Washington Society of
Interventional Pain Physicians

Our Mission: To promote the development and practice of safe, high quality, cost-effective
interventional techniques for the diagnosis and treatment of pain and related disorders,
and to ensure patient access to these interventions.

For our Members

The Healthcare Technologies Assessment committee is charged by the Governor of WA to determine if value is present in the state's expenditures on healthcare. Large expense items are being reviewed. If a non-coverage recommendation is made by the committee, the decision is likely to be respected by all the state healthcare coverages, ie L&I, DSHS, Healthy Options and UMP.

The 2010 agenda has a disproportionate number of IPM procedures.

Selected Technologies
1. Vertebroplasty / Kyphoplasty / Sacroplasty
2. Spinal Cord Stimulation
3. Breast MRI
4. Hyaluronic Acid
5. MRI or CT for the Abdomen / Pelvis
6. Routine Ultrasound for Pregnancy
7. ABA Therapy for Autism
8. Spinal Injections - quite nebulous. Needs to be individualized by diagnosis,
intervention, region, diagnostic versus therapeutic.
9. Knee Surgery - Replacement

Provocation Discography - HTA decision for non-coverage

The decision only denies coverage of provocation discography for uncomplicated degenerative discs with back pain. If the DDD is accompanied by other clear indicators for surgery, such as instability or stenosis and or neurologic impairment, then discography should be covered. UMP has been issuing denials wrongfully. They even include language such as investigational and experimental. If you receive a wrongful denial you should write an apeal for reconsideration, attach the HTA decision and give your reasoning for calling this comlicated DDD.

WSIPP thinks the decision was wrongful. Provocation discography is a diagnostic test that should be able to be performed as freely as others. Fusion is not the only possible treatment for painful DDD. A proper diagnosis helps guide treatment, surgical, minimally invasive or non-invasive and helps us counsel patients.

Implantable Pumps for chronic non-cancer pain - HTA Final Decision

The bottom line is they will not be covered for patients covered under state agencies.

Noridian proposed facet coverage - Thanks to Dr Jasper for discovering the problem and a big thnaks to Dr Dreyfuss for the presentation made at the Noridian CAC on behalf of all interventional pain physicians in the Noridian Regions. Dr Dreyfussthe also orchestrated an effort of about a dozen different societies to respond to this matter with a joint letter. Dr Manchikanti via ASIPP also sent a letter. The result will be a coverage LCD for facet interventions that require fluoro, contrast, 80% relief on diagnostics x 2 prior to neurolysis, acceptance of both therapeutic facet injections and neurolysis with some limitations. Please refer directly to the Noridian draft LCD for details. An open comment period will extend from May until August, at which pint the final policy will likely be released.

Specialty Designation

We are faced with the need to increase our 09 Interventional Pain Management specialty designation. Currently CMS claims there are too few IPM physicians, which negatively affects our reimbursement. Interventional Pain Physicians can now change their specialty code designation to 09 utilizing the CMS form CMS855I - see page 8, section D.

Board Certification

Check out ABIPP certification