Telehealth services, including telephone-only services, were added as an emergency at the onset of COVID with multiple efforts from ASIPP and other organizations. However, CMS has now extended this through 2023.
Telephone CPT codes (99212 -95, 99213 -95, 99214 -95, 99441, 99442, 99443) have been eliminated from the 2022 fee schedule effective December 31, 2021. However, the public health emergency (PHD) was later extended with a new effective date through April 17, 2022.
CMS has issued a new notification that:
All telehealth services temporarily added to the telehealth services list during the PHE will remain on the list through December 31, 2023. These services include those that would have been removed as of December 31, 2021.
This is great news. Consequently, we do not have to worry about it for 2 more years.
Thank you again for your interest in ASIPP. We will continue to update you as we obtain information on these crucial issues.
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On the cusp of the third year of the COVID-19 pandemic, the United States is battling back the biggest surge of the virus yet with the omicron variant.
Cases, even while receding in some places, are near record levels. And daily deaths, while lower than the peak of last winter, are still averaging more than 2,000 nationwide.
Despite pitched battles over masks and vaccines, life appears somewhat normal in many respects -- kids are going to school, people are going into work and large indoor gatherings and events are being held.
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What does it mean if a person’s rapid antigen test result comes back positive after five days of isolation due to covid-19? According to the experts, that person is most likely still carrying a viral load high enough to infect others.
“Anytime you’re positive by one of these rapid at-home covid tests, it means that you’ve still got a really high level of the viral protein, and most experts are interpreting that as a high level of virus present in your nasal passage,” said Matthew Binnicker, director of clinical virology at the Mayo Clinic and president of the Pan American Society for Clinical Virology.
The Biden administration is buying a billion rapid antigen tests to ship to American homes, aiming to address the need for increased covid testing and ease a nationwide shortage of tests. That influx of tests comes on the heels of revised federal guidelines that shortened the isolation period to five days after symptoms started or a positive test, followed by five days of masking.
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"Only having a transmissibility advantage at this stage of the game isn't a total showstopper"
The Omicron sublineage BA.2 is making headlines for its potentially increased transmissibility as its prevalence rises in some countries, but experts aren't too concerned about the variant just yet.
Late last week, the U.K. Health Security Agency designated BA.2 a "variant under investigation" as cases were doubling every 4 days and showing a 120% growth advantage over the original Omicron clade, known as BA.1, said Katelyn Jetelina, PhD, MPH, an epidemiologist at UT Health Science Center at Houston.
Other countries, including Denmark, Norway, Sweden, and India, have seen similar growth for BA.2, Jetelina reported in her Substack email. Still, she said, it's "likely nothing like the huge transmissibility jump we saw from Delta to Omicron," which was a 500% growth advantage.
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ASIPP is conducting a survey on the practice patterns of perioperative management covering antiplatelet and anticoagulant therapy in Interventional Pain Management. We last surveyed this topic 10 years ago. We would like to compare the 2011 data to 2021 to see the changes to the practice pattern. Your help is needed to accomplish this!
We recently mailed to you the survey titled Practice Patterns of Perioperative Management of Antiplatelet and Anticoagulant in Interventional Pain Management. If you did not complete the survey, please take a few minutes to complete it mail it back to us in the prepaid return address envelope.
If you did not receive the survey, you may download the survey by clicking here. Please complete and e-mail it back to drm@asipp.org or fax to 270.554.5394.
This survey is most important to ASIPP and its members. It will demonstrate how our members practicing Perioperative Management utilize antiplatelet and anticoagulant therapy in pain management procedures. The more members that participate will increase the impact of the survey.
Please complete the survey and mail, e-mail, or fax back as soon as possible.
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A new way to build back better
I'm reading a lot more stories about doctors leaving medicine for good. An internal medicine physician wants to spend more time with her children. A primary care physician desires to attend to his mentally handicapped adult son. A surgeon needs to escape a "toxic" workplace. A doctor has no avenue of appeal after he is unfairly reported to the National Practitioner Data Bank. A family medicine physician retires prematurely because practicing medicine has become a grind and lost its luster. A physician recollects, "the thing about primary care is 'poop rolls downhill' – and I'm absolutely glad I'm out of it."
