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 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.
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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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Hospira Issues a Voluntary Nationwide Recall for Two Lots of Naloxone Hydrochloride Injection, USP, in the Carpuject™ Syringe System due to the Potential Presence of Particulate Matter
June 4, 2018 [Source: FDA]
Hospira, Inc., a Pfizer company, is voluntarily recalling lots 72680LL and 76510LL of Naloxone Hydrochloride Injection, USP, 0.4 mg/mL, 1 mL in 2.5 mL, Carpuject Single-use cartridge syringe system (NDC 0409-1782-69), to the hospital/institution level due to the potential presence of embedded and loose particulate matter on the syringe plunger.
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Reinventing Medical Practice Discussion - Telemedicine in Practice – From Laws and Licensure to Adoption and Payment
May 29 - June 8, 2018 [Source: AMA]
Share ideas and innovative ways to build a thriving medical practice and improve patient satisfaction. Join the Reinventing Medical Practice digital community and connect with physician and other practice leaders to share insights and projects that drive you to have a greater impact on the practice of medicine and the health of patients. You do not have to be a physician or AMA member to join this community.
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New Medicare Beneficiary Identifiers (MBIs) Ready for Use
May 9, 2018 [Source: Emily Hill, PA, AAPM Coding Consultant]
Some Medicare beneficiaries are receiving new Medicare cards with new Medicare Beneficiary Identifiers (MBIs). The MBIs are 11 characters in length and will use randomly selected numbers and upper case letters. The new cards and numbers are being issued in phases by geographic location.
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Walmart Introduces Additional Measures to Help Curb Opioid Abuse and Misuse
May 7, 2018 [Source: Walmart]
Within the next 60 days, Walmart and Sam’s Club will restrict initial acute opioid prescriptions to no more than a seven-day supply, with up to a 50 morphine milligram equivalent maximum per day. This policy is in alignment with the Centers for Disease Control and Prevention’s (CDC) guidelines for opioid use. Where state law for fills on new acute opioid prescriptions is less than seven days, Walmart and Sam’s Club will follow state law.
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AAPM Immediate Past President Steven P. Stanos, DO, responds to the new Walmart policy in this NPR interview.

CMS Releases Tool to Check Your MIPS Eligibility
April 18, 2018 [Source: Emily Hill, PA, AAPM Coding Consultant]
CMS has recently released its updated MIPS Eligibility Lookup Tool. Enter your NPI number to determine if you need to participate in the MIPS program in 2018. Providers who meet the established low volume threshold do not need to participate.
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