September, 2012
Clinical Neurophysiology News Newsletter of the American Clinical Neurophysiology Society Message from the President As summer slowly winds to a close (sigh!), we begin to turn our thoughts back to work. The ACNS has many new activities planned for this Fall and into the coming year.
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First, please invite your new Fellows to become members of the ACNS. Junior membership is only $95 per year and includes a subscription to the Journal of Clinical Neurophysiology as well as discounted meeting, course and inservice exam fees. This year, Tobias Loddenkemper, M.D., Chair of the Membership Committee, has developed a webinar to introduce fellows to the field of clinical neurophysiology and the many services the ACNS offers. The live webinar will take place on Wednesday, September 19, at 1:00 p.m. EDT, and the video will be archived on the ACNS website for those who cannot attend the live program. This webinar will be a great opportunity for your fellows to get the “inside scoop” from ACNS Susan T. Herman, M.D. leaders on travel fellowships to the Annual Meeting, abstract deadlines, finding grant opportunities, planning their post-fellowship career, and many other topics.
Future Meetings 2012 Mid-Year Courses September 29-30, 2012 Hyatt Regency Minneapolis Minneapolis, MN
2013 Annual Meeting and Courses February 5-10, 2013 Miami Marriott Biscayne Bay Miami, FL Watch the ACNS website (ACNS.org) for more details.
Editor Jonathan C. Edwards, M.D
Join us in Minneapolis on September 28-29 for the 2012 Neurophysiologic Intraoperative Monitoring and ICU EEG Monitoring Courses. This year, Aatif Husain, M.D., Suzette LaRoche, M.D., and I have planned two full days of interactive and hands-on sessions for updates in these rapidly evolving fields. The courses will be invaluable for those planning to develop new programs in NIOM or ICU EEG and those who need a comprehensive update in techniques and indications. The brochure and meeting/hotel registration information can be found on the ACNS website, www.ACNS.org. Plans for the ACNS Annual Meeting and Courses in Miami, February 5-10, 2013, are well underway. We’re sure that the Miami location will be a great draw in the depths of winter, and we hope to have record attendance! William Tatum, M.D., Chair of the Annual Course Committee, will expand his already excellent courses to include more breakfast seminars, as well as interactive and hands-on evening sessions. Co-chairs of the Annual Meeting Program Committee, Jonathan Edwards, M.D. and Mark Hallett, M.D., have put together an outstanding program which will appeal to practitioners in every area of clinical neurophysiology. Look for the preliminary program on our website soon. The abstract submission deadline for posters will be October 15. Many of you commented on the draft version of the ICU EEG Nomenclature Guidelines. The final version will be available on our website and in the Journal of Clinical Neurophysiology soon. We are also working on Guidelines for invasive EEG monitoring, neonatal ICU EEG nomenclature, ICU EEG Monitoring, and Qualifications for Neurophysiologic Personnel, and anticipate release of draft versions for public comment over the next few months. Please let us know if there are other guidelines that would be helpful for your practice. As most of you know, the ACNS is a member of the North American Chapter of the International Federation of Clinical Neurophysiology (IFCN). This year, we are thrilled to have (Continued on page 2)
American Clinical Neurophysiology Society 2012-2013 Council Members PRESIDENT Susan T. Herman, M.D. Beth Israel Deaconess Medical Center Boston, MA 1ST VICE PRESIDENT Frank W. Drislane, M.D. Beth Israel Deaconess Medical Center Newton, MA 2ND VICE PRESIDENT Aatif M. Husain, M.D. Duke University Medical Center Durham, NC SECRETARY Jonathan C. Edwards, M.D. Medical University of South Carolina Charleston, SC
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one of our own outstanding members, Mark Hallett, M.D., as the nominee for President of the IFCN. Mark has been extremely active in the ACNS, serving on many committees, as Council Member, and as Co-Chair of the upcoming Annual Meeting. We wish Mark the best of luck in the election, which is taking place now. This past spring, the ACNS Council began a Strategic Planning process which will continue over the next year. Neurologists and clinical neurophysiologists are facing many new challenges, including decreased research funding, increased administrative burdens, declining clinical revenues, and new healthcare delivery models such as Accountable Care Organizations. But we can also see this time as an era of opportunity – to develop more efficient and effective practice models, perform collaborative research, and better prepare a new generation of young clinical neurophysiologists for their role as leaders in healthcare. We welcome your thoughts on how the ACNS could best help you meet challenges in both clinical and academic practice.
