Compounded by an escalating 9% inflation, this equals a 20% cut!
This is worse than we expected. Your survival is at stake - respond now!
Join ASIPP's effort to reverse these alarming trends by clicking here.
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To see sample rates compared to 2022, click here. In addition to the 4.4% cuts, some codes have faced higher reductions with very few codes facing increases. The same applies to 10.4% cuts.
In reference to ASCs, as of now, they are not proposing any cuts; however, a 6% cut will remain in effect unless the 2% sequester cut from ACA and 4% statutory PAYGO from the American Rescue Plan Act are eliminated.
The fee schedule remains stable except for a few small increases. Some of the procedures that received major increases include sacroiliac joint arthrodesis and moderate increases for peripheral nerve stimulators.
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WHY WE DID THIS STUDY
The COVID-19 pandemic created unprecedented challenges for how Medicare beneficiaries access health care. In response, the Department of Health and Human Services (HHS) and CMS took a number of actions to temporarily expand access to telehealth for Medicare beneficiaries. In addition, CMS temporarily paused several program integrity activities, including medical reviews of claims.
In a related report, the OIG found that the use of telehealth increased dramatically during the first year of the pandemic. More than 28 million Medicare beneficiaries—about 2 in 5—used telehealth services that first year. In total, beneficiaries used 88 times more telehealth services during the first year of the pandemic than they did in the prior year.
The changes to Medicare telehealth policies, along with the dramatic increase in the use of telehealth, underscore the importance of determining whether providers are billing for telehealth services appropriately and how to best protect Medicare and beneficiaries against fraud, waste, and abuse.
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Improve your techniques
with these 1.5-day hands-on CADAVER WORKSHOPS
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September 24-25, 2022
MERI, Memphis, TN | Hotel Accommodations: Hilton Memphis
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Interventional Techniques in IPM |
Basic | Intermediate | Advanced
12 AMA PRA Category I Credits™
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Peripheral Nerve Stimulation |
Interventional Techniques
12 AMA PRA Category I Credits™
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For a century, Americans have seen yearly increases in life expectancy at birth; such that we have taken it for granted that every generation will live longer than the ones before. Yet, as the latest data in 2022 reveal, we are experiencing persistent decreases in life expectancy, reaching levels not seen since 1996.
COVID-19 is partly to blame, with over 1 million COVID-related deaths having occurred over the past two years in the U.S. However, life expectancy at birth in the U.S. has been stagnating in the range of 78 years for over a decade. Furthermore, even during the pandemic years, more people have died from heart attacks and cancers than from COVID. It would, thus, be optimistic to assume that the newly recorded losses in survival are simply an aberration due to the unexpected arrival of a new and deadly infectious pathogen.
More starkly, since 2008, driven by increases in midlife mortality, and caused by several preventable conditions, all race/ethnic groups (although, starting in some groups first) have experienced decreasing life expectancy well before COVID. By contrast, the major decreases in life expectancy of the 20th century were preceded by, and followed by, major improvements in life expectancy. For example, life expectancy fell by almost 12 years in 1918, but increased by 14 years, to unprecedentedly high levels, the following year; similar recoveries were seen after decreases in life expectancy of about 2 years during both world wars.
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Register today for the CALSIPP Annual Meeting and join us for an Evening Cruise on the Bay!
Saturday, October 15 | 7:30 pm
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Enjoy an entertaining three-hour yacht cruise around Newport Bay on a two-level contemporary yacht. Take in the beautiful sights from the outdoor viewing areas on the large bow, aft deck, or by strolling the walk-around decks.
Limited tickets are available, so do not wait! Tickets are $100 per registered meeting attendee or guest and must be selected on the registration form.
Register for the meeting and select the Cruise Add On.
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Holdouts who used religious exemptions to avoid vaccination can get Novavax now
The Froedtert Health network in Wisconsin has sent a clear message to employees claiming religious exemptions from COVID-19 vaccination: with an alternative to mRNA vaccines now available, get vaccinated or resign.
In an email to a Froedtert staff member obtained by WTMJ-TV, the health network's COVID-19 Vaccine Religious Exemption Review Committee wrote, "Your original exemption submission and additional documentation you provided do not meet the criteria of explaining your sincerely held religious belief that conflicts with receiving the COVID-19 vaccine, including the new Novavax vaccine."
The religious exemption will not be upheld, despite additional comments provided that "related to opinions or non-factual information," the committee added. If the staff member does not get a first dose by September 21, they will be "considered voluntarily resigned."
