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Anesthesia Coding Alert

Reader Questions:

Get Pre-Authorization for Unlisted Procedures

Published on Mon Mar 08, 2010

Question: Our pain management specialist used pulse radiofrequency to treat a patient with suprascapular nerve pain. Since this procedure is new to our practice, is there anything we need to know before coding? Florida Subscriber Answer: For pulse radiofrequency of any anatomic region, any nerve, you should use 64999 (Unlisted procedure, nervous system), according to CPT Assistant from August 2005. This is reinforced in the CPT book with the guideline: "For therapies that are not destructive of the target nerve, (eg pulsed radiofrequency), use 64999." Be proactive: Billing for pulse radiofrequency is similar to billing for any other unlisted procedure. You might first try to obtain a pre-authorization from the payer in a letter. If you have clinical trials that have been conducted by recognized bodies of physicians, make sure you include that information in your preauthorization letter requesting approval for a pain management procedure for which you will be [...]
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