Content in this section will include the coding article written by Emily Hill, recommendations, guidelines, or any other updates that may have a direct impact on the way pain clinicians practice.

CMS Issues Final Rule for Physician Fee Schedule for 2020

The Centers for Medicare & Medicaid Services (CMS) issued its Final Rule for 2020 that that includes proposals to update payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS). As proposed, the 2020 PFS conversion factor is $36.09 which is $0.05 above the 2019 conversion factor. The conversion factor is multiplied by the total adjusted Relative Value Units (RVUs) to achieve a payment amount for the services included in the Medicare Physician Fee Schedule.

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Medicare Contractor Proposes Changes to Coverage Policy for Percutaneous Vertebral Augmentation (PVA)

  The Medicare Administrative Contractor, National Government Services, Inc.(NGS), released a future Local Coverage Determination for PVA Osteoporotic Vertebral Compression Fractures effective December 1, 2019. The ...
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Understanding the CMS Proposal for Opioid Treatment Services

AAPM members have asked about the impact on their practices of the CMS proposal for opioid treatment services. Starting January 1, 2020 the Centers for Medicare & Medicaid Services (CMS) plans to pay Opioid Treatment Programs (OTPs) for opioid use disorder (OUD) treatment services, including medication-assisted treatment (MAT) medications, toxicology testing, and counseling, when given to people with Medicare Part B.

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Understanding CPT, RUC and the 2020 Proposed Rule

The Proposed Rule for the 2020 Physician Fee Schedule proposes values for intrathecal/epidural pump procedures (CPT codes 62367-62370), the new codes for injection and ablation of genicular nerves (temporary CPT 64XX0 and 64XX1) and sacroiliac joint (temporary CPT 6XX00 and 6XX01), and somatic nerve injections (CPT codes 64405, 64418, 64420, 64421, 64425, 64430, and 64450).

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CMS Releases Proposed Rule for the 2020 Physician Fee Schedule

On July 29, 2019, 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 January1, 2020. CMS is requesting comments on the proposed rule by September 27, 2019, and a final rule is expected to be released in November. The proposed rule estimates a conversion factor (CF) of $36.09 which is a slight increase from the 2019 CF of $36.04. 

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CMS Proposes Payment for Acupuncture

CMS has announced a proposal to cover acupuncture for certain Medicare patients with chronic low back pain (CLBP). To be covered, patients must be enrolled participants either in clinical trials sponsored by the National...
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ICD-10 Changes for 2020 Released

The ICD-10-CM update for 2020 has been released. The 2020 ICD-10-CM codes are to be used from October 1, 2019 through September 30, 2020. The 2020 edition contains 273 additions, 30 code revisions and 21 deletions.  

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ICD-11: What It Means for Your Practice

The World Health Organization (WHO) adopted the eleventh revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-11) at its World Health Assembly meeting in May 2019. It addition to other major changes, ICD-11 includes a new classification for chronic pain as well as new groups of codes for chronic pain conditions. After a decade of preparation, ICD-11 will become effective in January 2022. The advance release allows countries to plan how to use the new version and train health professionals.

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World Health Assembly of the WHO Approves 11th Version of the International Classification of Diseases (ICD-11), Including New Diagnostic Codes for Chronic Pain

  ICD-11 will improve patient care by facilitating multimodal pain treatment and by boosting efforts to measure the quality and effectiveness of care and new research on the prevalence and impact of chronic pain Ful...
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Medicare Launches Initiative for Documentation Look-Up Tool

Medicare recently announced a plan to streamline the process of finding coverage and documentation requirements for applicable services. Currently, documentation requirements appear in various locations and on separate websites requiring physicians and staff to navigate multiple websites for information.

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