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

Getting Ready for the Change in Medicare Cards
August 9, 2017 [Source: Emily Hill, PA, AAPM Coding Consultant]
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires CMS to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. A new Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number (HICN) on the new Medicare cards for Medicare transactions like billing, eligibility status, and claim status.
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CMS Releases 2018 Physician Fee Schedule Proposed Rule
July 26, 2017 [Source: Emily Hill, PA, AAPM Coding Consultant]
The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that updates payment policies and payment rates for services furnished under Medicare’s Physician Fee Schedule (PFS) on or after January 1, 2018. CMS will accept comments on the proposed rule until September 11, 2017 and will respond to the comments in a final rule to be released in November 2017.
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ADA asks FDA to Expand Opioids Efforts to Include Managing Dental Pain
July 18, 2017 [Source: American Dental Association (ADA)]
The ADA is asking the Food and Drug Administration to better address the nuances of managing dental pain in its opioid prescriber education and training programs.
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Changes to Reporting 10- and 90- Day Global Codes to CMS
July 12, 2017 [Source: Emily Hill, PA, AAPM Coding Consultant]
The Centers for Medicare and Medicaid Services (CMS) is implementing new mandatory post-operative visit reporting requirements for patients with traditional Medicare. The requirement went into effect July 1, 2017 and impacts select procedures provided in certain states and provider groups.
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CMS Issues Proposed Rule for the 2018 Quality Payment Program
June 21, 2017 [Source: Emily Hill, PA, AAPM Coding Consultant]
The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would make changes in the second year of the Quality Payment Program (QPP) as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). As a reminder, the Quality Payment Program has 2 tracks: (1) The Merit-based Incentive Payment System (MIPS) and (2) Advanced Alternative Payment Models (Advanced APMs).
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Closing the Referral Loop Project
June 20, 2017 [Source: PCPI]
PCPI and the Wright Center for Graduate Medical Education (WCGME) have released the Closing the Referral Loop (CRL) Tool Kit based on their successful quality improvement collaborative that focused on improving the referral management process between primary care and specialist physicians. Participants moved from a 40% to 70% closed referral rate.
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New AMA Video shows Physicians How to Avoid Medicare Payment Penalties
June 16, 2017 [Source: AMA]
The Quality Payment Program (QPP) is new this year, and the American Academy of Pain Medicine and the AMA want to make sure physicians know what they have to do to participate and the QPP's "pick your pace" options for reporting. You can pick your pace of reporting for 2017 under the Merit-based Incentive Payment System (MIPS) of the QPP. View this video to learn how to avoid a negative 4% payment adjustment in 2019 by reporting on one measure for one patient via CMS' claim form before the end of 2017.
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LexisNexis Risk Solutions and AMA Launch Verify Health Care Portal
June 7, 2017 [Source: AMA]
LexisNexis® Risk Solutions and the American Medical Association (AMA) have launched the Verify Health Care Portal, the clinician attestation component of VerifyHCP, a robust solution for monitoring physician information that simplifies a successful data strategy for managing a health plan network. (Please note that AMA membership is not required to use the resource. The only current requirement is that you must be in the network of at least one participating Payer.)
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Coding Refresher: Paravertebral Facet Joint Nerve Destruction Codes (64633-64636)
June 7, 2017 [Source: Emily Hill, PA, AAPM Coding Consultant]
Although codes 64633-64636 were introduced in 2012, there continues to be confusion about how to appropriately report these services. The codes are based on the number of facet joints that are treated. The number of nerves injected does not affect code selection.
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CMS Releases Electronic Clinical Quality Measures (eCQMs)
May 24, 2017 [Source: Emily Hill, PA, AAPM Coding Consultant]
CMS has released the eCQMs that may be used to electronically report 2018 clinical quality measure data for CMS quality reporting programs. The measures, while fully specified, will not be eligible for 2018 reporting unless they are proposed and finalized through notice-and-comment rulemaking for each applicable program.
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