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 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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AMA Webinar: Thriving in Practice - Staywell Performance Story

Register here for a webinar on May 22 at 12 pm CT to hear a long-time physician share her practice's journey through the phases of transformation and how both the struggles and the triumphs have prepared the practice tea...
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E/M Services and Procedures on the Same Day: When Can You Report Both?

According to CPT, both an Evaluation and Management (E/M) service and a procedure code can be reported if the patient's condition requires a significant, separately identifiable E/M service. "Significant" implies that th...
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New Part D Opioid Overutilization Policies

CMS implemented new opioid policies for Medicare drug plans effective January 1, 2019. Medicare Part D enrollees who have not filled an opioid prescription recently (within the last 60 days) will be limited to up to a 7-...
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PCSS Discussion Forum: A Quick, Evidence-Based Resource from Clinical Experts

The PCSS Discussion Forum provides the opportunity for health professionals to discuss clinical practices around substance use disorders and opioid use disorder with colleagues and addiction and pain experts. (Sign up is required.) 

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