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NEXT EXAM DATES:
Part I
October 22, November 19, & December 17
Part II
September 23
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Incident dementia dropped by 25% with as little as 3,800 steps per day, study found
A daily total of 3,800 to 9,800 steps was tied to lower dementia risk, longitudinal data from the U.K. Biobank showed.
The optimal dose of daily steps -- the value with the highest dementia risk reduction -- was 9,826 steps (HR 0.49, 95% CI 0.39-0.62), according to Borja del Pozo Cruz, PhD, of the University of Southern Denmark in Odense, and colleagues.
The minimal step dose -- the point at which dementia risk was half of the maximum reduction -- was 3,826 steps per day (HR 0.75, 95% CI 0.67-0.83), the researchers reported in JAMA Neurology.
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The abstract submission deadline is September 23.
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But hospitalizations among the vaccinated are on the rise
Unvaccinated adults were over 10 times more likely to be hospitalized for COVID-19 during the Omicron wave compared with those who were vaccinated and boosted, a U.S. population-based cross-sectional study showed.
Among nearly 200,000 hospitalizations recorded in the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET), monthly hospitalization rates from January 2021 through April 2022 were 3.5 to 17.7 times higher in unvaccinated people versus those who were vaccinated, irrespective of booster dose status, reported Fiona Havers, MD, MHS, of the CDC, and colleagues.
Compared with individuals who were both vaccinated and had received a booster dose during the January to April Omicron wave, hospitalization rates were 10.5 times higher in those who were unvaccinated and 2.5 times higher in those who were fully vaccinated but had not received a booster, they noted in JAMA Internal Medicine.
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Please plan to join us at the
2023 ASIPP Annual Meeting
March 16-18 National Harbor, Maryland
Register Early
More details will be posted on our website at asipp.org.
Registration begins November 2022.
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For meeting or exhibitor/sponsor information:
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Nick Carusillo died when he was hit by multiple vehicles on a Georgia interstate, just days after he was abruptly discharged from an addiction treatment center. Now his parents hope a substantial jury verdict in their favor will prompt change that helps others suffering from mental illness and substance abuse.
Carusillo died on Sept. 22, 2017, and his parents filed a wrongful death lawsuit in 2019 against the facility that released him and several people who were responsible for his care there. A jury just outside Atlanta awarded them a total of about $77 million last week — $10 million for their son’s pain and suffering, $55 million for the value of his life, $1 million in punitive damages and the remainder for attorneys’ fees and expenses.
“This verdict, for us, is validation,” Tina Carusillo told The Associated Press in a phone interview Wednesday.
“It wasn’t his fault. He was caught up in a bad system,” she said. “I’m hopeful that the size of this verdict makes a lot of people pay attention, from insurance companies to facilities to parents to loved ones to people seeking treatment.”
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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 |
Vishal Pratap Varshney, MD, and Jillian Alison Osborn, MD, PhD
Abstract
BACKGROUND: Kienbock’s disease, or osteonecrosis of the lunate, is associated with a history of pain and weakness of the affected wrist. To date, no reports have been published demonstrating use of spinal cord stimulation (SCS) for management of this disease. The patient provided HIPAA compliant informed consent for the inclusion of their clinical information in this report.
CASE REPORT: A 31-year-old woman presented with a 10-year history of right wrist pain, absent of a history of trauma, that did not improve with conservative therapy, found to be secondary to avascular necrosis of the right lunate bone. A spinal cord stimulator trial and implant were subsequently performed, demonstrating a 75% reduction in pain intensity with paresthesia-free stimulation at 8-week follow-up and return to work.
CONCLUSIONS: SCS can help significantly improve symptoms and function in patients with Kienbock’s disease.
KEY WORDS: Spinal cord stimulation, Kienbock’s disease, vascular disease, case report
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| RETROSPECTIVE STUDY |
Wu Tao, MD, Wang Biao, MD, Chen Xingmei, MD, Qin Hu, MD, Sun Jinpeng, MD, Gu Yue, MD, and Liu Jun, MD
Abstract
BACKGROUND: Adjacent vertebral fracture (AVF) seemed to be a frequent and severe complication in osteoporotic vertebral compression fracture (OVCF) patients receiving percutaneous vertebroplasty or percutaneous kyphoplasty (PKP), resulting in poor long-term outcome and recurrence of pain-related symptoms. Nonetheless, its mechanism remains unclear.
OBJECTIVES: To investigate the potential predictor of AVF after PKP and figure out whether the intervertebral disc plays a role during the process of AVF.
STUDY DESIGN: Retrospective study
SETTING: Department of Orthopedic, an affiliated hospital of a medical university.
