Pain Management & Anesthesia. What you center needs to know Presented by John Mak, MD Surgery Center Coalition 10/4/18

Premier Pain Centers Specialty Anesthesia Associates No disclosures

Intervetnional pain management at ASC Board certified and fellowship trained Full spectrum of procedures Qualified interventional pain management physician Quick turnover Experienced and well trained staff Efficient operation/equipment Wait times Patient comfort post procedure. Patient experience Precertification Contract for implantable devices Payor issues specific to IPM Efficient- 15 min procedures. Staff trained in IPM. Pre-op expectations to alleviate anxiety. PACU discharge instructions. Patient experience- Keep patient and family informed on wait times. PACU post op pain control. Look out for possible complications.

Anesthesia for interventional pain Local anesthesia by pain management MD Local IV sedation administered by sedation nurse under guidance of pain management MD IV Sedation Sedation provided by Anesthesiologist MAC Anesthesia

Anesthesia for interventional pain Local Anesthesia Quick recovery Limited amount of procedures Poor patient satisfaction No additional billing

Anesthesia for interventional pain IV Sedation Broader procedures performed Increased risk for anesthetic complications No Additional Billing

Anesthesia for interventional pain MAC Anesthesia All procedures Increased patient satisfaction Safest anesthetic Additional billing by anesthesiologist

Monitored Anesthesia billing Precertification Advance Beneficiary Notice Self Pay

Medical Necessity for MAC anesthesia Morbid obesity >45 Sleep Apnea Inability to follow commands Comorbidities for ASA 3 Spastcity disorder Failed attempt at performing procedure with sedation or under local

John Mak, MD jmak@treatingpain.com (732) 930-2434 ?Questions? John Mak, MD jmak@treatingpain.com (732) 930-2434