TREASURER Stephan Schuele, M.D., M.Ph. Northwestern University Neurology Chicago, IL
As always, we welcome your feedback on any topic in this newsletter. To send us a brief note or to volunteer for an ACNS committee or task force, click here: https://www.smartsheet.com/ACNScommittees
IMMEDIATE PAST PRESIDENT Douglas R. Nordli, M.D. Children’s Epilepsy Center Chicago, IL
My heartfelt thanks go out to all the volunteers who make the ACNS a vibrant and collegial community. I’m looking forward to seeing you soon in Minneapolis and Miami. In the meantime, have a relaxing and peaceful last few weeks of summer.
PAST PRESIDENT Peter W. Kaplan, M.B., FRCP Johns Hopkins Medical Center Baltimore, MD COUNCIL MEMBERS Cecil D. Hahn, M.D. Hospital for Sick Children Toronto, ON
Susan T. Herman, MD President, American Clinical Neurophysiology Society
Terrence D. Lagerlund, M.D. Mayo Clinic Rochester, MN Suzette LaRoche, M.D. Emory University Medical Center Atlanta, GA Tobias Loddenkemper, M.D. Children’s Hospital Boston Boston, MA Jaime R. Lopez, M.D. Stanford University Neurology Stanford, CA Suraj Ashok Muley, M.D. St. Joseph's Hospital and Medical Center Phoenix, AZ Piotr W. Olejniczak, M.D. Louisiana State University Health Sciences Center New Orleans, LA William O. Tatum IV, D.O. Mayo College of Medicine Jacksonville, FL Francis O. Walker, M.D. Department of Neurology Winston-Salem, NC
2012 NIOM and ICU EEG Monitoring Courses September 29-30, 2012 Hyatt Regency Minneapolis - Minneapolis, Minnesota Register and make your hotel reservation online: www.ACNS.org Early registration deadline is September 17
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Journal of Clinical Neurophysiology Dr. John Ebersole, Journal Editor, welcomes suggestions and guest editors for special issues of the Journal. Potential authors may now submit their manuscript online at www.EditorialManager.com/JCNP.
Free Webinar for Clinical Neurophysiology Fellows and Program Directors – Introduction to the ACNS Announcing an exciting new opportunity for Clinical Neurophysiology Fellows and Program Directors! If you are looking for a chance to connect with other clinical neurophysiologists, take advantage of educational opportunities and receive mentoring, you should know about the American Clinical Neurophysiology Society (ACNS). Drs. Tobias Loddenkemper and Suraj Muley, Co-Directors of the American Clinical Neurophysiology Society’s Membership Committee, will be hosting a webinar for new Clinical Neurophysiology Fellows and Program Directors entitled Introduction to the American Clinical Neurophysiology Society (ACNS). Date: Wednesday, September 19, 2012 Time: 1:00 p.m. (Eastern Time) This is a free webinar to explain how you can participate in the activities of the organization most suited to their training and interests. The topic list is below. Again, this webinar is free. Please take advantage of this opportunity to enhance your training with real practical knowledge that will help you in your career. Introduction to the American Clinical Neurophysiology Society Moderator: Dr. Tobias Loddenkemper Welcome to Clinical Neurophysiology - Dr. Susan Herman Timeline for new Fellows - Dr. Piotr Olejniczak Meetings/Deadlines/Grant Opportunities - Dr. Jurriaan Peters How to get involved with the ACNS - Dr. Suraj Muley Mid-Year Courses - Dr. Susan Herman Annual Meeting and Courses - Dr. Jonathan Edwards Journal of Clinical Neurophysiology - Dr. Aatif Husain ABCN/ABPN/Epilepsy Boards - Dr. Tobias Loddenkemper To register, please click here: https://www.smartsheet.com/IntroductionACNSwebinar Webinar connection details and other information will be sent to all registrants in early September. Please contact the ACNS Executive Office by email (ACNS@ssmgt.com) or phone (860-243-3977) if you have questions or if we can be of assistance to you.
ACNS Newsletter
VNS and DBS CPT Codes: Clarifying the Code Use Rules Submitted by Mark Nuwer, M.D., Ph.D. Reprogramming implanted stimulators for DBS and VNS CPT codes had minor changes effective January 2012. These codes are “per hour� codes. In cases where the service is half an hour or less, the short duration needs to be flagged in the coding system using modifier -52. In addition, the time taken for reprogramming should be documented in the medical records.
