Neurology & Pain Management Coding Alert

Stay tuned for details on how to keep your claims clean.The Office of Inspector General (OIG) recently released its findings from its latest review of transforaminal epidural injections, and the news isn't good for pain management practitioners. The review showed that 34 percent of transforaminal epidural injection services that Medicare allowed in 2007 did not meet Medicare requirements. The mistakes resulted in approximately $45 million in improper payments.Most mistakes stemmed from errors in documentation, medical necessity, or coding. CMS plans to educate providers on correct documentation and strengthen safeguards against improper payments (such as examining office-based injections or asking local contractors to develop local coverage determinations [LCDs] regarding transforaminal epidural injections).Understand What You're CodingPhysicians often administer transforaminal epidurals laterally through the selected neuroforamen under fluoroscopy, says Joanne Mehmert, CPC, CCS-P, president of Joanne Mehmert and Associates in Kansas City, Mo. Once there, the physician performs an injection at the nerve [...]