Practice Management

Pain physicians are not only highly trained in the many treatment approaches of pain medicine, but are often required to run successful pain businesses. This section offers practical tools and resources for you to use in your pain practice. Coding, policies, patient education and other helpful information will support your daily practice decisions and business needs. This area is also a favorite of office managers and other support staff.

Latest News and Updates

CMS Re-Calculates 2017 MIPS Final Scores
September 26, 2018 [Source: Emily Hill, PA, AAPM Coding Consultant]
Under the Merit-Based Incentive Payment System (MIPS), CMS (Centers for Medicare and Medicaid Services) must provide practices with performance feedback based on the data reported for the prior year.
Full story.

AMA and Medical Groups Respond to the CMS Proposed E/M Changes
September 12, 2018 [Source: Emily Hill, PA, AAPM Coding Consultant]
As noted in a previous e-news article, CMS proposed extensive changes to documentation and payment for new and established office visit Evaluation and Management (E/M) services in the July 27, 2018 Federal Register. CMS proposed a new, single blended payment rates for new and established patients for office/outpatient E/M level 2 through 5 visits. In conjunction with that, documentation requirements would be significantly reduced as part of its “Patients Over Paperwork” Initiative.
Read more.

UC San Diego Offers Course on Management of Low Back Pain and Osteoarthritis: Current and Future Treatments
This course will be held on September 22 at UC San Diego, and is designed to improve knowledge on shared pathophysiological mechanisms between osteoarthritis (OA) and low back pain (LBP), which will enhance competence in the diagnosis and directed treatment planning of OA and LBP.
For more information.

Johns Hopkins Experts Create Opioid Prescribing Guidelines for 20 Common Surgical Procedures
August 14, 2018 [Source: Johns Hopkins Medicine]
The guidelines are based on the premise that opioid prescribing limits should be based on the operation performed rather than a blanket approach.
Full story.

Highlights of the CMS Proposed Rule for the Quality Payment Program
August 8, 2018 [Source: Emily Hill, PA, AAPM Coding Consultant]
The CMS Proposed Rule for the Quality Payment Program (QPP) addressed several key changes to the 2019 QPP. The Rule expands the definition of MIPS (Merit-Based Incentive Payment System) eligible clinicians to include physical therapists, occupational therapists, clinical social workers, and clinical psychologists and provides additional flexibilities for small physician practices.
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CMS Releases Proposed Rule for 2019
July 23, 2018 [Source: Emily Hill, PA, AAPM Coding Consultant]
On July 12, 2018, the Centers for Medicare and Medicaid Services (CMS) released the 2019 Medicare Physician Fee Schedule (PFS) and Quality Payment Program (QPP) Proposed Rule. This is the first time that CMS has combined the two programs into a single proposed rule. CMS is requesting comments on the proposed rule by September 10, 2018, and a final rule is expected to be released in November.
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Proposed Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2019
July 12, 2018 [Source: CMS]
On July 12, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that includes proposals to update payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2019.
Full story.

Clinical Documentation Improvement (CDI): Initiating a Program for Your Practice
July 11, 2018 [Source: Emily Hill, PA, AAPM Coding Consultant]
CDI has been described as the process of improving healthcare records to ensure improved patient outcomes, data quality, and accurate reimbursement. Historically this has been a hospital-based program that may have important applications to physician practices. Last month, we reviewed the basics of CDI. It is now time to consider the steps of incorporating this into your office-based practice.
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RUC Survey of CPT Codes for Injection of Somatic Nerves
June 20, 2018 [Source: Emily Hill, PA, AAPM Coding Consultant]
Next week we will be contacting a random selection of members to participate in an important AMA/Specialty Society Relative Value Scale Update Committee (RUC) survey of physician work for several somatic and genicular nerve injection CPT codes. In the survey, you may be asked to provide information on several codes, two of which are new to CPT and six of which are established codes.
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What Is CDI and How Does It Impact You?
June 6, 2018 [Source: Emily Hill, PA, AAPM Coding Consultant]
CDI (Clinical Documentation Improvement) has been described as the process of improving healthcare records to ensure improved patient outcomes, data quality, and accurate reimbursement. Hospitals began CDI programs as a response to the advent of DRGs (Diagnosis Related Groups) as a form of reimbursement. Most physicians have experienced the request for supplementary documentation to support additional or more specific ICD codes to enhance hospital reimbursement and data collection.
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