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Compliance and Documentation for Interventional Techniques

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Compliance and documentation for interventional techniques have a multitude of regulations but are an essential part of medicine. Developments in the mid-1970s irrevocably affected the role of documentation in medicine as a result of a dramatic nationwide increase in medical liability claims and awards and changes in the fledgling Medicare program, followed by the emergence of electronic review progress in the 1980s. The Health Insurance Portability and Accountability Act (HIPAA), the Medicare Modernization Act (MMA), and the Affordable Care Act (ACA), each with numerous component regulations, propelled the growth and importance of documentation to an unimaginable level.

All interventional techniques are considered surgical procedures. Documentation requirements include history and physical, indications and medical necessity, intraoperative procedural description, postoperative monitoring and ambulation, and discharge/disposition.

Documentation requirements vary among interventional techniques; detailed documentation is required for hospital outpatient departments (HOPDs) and ambulatory surgery centers (ASCs), with less stringent requirements for in-office practices.


  • Compliance
  • Documentation
  • Interventional techniques
  • Hospital outpatient departments
  • Ambulatory surgery centers
  • In-office procedures

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  1. Manchikanti L, Singh V, Pampati V, et al. Description of documentation in the management of chronic spinal pain. Pain Physician. 2009;12:E199–224.

    PubMed  Google Scholar 

  2. Manchikanti L, Falco FJE, Singh V, et al. Utilization of interventional techniques in managing chronic pain in the Medicare population: analysis of growth patterns from 2000 to 2011. Pain Physician. 2012;15:E969–82.

    PubMed  Google Scholar 

  3. Department of Health and Human Services. Office of Inspector General (OIG). Medicare Payments for Facet Joint Injection Services (OEI-05-07-00200). 2008.

  4. US Department of Health and Human Services. Office of Inspector General (OIG). Inappropriate Medicare Payments for Transforaminal Epidural Injection Services (OEI-05-09-00030). 2010.

  5. Centers for Medicare and Medicaid Services’ (CMS) Use of Medicare Fee-for-Service Error Rate Data to Identify and Focus on Error-Prone Providers. 2010.

  6. Manchikanti L, Helm S II, Singh V, et al. Accountable interventional pain management: a collaboration among practitioners, patients, payers, and government. Pain Physician. 2013;16:E635–70.

    PubMed  Google Scholar 

  7. Health Insurance Portability and Accountability Act (HIPAA) of 1996, P.L.104–191, August 21, 1996.

    Google Scholar 

  8. H.R. 1. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003, P.L. 108–173, Enacted December 8, 2003.

    Google Scholar 

  9. Manchikanti L, Hirsch JA. Obamacare 2012: prognosis unclear for interventional pain management. Pain Physician. 2012;15:E629–40.

    PubMed  Google Scholar 

  10. Manchikanti L, Caraway DL, Parr AT, et al. Patient protection and affordable care act of 2010: reforming health care reform for the new decade. Pain Physician. 2011;14:E35–67.

    PubMed  Google Scholar 

  11. Manchikanti L, Hirsch JA. Regulatory burdens of the affordable care act. Harvard Health Policy Rev. 2012;13:9–12.

    Google Scholar 

  12. Manchikanti L, Abdi S, Atluri S, et al. An update of comprehensive evidence-based guidelines for interventional techniques of chronic spinal pain: part II: guidance and recommendations. Pain Physician. 2013;16:S49–S283.

    PubMed  Google Scholar 

  13. Manchikanti L, Falco FJE, Kaye AD, et al. The disastrous but preventable consequences of ICD-10. Pain Physician. 2014;17:E111–8.

    PubMed  Google Scholar 

  14. Blumenthal D, Tavenner M. The “meaningful use” regulation for electronic health records. N Engl J Med. 2010;363:501–4.

    CAS  CrossRef  PubMed  Google Scholar 

  15. Department of Health and Human Services, Centers for Medicare & Medicaid Services. 42 CFR Part 416. Medicare Program; Update of Rate setting Methodology, Payment Rates, Payment Policies, and the List of Covered Surgical Procedures for Ambulatory Surgical Centers; Federal Register, Proposed Rule, October 1, 1998.

    Google Scholar 

  16. Kentucky Legislature, Kentucky Administrative Regulations. Operation and services; Ambulatory Surgical Center. In: Title 902 KAR 20:106. Cabinet for Health and Family Services Department for Public Health.

  17. 2014 Comprehensive Accreditation Manual for Ambulatory Care (CAMAC). Joint Commission Resources, November 2013.

    Google Scholar 

  18. Centers for Medicare and Medicaid Services Memorandum to State Survey Agency Directors RE: State Operations Manual (SOM) Appendix L, Ambulatory Surgical Centers (ASC) Comprehensive Revision. May 15, 2009.

    Google Scholar 

  19. Centers for Medicare and Medicaid Services Memorandum to State Survey Agency Directors RE: Clarifications to the Ambulatory Surgical Center (ASC) Interpretive Guidelines – Comprehensive Medical History & Physical (H&P) Assessment. Ref: S&C-11-06-ASC. December 17, 2010.

    Google Scholar 

  20. Department of Health & Human Services, Centers for Medicare and Medicaid Services Manual System. Pub. 100-07 State Operations. Provider Certification. RE: Clarifications to Appendix L, Ambulatory Surgical Center Interpretive Guidelines—Comprehensive Medical History and Physical (H&P) Assessment and Anesthetic Risk and Evaluation.

    Google Scholar 

  21. Davenport DL, Bowe EA, Henderson WG, et al. National Surgical Quality Improvement Program (NSQIP) risk factors can be used to validate American Society of Anesthesiologists Physical Status Classification (ASA PS) levels. Ann Surg. 2006;251:344–50.

    Google Scholar 

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Correspondence to Laxmaiah Manchikanti .

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Manchikanti, L., Singh, V., Hirsch, J.A. (2018). Compliance and Documentation for Interventional Techniques. In: Manchikanti, L., Kaye, A., Falco, F., Hirsch, J. (eds) Essentials of Interventional Techniques in Managing Chronic Pain. Springer, Cham.

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  • Print ISBN: 978-3-319-60359-9

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