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Furthermore, the codes have been separated into simple and complex levels. To use the complex VNS and DBS codes now will require reprogramming that includes changes at least 4 features during the programming session. The features changed or assessed are from the following list of twelve features: Changes to: 1. pulse amplitude, 2. pulse duration, 3. pulse frequency, 4. eight or more electrode contacts, 5. cycling, 6. stimulation train duration, 7. train spacing, 8. number of programs, 9. number of channels, 10. alternating electrode polarities, 11. dose time (stimulation parameters changing in time periods of minutes including dose lockout times), Or, assessment of: 12. more than one clinical feature (eg, rigidity, dyskinesia, tremor) The specific new CPT code rule change is given in the final sentence below: 95974 Complex cranial nerve neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming, with or without nerve interface testing, first hour 95978 Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, battery status, electrode selectability and polarity, impedance and patient compliance measurements), complex deep brain neurostimulator pulse generator/transmitter, with initial or subsequent programming; first hour For 95974 and 95978, use modifier 52 if less than 31 minutes in duration. Use code 95970 for simple assessment of the settings without any changes.
2013 Inservice Exam INSERVICE EXAM IN CLINICAL NEUROPHYSIOLOGY Thursday, February 21 - Monday, February 25, 2013 In February, 2013, the American Clinical Neurophysiology Society (ACNS) will offer the 14th annual in-service examination assessing knowledge of clinical neurophysiology of the central nervous system. This online examination is offered to Clinical Neurophysiology Fellows, Neurology Residents, and also to Attending Physicians. The exam will be offered Thursday, February 21, 2013, through Monday, February 25, 2013. Training directors may set the specific time and date of the examination at their sites. The examination will cover basic neurophysiology relevant for the understanding of clinical neurophysiology tests, technical aspects of physiological recording and testing methodology, and interpretation of tests with regard to neurological and general medical disease.
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2013 Inservice Exam (continued) (Continued from page 4)
Specific topic areas will include: • • • • • • •
basic neurophysiology instrumentation clinical EEG epilepsy clinical evoked potentials sleep monitoring intraoperative monitoring
In order to provide residents and program directors with the most useful feedback, scores will be given in each topic area as well as for the test as a whole. Program Directors will receive all scores and the residents will receive their individual scores. Percentile scores will be calculated separately for Neurology residents and Clinical Neurophysiology residents. Clinical Neurophysiology training program directors, in particular, will find this examination to be a useful formal method of trainee assessment. Registration fees are as follows: for Residents/Fellows who are ACNS Members, registration fee is $90; Program Directors who are ACNS Members can register their Residents/Fellows at $90 each; all others will pay $150. Please watch your email and the ACNS website for registration instructions.
Nominations for 2014 Awards The American Clinical Neurophysiology Society (ACNS) welcomes members' suggestions for its three awards. Please click on this link to complete the nomination form https://www.smartsheet.com/2014Awards. The Herbert H. Jasper Award is given to an individual for a lifetime of outstanding contributions to the field of clinical neurophysiology including research, teaching and mentoring. It is analogous to a lifetime achievement award. Previous award recipients: Robert Ellingson, Cesare Lombroso, Gian Emilio Chatrian, Robert Naquet, Donald Lindsley, Eli Goldensohn, Reginald Bickford, Peter Kellaway, Donald Klass, Dominick Purpura, Pierre Gloor, Cosimo Ajmone-Marsan, Herbert Jasper, Fernando Lopes DaSilva, Ernst Niedermeyer, Juhn Wada, Roger Cracco, Frank Sharbrough, Barbara Westmoreland, Gastone Celesia, Barry Tharp, Omkar Markand, Jasper Daube, C. William Erwin and Warren Blume. The Pierre Gloor Award is given to an individual for outstanding contributions to central clinical neurophysiology research. The recipient delivers a lecture at the ACNS Annual Meeting. Previous award recipients: Gyorgi Buzsaki, Mircea Steriade, Jerome Engel, Jean Gotman, Gregory Holmes, Timothy Pedley, Hans Lüders, Mark Hallett, Solomon Moshé, Claude Wasterlain, François Mauguière, John Ebersole, Robert Fisher, Paul Nunez and Donald Schomer. The Robert S. Schwab Award is given to an individual for outstanding contributions to peripheral clinical neurophysiology research. The recipient delivers a lecture at the ACNS Annual Meeting. Previous award recipients: Michael Merzenich, Nicolas Bazan, Kenneth Fischbeck, Christopher Goetz, Mark Hallett, Jeffrey Noebels, Phillip Low, Jun Kimura, Marc Nuwer, Austin Sumner, Erik Stalberg, Salvatore DiMauro, William Catterall, Andrew Eisen and William Kennedy.
