March 26, 2020
A Message from NJSIPP President Charles Daknis, M.D.
During this time of crisis, the New Jersey Society of Interventional Pain
Physicians wishes to provide guidance for our membership during the COVID 19
outbreak especially in light of Governor Murphy’s Executive Order 109.
Members should understand that the society fully supports current state and
CDC guidelines for restricting elective cases. Interventional treatments including
injection therapy may be necessary to prevent our patients from visiting the
Emergency Room and overburdening the professionals currently on the front line
of this disaster. If a patient is able to wait without significant compromise to their
health their interventional procedure should be postponed. However, if your
patient(s) comorbidities and pain problem are likely to lead to an Emergency
Room visit then an interventional technique may be appropriate to conserve
resources for treatment of the COVID 19 outbreak.
Strictly elective cases are not recommended and are prohibited as of March 27,
2020 by state order. The Society wishes to emphasize that during this crisis
individual physicians need to use best judgement to preserve the health of their
patients as well as limit the spread of COVID19 in the community. In short… it is
not business as usual. While we realize the significant impact, this will have on
the sense of wellness to our patient population it is our duty to protect the
community at large as well as our individual patients.
Please be aware that all practices will be required to submit an inventory of PPE.
A message from the Division of Consumer Affairs will be coming out later today
with more details. The Society will provide more specific information as soon as
This guidance is advisory only and does not constitute legal or coding advice.
Thank you. Please stay alert for further messages as more urgent information will
be coming out this week.
Dr. Woska being honored for his service to our society as the Executive Director for the past 5 years. We congratulate him for all the time and effort that he put forth and the excellent job that he did.
URGENT - Medicare proposed reduction in sacral and knee RF reimbursement
This topic was discussed the NJSIPP meeting on Wednesday night. It is Urgent you respond - there are only 10 days left!!!
Medicare has proposed to significantly decrease the payment rates for both the physician and the facility setting for the new knee and SIJ radiofrequency ablation CPT codes that are effective January 1, 2020. These new codes will impact all RFA technologies, both cooled and conventional.
1. review the proposed rules and provide comments to Medicare. The deadline for comments is September 27, 2019. Links to the proposed rules and information on how to submit comments are noted at the end of this e-mail. It is very important that Medicare receives comments from as many stakeholders as possible before the Final Rules are released later this year.
2. connect with your societies who participated in the new CPT code development process to express your concerns and encourage them to comment on the proposed rules as well.
Here are some important key facts from the proposed rules:
- Physician Rule – The proposed physician RVU valuation for the new CPT code for RFA in the knee has significantly decreased from the current peripheral nerve ablation RVUs. Avanos believes the reduction in rate is not appropriate and will likely result in a decrease in usage of this non-opioid alternative to treating pain. Avanos plans to raise this issue in its comment letter.
- Physician & HOPD Rules – The new Knee RFA CPT code was developed to report 3 nerve ablations during a single procedure versus the current peripheral nerve ablation code where reporting is on a per ablated nerve basis.
- HOPD Rule – The hospital outpatient facility payment for the knee RFA procedure has significantly decreased. The new knee RFA CPT code was assigned to the Nerve “Injection” APC (Ambulatory Payment Classification) unlike the new SIJ procedure CPT code which was assigned to the Nerve “Procedure” APC. Avanos believes that the knee RFA procedure should be properly placed in the Nerve Procedure APC and intends to address this in its comment letter.
The following table provides a snapshot of the proposed changes in Medicare National average payment rates:
- Physician Rule – The proposed physician RVU valuation for the new code for SIJ RFA procedures has significantly decreased from the current peripheral nerve ablation RVUs. Avanos believes the reduction in rates is not appropriate and will likely result in a decrease in usage of this non-opioid alternative to treating pain. Avanos plans to raise this issue in its comment letter.
- Physician & HOPD Rules – The new SIJ RFA CPT code was developed to report 3 nerve ablations during a single procedure versus the current peripheral nerve ablation code where reporting is on a per ablated nerve basis.
- The following table provides a snapshot of the proposed changes in Medicare National average payment rates.
Submit your online comments related to CMS Proposed HOPD:
Submit electronic comments on this HOPD regulation to:
Follow the instructions under the “Comment Now” tab. Reference Rule CMS-1717-P.
Submit your online comments related to CMS Proposed Physician:
Submit electronic comments on this Physician regulation to:
Follow the instructions under the “Comment Now” tab. Reference Rule CMS-1715-P.