Interesting clawback from Humana
Got a "refund request" from our good friends at Humana today. Clawing back two 99204s and one 99214 because "diagnosis code(s) are inappropriate". The only code all three charts have in common is G894 chronic pain syndrome. None of them use it as a primary or even secondary diagnosis, but as a 3rd or 5th diagnosis. Just a heads up don't use that code at all for Humana pts. (Source: Student Doctor Network)
Source: Student Doctor Network - April 19, 2024 Category: Universities & Medical Training Authors: drrosenrosen Tags: Pain Medicine Source Type: forums
SCS doesn ’t work?
Evidence doesn’t support spinal cord stimulators for chronic back pain – and they could cause harm
A recent Four Corners episode questioned the use of surgically implanted devices called spinal cord stimulators for chronic back pain. Here’s what the evidence says.
theconversation.com (Source: Student Doctor Network)
Source: Student Doctor Network - April 12, 2024 Category: Universities & Medical Training Authors: lobelsteve Tags: Pain Medicine Source Type: forums
Compression fx FJI vs RFA for post element tx
Is there any dif in doing a FJI vs Mbb/RFA in treating posterior elements for chronic compression fractures. I did a mbb and RFA on a patient with T11, T12 old comp fractures. Did pretty well with first RFA, 2nd RFA with less benefit. Saw a surgeon who said of course it didnt work do a facet injection instead. Not sure if there is any data on one being superior to the other specfically for treating posterior comp for chronic compression fx.
I havent found anything other then case...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - April 5, 2024 Category: Universities & Medical Training Authors: schmee90 Tags: Pain Medicine Source Type: forums
VIV TMVR with Sapien 3
80 y/o s/p cabg 20 years ago. Redo sternotomy for severe Mitral regurgitaiton 15 years ago.
Other hx: Bil Fem-pop bypass, h/o stroke, severe COPD and severe pulm htn on ATC O2.
Chronic pain, CKD, etc.
Presented at valve conference for failure of mitral bpv. Mean gradient of 15 mmHg.
It was decided that we would proceed with VIV TMVR with a Sapien 3.
On paper, it sounded like a bad idea. Once I met the patient, it was clear to me she wanted this done as her severe MS was going to...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - March 12, 2024 Category: Universities & Medical Training Authors: sevoflurane Tags: Anesthesiology Source Type: forums
WEBINAR: Early Career Spine Professionals - Working with Multidisciplinary Colleagues
Presented by the North American Spine Society (NASS)
This webinar is designed to enhance your collaborative skills and effectiveness in a multidisciplinary healthcare setting. In today's dynamic medical landscape, successful patient outcomes often rely on seamless cooperation and communication among diverse specialists. Whether you're involved in Medical and Interventional Spine Practice, Ketamine and Chronic/Comprehensive Pain Practice, or Surgical Spine Practice...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - March 8, 2024 Category: Universities & Medical Training Authors: NASS Tags: Nonprofit / Educational / Student Orgs Source Type: forums
Re: Chronic prostatitis (chronic pelvic pain syndrome)
(Source: BMJ Comments)
Source: BMJ Comments - January 5, 2024 Category: General Medicine Source Type: forums
Nevro Acquires Vyrsa
I can't wait for the debrief on this at NANS...together, we are stronger.
Nevro Announces Acquisition of Vyrsa™ Technologies
Nevro Corp. (NYSE: NVRO), a global medical device company that is delivering comprehensive, life-changing solutions for the treatment of chronic pain, today announced that it has acquired Vyrsa Technologies ("Vyrsa"), a privately held medical technology company focused on a minimally invasive...
nevro.com (Source: Student Doctor Network)
Source: Student Doctor Network - December 2, 2023 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums
Re: Chronic prostatitis (chronic pelvic pain syndrome)
(Source: BMJ Comments)
Source: BMJ Comments - November 22, 2023 Category: General Medicine Source Type: forums
How do you manage patient expectations?
Every so often, I may get a referral from a PCP as their patient gradually became a chronic opioid user for various conditions I wouldn't necessarily prescribe opioids for. The expectation that I run into often times revolves around the patient coming with the idea they will be getting opioids from me (at equivalent dosing or higher), but unfortunately what they are met with is optimizing non-opioid options along with the offering to down-titrate opioids. Understandably, this is often met...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - November 17, 2023 Category: Universities & Medical Training Authors: Slowpoke Tags: Pain Medicine Source Type: forums
SCS trial, splenectomy
78 yo M with FBSS and he's s/p splenectomy on acyclovir, fluconazol and PRN levofloxacin. He's got chronic leukopenia. Scheduled for trial next week and WBC 1.0 today. PLT normal.
What does everyone do in this situation? He's miserable.
Thinking move forward with the trial and be meticulous with sterile technique. Hibiclens BID x 3d prior. Keflex PO TID during the trial, which would be shortened to 3 days.
Reasonable? (Source: Student Doctor Network)
Source: Student Doctor Network - November 7, 2023 Category: Universities & Medical Training Authors: MitchLevi Tags: Pain Medicine Source Type: forums
Does advanced imaging guide therapy
I’m a PMR/spine specialist and was curious if MRIs help you all when treating chronic neck and/ or low back pain? If so can you give specific examples of how it would guide your treatment plan in both the neck and low back.
Appreciate all that you do (Source: Student Doctor Network)
Source: Student Doctor Network - September 22, 2023 Category: Universities & Medical Training Authors: clubdeac Tags: Physical Therapy Source Type: forums
Word-play will not mitigate suffering ... Re: Chronic pain is not merely a physical sensation
(Source: BMJ Comments)
Source: BMJ Comments - September 6, 2023 Category: General Medicine Source Type: forums
Inpatient Call
For hospital employed physicians, are you expected to take chronic pain inpatient call at your institution in addition to your clinic/procedure days? If yes, is there always midlevel coverage including weekends? (Source: Student Doctor Network)
Source: Student Doctor Network - August 11, 2023 Category: Universities & Medical Training Authors: nynydoc Tags: Pain Medicine Source Type: forums
Re: Chronic pain: definitions and diagnosis
(Source: BMJ Comments)
Source: BMJ Comments - August 3, 2023 Category: General Medicine Source Type: forums