The stories and reasons for leaving go on and on, but one theme many have in common is the realization that physicians no longer control their professional destiny -- it's in the hands of attorneys, corporate CEOs, government officials, and the like.
Over 500,000 healthcare workers have left the industry since early 2020. To be sure, the coronavirus pandemic has hastened the exodus. But the firestorm was ignited long before COVID-19 arrived on the scene, when, at baseline, physicians were overworked, underpaid, bogged down, second-guessed, litigated, and burned out beyond belief. The pandemic simply brought the cauldron to a boiling point.
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No insurer has ever made that kind of money in U.S. history.
Just days after a Commonwealth Fund report showed that American families are sending health insurance companies more and more of their income every year even as their deductibles skyrocket, the country’s biggest insurer reported massive 2021 profits and told investors to expect even higher 2022 profits.
UnitedHealth on Wednesday reported 2021 profits of $24 billion on revenue of $287.6 billion. Executives told Wall Street they expect United will be the first insurer to take in more than $300 billion from its customers this year.
Instead of giving its health plan customers relief from ever-increasing out-of-pocket requirements, United spent $5 billion last year buying back its own shares of stock, a gimmick that boosts the value of shares and makes shareholders richer. United also paid shareholders $5.3 billion in dividends in 2021.
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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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Omicron's race across the globe has amped up concerns about long COVID, which some estimates suggest affects a third of COVID-19 survivors
More than a year after a bout with COVID-19, Rebekah Hogan still suffers from severe brain fog, pain and fatigue that leave her unable to do her nursing job or handle household activities.
Long COVID has her questioning her worth as a wife and mother.
“Is this permanent? Is this the new norm?’’ said the 41-year-old Latham, New York, woman, whose three children and husband also have signs of the condition. “I want my life back.’’
More than a third of COVID-19 survivors by some estimates will develop such lingering problems. Now, with omicron sweeping across the globe, scientists are racing to pinpoint the cause of the bedeviling condition and find treatments before a potential explosion in long COVID cases.
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Call for
Abstracts & Poster Presentations
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Proposals accepted through March 1st
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A $50 submission fee is required upon completion of the form. |
Questions can be directed to
Savannah Gold at 270.554.9412 ext 4219 or
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After reading the 2022 Abstracts & Poster Presentations guidelines, please complete the form along with the presenter's CV by clicking here.
- Top 3 will present during the general session on the final day.
- Top 10 will present during the abstract breakout session.
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Rapid review and publication in the Pain Physician journal will be extended to the Top 10 authors accepted for meeting presentations.
Click here for Abstract and Poster Presentation
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As Omicron infections and weather challenges hampered operations, some carriers struggled more than others to return to some version of pre-pandemic normal
The good news: Flying is more like it used to be. The bad news: Flying is more like it used to be.
Leisure travel came roaring back in 2021. So did cancellations, delays and other flight problems. Airlines began to resemble their pre-pandemic selves, even if they still flew less overall than they did in 2019.
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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 |
Andrew Aboujaoude, BS, and Daltry Dott, MD
Abstract
BACKGROUND: Memantine is a N-methyl-D-aspartate receptor antagonist that is prominently known as an Alzheimer’s disease medication. In recent years, it has started to receive attention for pain management purposes, especially for neuropathic pain. There has been little focus on its use for nociceptive pain. We present a case where the use of memantine for nociceptive pain in a patient yielded significant associated improvement.
CASE REPORT: A 49-year-old man presented with a one-year history of severe nociceptive left neck pain subsequent to a whiplash injury. The patient failed multiple first-line therapies and pursued consults with multiple specialties without symptomatic improvement. He was put on memantine with subsequent sustained resolution of his nociceptive neck pain.
CONCLUSIONS: Memantine’s optimal safety profile and effectiveness in this case make it important that more human patient research be conducted to further explore its efficacy for nociceptive pain.
KEY WORDS: Nociceptive pain, memantine, inflammation, chronic pain, case report
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| LITERATURE REVIEW |
Erick Argüello, PhD, Leonardo Bermeo, PhD,
and Javier Castillo, PhD
Abstract
BACKGROUND: Pain is essential for survival, but it is also a major clinical, social, and economic problem that demands adequate management. The latter involves timely and accurate assessment, so several efforts have been made to develop accurate and reliable pain assessment tools. Advances in objective pain assessment include a large body of work focused on determining whether autonomic-mediated peripheral responses can be used to predict pain intensity. However, there is still no clinically validated autonomic marker for objective pain assessment.
