defense.
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 https://pedspal.org/Pages/default.aspx

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 |
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
Take Control Of Your Waiting Room TV With ASIPP-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 |
PainExam is proud to announce that it now offers preparation for the ABIPP Pain Management Board Exam!  

In addition, PainExam has now collaborated with ASIPP and offer 2 new programs:
STATE SOCIETY MEETINGS AND WEBINARS
The California Society of Interventional Pain Physicians is providing a unique, townhall type webinar on health policy and advocacy of both state and national issues that are of interest to CALSIPP members as well as pain physicians across the country.
 
The webinar consists of two separate sessions, each with a moderator and three expert panelists on state and national issues. The webinar will be 90 minutes. The first session will be 30 minutes focused on issues in the state of California that may have an impact on pain physician's practices and patients. After a 10 minute break, the next 30 minute session will focus on larger national issues related to recent actions of the Center for Medicaid and Medicare Services (CMS), national coverages, as well as ongoing concerns regarding prescription medications and physician autonomy.
 
The webinar is intended to provide discussion and different perspectives from experts. Following each session there will be a brief question and answer period that will bring additional viewpoints from attendees. The objective of this webinar is to provide focus on healthcare policies and advocacy issues that are of interest to CALSIPP members and America's pain community.
Please join us for this complimentary webinar and join the
discussion on health policy and advocacy.
If you can't make the live webinar, you will be able to view the
recorded version any time you desire at no extra charge.
Register Today!

This live webinar and recorded version is brought to you free of charge by:
25131 Narbonne Avenue | PO Box 2072 | Lomita, California 90717-8777
Send in your state society meeting news to Ray Lane, rlane@asipp.org
STAY CONNECTED