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

Prior Authorization and the Physician Practice
September 27, 2017 [Source: Emily Hill, PA, AAPM Coding Consultant]
Prior authorization is a cost-control process used by health plans that require physician practices to obtain approval for services in order to qualify for reimbursement. The lack of transparency and the inefficiency associated with prior approval programs are frequently costly to physician practices and may delay patient treatment.
Read more...

Get Ready for ICD-10-CM 2018
September 13, 2017 [Source: Emily Hill, PA, AAPM Coding Consultant]
The ICD-10-CM update for 2018 becomes effective October 1, 2017. The 2018 edition contains 360 additions, 142 deletions and 226 revisions for a total of 71,704 ICD-10-CM codes. The ICD-CM code set in the United States is maintained by the ICD Coordination and Maintenance Committee.
Read more...

Unexpired Lots of Oxytocin Compounded with Either Lactated Ringers or Lactated Ringers and Dextrose by PharMEDium - Recall - Sub-Potency
September 1, 2017 [Source: FDA]
ISSUE: PharMEDium Services, LLC (PharMEDium) is voluntarily recalling all unexpired lots of Oxytocin compounded with Lactated Ringers and all unexpired lots of Oxytocin compounded with Lactated Ringers and Dextrose products that were produced between July 6, 2017 and August 29, 2017 to the hospital/user level.
Full story...

AMA Develops Customizable MIPS Tool
August 23, 2017 [Source: Emily Hill, PA, AAPM Coding Consultant]
Beginning in 2019, your Medicare reimbursement may be adjusted based on your participation in the CMS Quality Payment Program (QPP). The QPP was authorized under MACRA (Medicare Access and CHIP Reauthorization Act of 2015) with the intent of shifting payments from a volume based program (fee-for-service) to a value-based program based on quality measures and outcomes.
Read more...

Express Scripts to Limit Opioids for First Time Users: 4 Things to Know
August 21, 2017 [Source: Becker’s Hospital Review]
Express Scripts — the nation's largest pharmacy benefit manager — will begin limiting the potency and number of opioid painkillers prescribed to first-time users, according to a report from CBS News and the Associated Press.
Here are four things to know...

Express Scripts Limits on Opioids Rankles Physicians
August 22, 2017 [Source: Medscape]
AAPM President Steven P. Stanos, DO and AAPM Foundation President Charles Argoff, MD are interviewed in Medscape regarding the new polices to limit opioids by Express Scripts.
Full story (login required)...

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.
Read more...

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.
Read more...

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.
Full story...

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.
Read more...