OBJECTIVES: In order to identify possible causes of this situation, the present study reviews the most recent advances examining peripheral autonomic markers’ ability to describe pain intensity.
STUDY DESIGN: Systematic literature review.
METHODS: We conducted an online search on PubMed using terms such as “pain assessment,” “experimental pain,” “autonomic arousal,” “heart rate,” “heart rate variability,” “electrodermal activity,” “pupillary diameter,” and “blood pressure.” Articles published from 2010 through 2020 examining the abilities of peripheral autonomic markers to describe experimental pain intensity were collected and reviewed. From each of the included studies, we extracted information regarding autonomic parameters and stimulation modalities used by experimenters, as well as the sample size, gender, and health condition of the patients.
RESULTS: Twenty-six articles were included for analysis, from which only 2 studies reported the use of multiple modalities. Half of the documents reported sample sizes ranging from 20 to 50 patients, and only 3 studies used formal power calculation to determine the sample size. Most of the articles included only healthy patients, so the influence of age, gender, and pre-existing health conditions on the autonomic peripheral parameters’ capabilities to reflect the experience of pain remains unexplored.
LIMITATIONS: It is possible that several documents were not retrieved due to a potential search engine bias or the use of very specific terms. Furthermore, only studies reporting pain intensity as a unique measure of its severity were included.
CONCLUSION: The measurement of autonomic responses elicited by experimentally induced pain is one crucial step toward the development of reliable pain assessment tools. Still, several issues need to be addressed before continuing to explore the use of autonomic parameters for the assessment of pain. It is also recommended that future research endeavors in capturing the singularity of the pain experience involve the measurement of both peripheral (end organs) and central (brain) autonomic responses to pain.
KEY WORDS: Pain assessment, autonomic nervous system, experimental pain research, peripheral autonomic markers, painful stimulation
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| RANDOMIZED CONTROLLED STUDY |
Margaret Anne Zielinski, BA, Natalie Eleanor Evans, BA,
Hyun Bae, MD, Evish Kamrava, MD, Aaron Calodney, MD,
Kent Remley, MD, Ramsin Benyamin, MD, Daniel Franc, MD, PhD,
Matthew R. Peterson, MD, Jessica Lovine, BA,
Hannah R. Barrows, BA, Kennedy Mahdavi, BA,
Taylor P. Kuhn, PhD, and Sheldon Jordan, MD
Abstract
BACKGROUND: Interventions for chronic discogenic spine pain are currently insufficient in lowering individual patient suffering and global disease burden. A 2016 study of platelet rich plasma (PRP) for chronic discogenic pain previously demonstrated clinically significant response among active group patients compared with controls.
OBJECTIVES: To replicate the previous research to move this intervention forward as a viable option for patient care.
STUDY DESIGN: A double-blind, randomized, placebo-controlled study.
SETTING: Multicenter private practices.
METHODS: Twenty-six (12 men, 14 women) human patients, ages 25 to 71 with a diagnosis of chronic lumbar discogenic pain, were randomly assigned to active (PRP) or control (saline) groups in a ratio of 2 active to 1 control. Baseline and follow-up Oswestry Disability Index and Numeric Pain Rating Scale questionnaires were obtained to track patient outcomes at 8 weeks postoperatively.
RESULTS: Within group assessment showed clinically significant improvement in 17% of PRP patients and clinically significant decline in 5% (1 patient) of the active group. Clinically significant improvement was seen in 13% of placebo group patients and no placebo patients had clinically significant decline secondary to the procedure.
LIMITATIONS: Possible explanations may include a range of factors including differences in patient demographics, outcome-measure sensitivity, or misalignment of statistical analyses.
CONCLUSIONS: These findings are markedly different than the highly promising results of the 2016 PRP study. This study posits necessary caution for researchers who wish to administer PRP for therapeutic benefit and may ultimately point to necessary redirection of interventional research for discogenic pain populations.
KEY WORDS: PRP; disc; growth factors; lumbar; pain; plasma; platelet; regenerative; spine; Degenerative.
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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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