American Society for Peripheral Nerve (ASPN)
Summer 2019
Like the new look?

Alison Snyder-Warwick, MD
Alison Snyder-Warwick, MD
The ASPN Newsletter has turned over a new leaf... welcome to Synapse, the practical, concise, and sometimes witty ASPN communication led by Hollie Power (Associate editor), Gedge Rosson (Associate editor), and Alison Snyder-Warwick (Editor). In this inaugural issue the focus is you, our members. We look forward to sharing special issues and recurring columns multiple times throughout the year. Please send us your ideas for content, comments, suggestions, and inquiries. We look forward to collaborating and communicating with you on all things nerve-related!

In just under 30 short years, our Society has grown and expanded to include and represent members from about the globe! ASPN includes members from 23 countries and 9 specialties. Amazingly, even though our membership is global across many disciplines, our community remains tightknit and connected. Learn more about ASPN's wide reach in membership.

Gwen Hoben, MD, PhD Gwen Hoben, MD, PhD
Medical College of Wisconsin
Wauwatosa, WI
Suresh Mohan, MD Suresh Mohan, MD
Mass Eye and Ear/Harvard Medical School
Boston, MA
Xuejian Wang, PhD Xuejian Wang, PhD
The No. 1 Hospital of Nantong City
Nantong City, China

Toward the Bionic Face: A Novel Neuroprosthetic Device Paradigm for Facial Reanimation Consisting of Neural Blockade and Functional Electrical Stimulation.
Highlights of an ASPN Member Publication, compiled by Hollie Power, MD

In case you missed us in Palm Desert...

The 2019 Annual meeting was full of innovation, excellent science, collaboration, and camaraderie. Updates from the ASPN/PSF grant recipients, Stephen Kemp and Alison Snyder-Warwick, kicked off the event. Panels on Ulnar Nerve: Beyond the Debate, Approach to Lower Extremity Nerve Injury, Optimizing Pain Control in the Opioid Epidemic Era, Paradigm Shifts in Practice, and Diffusions of Innovation were highlights of the program. The 2019 invited lecturers did not disappoint. We were lucky to learn from the experiences of former White House correspondent, Ann Compton, and Vincent Hentz, MD taught us about the intriguing—and sometimes horrific—Secret Life of Bees. Hugh Herr, Professor of Media Arts and Sciences at MIT delivered an inspiring lecture about the merging the human body with machine. There were a total of 58 podium papers presented, in addition to the not-to-be-missed—and always entertaining—ASPN Poster Session, run by Alan Belzberg and Howard Clarke. Electronic posters added even more depth to the program. 2019 hosted a few firsts as well. The ASPN Mentorship Program kicked off its inaugural year with Susan Mackinnon providing words of wisdom on mentorship. The inaugural ASPN Traveling Fellow, Alison Snyder-Warwick, was announced, and in-meeting yoga, led by Susan Mackinnon helped start our Sunday morning with positivity, breathing, and mindfulness. Of course, the meeting included epiphanies, debates, cocktails, and even a Super Bowl. 2019 was one for the books! Congratulations to David Brown (President), Catherine Curtin (Program Co-Chair), and Kristen Davidge (Program Co-Chair), the Program Committee, and all of the meeting participants on a job well-done… you nailed it!!!

Click on the thumbnails to view the full size image.

Palm Desert Photo Palm Desert Photo Palm Desert Photo Palm Desert Photo
Palm Desert Photo Palm Desert Photo Palm Desert Photo

Coding Corner: Nerve Allograft Coding

Dr. Noah Raizman, ASPN Coding Committee
Dr. Noah Raizman
ASPN Coding Committee
In 2018, based upon the ample literature confirming the safety and utility of processed nerve allograft, CMS created two new codes to address nerve grafting using these products. The new codes, now in effect, will hopefully simplify coding and reimbursement for surgeons performing peripheral nerve work:

64912 - Nerve repair; with nerve allograft, each nerve, first strand (cable)

64913 - Nerve repair; with nerve allograft, each additional strand (List separately in addition to code for primary procedure)

64912 is the primary code for nerve repair using processed nerve allograft. 64913 should only be used when multiple strands are used, and can be used for each additional strand, eg. a 4-strand cabled allograft. Since it is an "add-on" code, it is NOT subject to the multiple procedures discount.

The work of 64912/64913 INCLUDES the use of the operating microscope, so 69990 CANNOT be coded with it. It is also inappropriate to code for neurolysis of the nerve which you are grafting unless it is in a completely different anatomical location. The work of microsurgical neurorrhaphy at each end of the graft is included in the procedure and thus a conduit-assisted graft neurorrhaphy should be coded as 64912 ONLY, not 64912 and 64910.

Provided by Dr. Noah Raizman of the ASPN Coding Committee

Did you know?

Aristotle (384-322 BC) believed that the heart was the origin of all nerves, perhaps due to the presence of the nerve-like, but non-neuronal, chordae tendineae. Likely because of this belief, he did not think the brain was related to the sensory organs. Aristotle was not alone in mistaking connective tissue as nerve. Nerves were commonly confused with tendons in early times. In fact, the Greek origins of the word "neuron" originally meant "sinew". We give these early thinkers a pass... it's not always straight forward today (although we do know a bit more about the connections between the central and peripheral nervous systems)!

Penny for your thoughts?

What proportion of your clinical practice is nerve surgery?
75% or more
Results will be shared in the next issue of Synapse!

Don't forget...!

The 2020 ASPN Annual Meeting abstract submission site is currently open! The deadline for abstract submissions for the 2020 ASPN annual meeting is Sunday, July 14th. Don't let it pass you by... we want to hear about your work this January in Ft. Lauderdale! View instructions and submit your work.

Upcoming Meetings from Around the Globe

International Society for Pediatric Neurosurgery 47th Annual Meeting | October 20-24, 2019 | Birmingham, UK |

The annual ISPN meeting is the place to keep up to date with the rapidly advancing knowledge and improving standards of care within the field of pediatric neurosurgery. The meeting offers an outstanding scientific program, and equally important, is the platform to share comradery and international friendships. Join this inspiring meeting, enhance your knowledge and practice and network with professionals from all over the world.

I know you!

Here they are... your fearless 2019 ASPN Executive Council