METHODS: Clinical data of OVCF patients receiving PKP were reviewed in our hospital from January 2016 to December 2020. Four hundred and forty-five patients were recruited who met the abovementioned criteria in this study. The clinical data, including age, gender, bone mineral density (BMD), vertebral height, vertebral kyphosis angle, cement volume, cement distribution, as well as adjacent disc degeneration extent, were recorded for each patient. Independent-sample t tests and chi-squared tests were performed to compare these indexes. Bivariate correlation tests and multiple linear regression analyses were performed among potential predictors. Receiver operator characteristic (ROC) analysis and Kaplan-Meier plotter were applied to evaluate the diagnostic efficiency of parameters for predicting the occurrence of AVF.
RESULTS: Patients in both groups gained obvious improvements in symptomatic and radiographic indexes after first PKP. Statistically significant difference (P < 0.05) was only found between 2 groups with respect to BMD, kyphosis angle at last follow-up before second PKP, cement distribution, and disc degeneration grade. The ROC analysis showed that BMD <= -3.45 was weakly associated with AVF after PKP (sensitivity, 33.3%; specificity, 40.4%; area under curve, 0.324, P = 0.000). In addition, kyphosis angle at last follow-up before second surgery >= 15.5° was highly predictive of AVF after PKP (sensitivity, 92.2%; specificity, 24.6%; area under curve, 0.569, P = 0.109). Statistically significant difference of AVF incidence amongst patients with different cement distribution (P = 0.018) and similar trend was also found amongst patients with different disc degeneration (P = 0.000). Statistically significant difference was noted in terms of disc degeneration grade between 2 adjacent discs in AVF group.
LIMITATIONS: The main limitation is the retrospective nature of this study.
CONCLUSIONS: The risk of AVF should be focused, especially when OVCF patients with the following predictors: (1) BMD < -3.45; (2) kyphosis angle at last follow-up > 15.5°; (3) I or II cement distribution; and (4) IV or V disc degeneration. More prophylactic treatment should be prescribed for these patients to avoid the occurrence of AVF.
KEY WORDS: Predictive factors, adjacent vertebral fracture, percutaneous kyphoplasty, osteoporotic vertebral compression fracture
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| RETROSPECTIVE STUDY |
Hannu Heikkila, MD, PhD, and Aet Ristmagi, MD
Abstract
BACKGROUND: Preoperative exposure to opioids has recently shown to be associated with poor outcomes after elective major surgery, but little is known as to how pretreatment opioid use affects results of interventional back pain management.
OBJECTIVE: We aimed to determine the effect of pretreatment opioid use on outcomes after interventional pain management procedures on patients with chronic back pain.
STUDY DESIGN: A retrospective study.
SETTING: Department of Physical Medicine and Rehabilitation at Satakunta Central Hospital (Satasairaala), Finland.
METHODS: A high-volume, single-center, quality register analysis was performed on patients who underwent interventional pain management for suspected facet-mediated chronic back pain as a part of a multidisciplinary pain management program. Chronic opioid use was defined as having a concurrent opioid prescription for 90 days.
RESULTS: A total of 797 patients underwent an intervention during the study period from August 1, 2019 through December 31, 2020. Pretreatment opioid use was present in 262 patients (33%). Patients with chronic back pain using opioids reported significantly more pain and discomfort before treatment as well as lowered working ability. Facet joint medial branch blocks resulted in significant improvement for both groups directly after the treatment as well as at 2-hours follow-up. However, the nonopioid group reported significantly more improvement at 2-days follow-up as well as at one month follow-up compared to opioid users. Opioid users reported nearly the same pain level at one-month follow-up as they did before treatment.
LIMITATIONS: As a single-center analysis, these data may not be generalizable to other institutions. A retrospective study may include inevitable bias. The disease processes themselves may possibly predispose patients to different degrees of opoid use. Although we have identified preoperative opioid use as a risk factor for treatment failure, we were unable to determine the size of the association based on our statistical analysis and sample size. Pain intensity evaluation using the visual analog scale is inevitably subjective.
CONCLUSION: Pretreatment opioid use is associated with greater pain discomfort, impairment, and reduced functional ability, as well as poorer long-term effect of interventional back pain treatment at one-month follow-up. In our study, opioid users reported the same positive effects of facet joint nerve blocks immediately after the treatment and 2 hours after the treatment, but a significantly smaller effect at one-month follow-up. This could indicate that opioid use may diminish the effects of pain treatments by affecting relearning, behavioral changes, and central pain modulation. These findings may help providers understand the effect of pretreatment opioid use on patient care, and its implications on hospital and societal costs.
KEY WORDS: Opioids, interventional pain management, medial branch block, outcome
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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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