7 important Q&As on ERAS, multimodal pain management for orthopedics and spine

Written by Laura Dyrda | November 19, 2018 | Print  |

Orthopedic and spine surgery is headed to the outpatient setting. However, surgeons must ensure their patients receive high quality care to return home within 24 hours of surgery, if possible without opioids.

The CMS 2019 final payment rule for hospital outpatient surgery departments and ASCs includes a new code for non-opioid pain management drugs. CMS will now make separate payments for non-opioid pain management drugs for ASCs. The only HCPCS code falling into this category is Exparel, from Pacira Pharmaceuticals, which will now receive separate payment when used in the ASC.

To learn more about the new CMS rule as well as hear from ASC owners, administrators and leaders in ASC billing and coding on their experiences with Exparel, register for this webinar.

Here are three important Q&As about enhanced recover after surgery, and four more on trends in multimodal solutions for orthopedic and spine pain management.


ERAS 101: The recovery protocols transforming outpatient spine surgery
To remain successful, ambulatory surgery centers and spine practices must work to improve patient satisfaction and educate consumers on the benefits of outpatient spine surgery. Michael Wang, MD, a neurosurgeon at the University of Miami Health System, believes these organizations can use Enhanced Recovery After Surgery protocols to reduce procedure costs, shorten recovery time and standardize clinical outcomes, which will ultimately improve patient satisfaction and help facilitate spine surgery's shift to the outpatient setting.

How to optimize orthopedic surgery patients for ERAS: 6 Qs with Dr. Daniel Hoeffel
Daniel Hoeffel, MD, is a private practice orthopedic surgeon based in St. Paul, Minn. At the Becker's ASC 25th Annual Meeting: The Business and Operations of ASCs on Oct. 18, 2018 in Chicago, Dr. Hoeffel gave a presentation titled "Optimizing the Orthopedic Patient for ERAS (Enhanced Recovery After Surgery): Importance of Pathway & Partnership" sponsored by Johnson & Johnson Medical Devices Companies.

During the presentation, Dr. Hoeffel, a consultant for DePuy Synthes, discussed how ERAS protocols for orthopedic and total joint replacement patients can improve patient care. He examined the philosophy behind ERAS and how new technology and industry partners such as the Johnson & Johnson Medical Devices Companies can help orthopedic surgeons meet their patient recovery and outcome goals.

Dr. Adam Blomberg on pain management, recovery protocols and opioids
Envision Physician Services' National Education Director of Anesthesiology Adam Blomberg, MD, FASA, spoke to Becker's ASC Review about enhanced recovery after surgery protocols, opioids and the future of pain control.

Multimodal pain management

Multimodal pain management: 4 questions with Dr. Asokumar Buvanendran
In recent years, multimodal pain management has become a routine part of surgical care, as pain management specialists incorporate regional nerve blocks, oral medications and intraoperative methods to safely produce effective analgesia.

Asokumar Buvanendran, MD, professor of anesthesiology at Rush University Medical Center in Chicago and chair of the American Society of Anesthesiologists' committee on pain medicine, spoke with Becker's ASC Review about how a multimodal approach can improve pain management while also reducing risk of opioid dependence.

The latest pain management trends in spine care
In this article, six spine surgeons discussed the big trends in pain management, including non-opioid solutions.

What spine surgeons can do to fight the opioid crisis
In this article, seven spine surgeons discuss the physician's role in improving the opioid crisis and key alternatives to pain management for post-surgical patients as well as chronic back pain sufferers.

Pain management in the ambulatory setting — Key thoughts on a multimodal approach for TJR procedures

Surgery centers will need strong pain management protocols in place to successfully perform total joint procedures on an outpatient basis. Keith Long, MD, associate chairman in the anesthesia department of anesthesia at Winchester (Mass.) Hospital and medical director of Winchester Hospital's ASC, discusses the benefits of a multimodal approach and the importance of this approach for outpatient total joints procedures.

More articles on spine and orthopedic surgery:
CMS to pay separately for Exparel, nonopioid pain management at ASCs in 2019
10 benchmarks to know on orthopedics in ASCs
Aetna expands coverage for Exparel in select Florida and New Jersey ASCs: 3 details


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