ACNS Newsletter
Council Nominations ACNS voting members...please watch your email for news of Council nominations for the upcoming year.
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Save the Date! 2013 Annual Meeting and Courses February 5 - February 10, 2013 Miami Marriott Biscayne Bay - Miami, Florida Click here for preliminary program. Registration materials will be available soon.
FOURTH ANNUAL ACNS NEUROPHYS BOWL
Co-Chairs, Drs. Lawrence J. Hirsch, M.D., and Mark A. Ross, M.D., invite you to participate in the Fourth Annual ACNS NEUROPHYS BOWL which will take place on Friday, February 8, 2013, from 5:30 p.m. to 6:45 p.m., at the Miami Marriott Biscayne Bay in Miami, Florida. Come cheer on your colleagues as they test their knowledge of clinical neurophysiology! To participate as an individual or with a team, download the form from www.ACNS.org and email to ACNS@ssmgt.com or fax to 860-286-0787.
Consortium of Clinical Neurophysiology Program Directors The Consortium of Clinical Neurophysiology Program Directors (CCNPD) will meet Saturday, February 9, 12:30 p.m. to 1:30 p.m., at the Miami Marriott Biscayne Bay in Miami, Florida. The meeting will take place in the Watson Room and luncheon will be served. Please plan to attend.
ACNS Newsletter
Call for Abstracts for Posters AMERICAN CLINICAL NEUROPHYSIOLOGY SOCIETY 2013 Annual Meeting and Courses February 5-10, 2013 Miami Marriott Biscayne Bay Miami, Florida Program Co-Chairs Jonathan Edwards, M.D., and Mark Hallett, M.D.
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Call for Abstracts for Posters Deadline: October 15, 2012 You are invited to submit abstracts for a poster presentation at the 2013 Annual Meeting of the American Clinical Neurophysiology Society (ACNS). The meeting will take place at the Miami Marriott Biscayne Bay in Miami, Florida. Several young physician investigators will be awarded Travel fellowships at $1,000 each. These fellowships are determined based upon the ranking of the applicant's abstract by the Program Committee. For the Travel Fellows, the meeting registration fee is waived. Prior recipients of Travel Fellowships are not eligible for additional Travel Fellowship awards. A poster provides a learning experience that can be understood without a presenter. It should include self-explanatory photos, drawings, graphs and brief written texts as appropriate. Poster board size is 4 feet tall by 8 feet wide. Abstract titles are limited to 60 characters or less and the body of the abstract is limited to 200 words or less. The purpose of the ACNS Annual Meeting is continuing medical education as defined by the ACCME. Abstracts will be evaluated for scholarly and relevant content by reviewers from the ACNS Program Committee. Abstracts are submitted online via the ACNS website: www.ACNS.org For further information on abstract submission, membership or the Annual Meeting and Courses, please email the ACNS Executive Office at ACNS@ssmgt.com or call 860-243-3977.
The American Clinical Neurophysiology Society’s New Guideline Standardized Critical Care EEG Terminology: 2012 version can be found on the ACNS Website (www.ACNS.org).
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ACNS Membership If you are not presently a member of the ACNS, please consider joining. Membership benefits include reduced fees for CME-accredited meetings and courses, reduced dues for members in training and early practice physicians, a subscription to the Journal of Clinical Neurophysiology and MORE! For additional information on ACNS and the benefits of membership, please visit the ACNS website: www.ACNS.org.
Save these Dates! 2012 NIOM and ICU EEG Monitoring Courses September 29 - 30, 2012 Hyatt Regency Minneapolis - Minneapolis, Minnesota 2013 Annual Meeting and Courses February 5 – February 10, 2013 Miami Marriott Biscayne Bay - Miami, Florida 2013 Inservice Exam February 21 – February 25, 2013
American Clinical Neurophysiology Society One Regency Drive P.O. Box 30 Bloomfield, CT 06002 Phone: 860-243-3977 Fax: 860-286-0787 E-mail: ACNS@ssmgt.com Website: www.ACNS.org