Pain Management Coding Alert

Treatment Focus:
Don't Forget This Code When Reporting Dupuytren's Contracture Treatment
Plus: Here’s how your coding will change with ICD-10. Physicians have several op... Read more
Condition Refresher:
Remember What Dupuytren's Contracture Is
Condition affects millions of Americans. Dupuytren’s contracture is a painless t... Read more
Patient Care:
Coding Post-op Pain Control Injections? Remember 5 Important Things
Provider documentation can make or break your claim. Postoperative pain control is a stan... Read more
Prepare Now for More Diagnosis Options for Sciatica
You’ll shift from 1 to 6 code choices.  Sciatica is pain caused by compress... Read more
Reader Question:
Watch Medicare Vs. CPT® Guidelines for 77002 and 77003
Question: What is the difference between the codes 77002 and 77003? Is it based on ... Read more
Reader Question:
Remember Fluoro Guidance Is Part of 27096
Question: Our physician documented that he performed a left SI joint injection unde... Read more
Reader Question:
Watch for the New Chronic Care Payment Rate in 2015
Question: What is the final rule from CMS on the payment rate change for care manag... Read more
Reader Question:
Procedure Specifics Dictate Whether 96372 Can Be Billed With 62310 or 62311
Question: A patient visited our office for therapeutic injections of Toradol and Ke... Read more
Reader Question:
Don't Expect Post-op Pay for Care Requiring Modifier 78
Question: For a related procedure done during the global period with modifier 78 atta... Read more
Reader Question:
Verifying POS Leads You to Correct RVU
Question: Using the RVUs provided for a particular code, how do I arrive at the appro... Read more
Reader Question:
Know Whether You're Coding Pump Placement or Anesthesia
Question: When the surgeon places a port for chemotherapy access, the patient might... Read more
You Be the Coder:
Check How Many Levels T12-L1 Injection Represents
Question: The procedure performed was “Right T12-L1 transforaminal epidural s... Read more
PM Payment:
Watch for These Potential Fee Changes in 2015
CMS proposes updates to epidural injection codes and more.  Every provider expect... Read more
News Flash:
Don't Miss the New Criteria for Prescribing Hydrocodone Combo Meds
DEA cracks down on who can order what. States have very specific rules regarding presc... Read more
Ease the Stress of Coding Diagnoses for Spinal Nerve Root Injuries
Hint: Single cross-over code doesn’t mean simple reporting. Choosing the best diagn... Read more
E/M Coding:
Follow This Advice to Choose the Best E/M Level
Hint: Check for patterns of reporting highest codes in a range. Some errors tend plagu... Read more
Reader Question:
Keep Up With Change to Radiofrequency Ablation Counting
Question: We used to bill radiofrequency ablation codes 64633, 64634, 64635, and 64... Read more
Reader Question:
+64494 and +64495 Coding Centers on Levels
Question: Our physician documented that he administered injections to the patient&r... Read more
Reader Question:
64640 Covers Rhizotomy of Greater Occipital Nerve
Question: Our provider documented “therapeutic greater occipital nerve rhizot... Read more
Reader Question:
Remember Modifier GC for Teaching Physician Claims
Question: When a resident assists a physician in a teaching hospital, do we need to... Read more
Reader Question:
Think 'Space,' Not 'Joint' for Sinus Tarsi Injection
Question: I recently received a denial for a cortisone injection to the sinus tarsi... Read more
Reader Question:
Prepare Now for Potential Single-Person PHI Breach
Question: What must we do in terms of breach notification if we mail a statement to... Read more
You Be the Coder:
Successful Coding for an Unsuccessful Injection
Question: The physician attempted to inject L4 and was unsuccessful, but then succe... Read more
CPT® 2015:
Prepare Now for New Vertebroplasty and Kyphoplasty Code Choices in 2015
Plus: Don’t miss these spinal myelography updates. Some of your spinal coding wi... Read more
Modifier Update:
Look Ahead to Opportunities to Use New Modifiers in Place of 59 in 2015
CMS introduces new options for some situations in 2015.  Big changes are on the h... Read more
Take 2 Steps to Strengthen Your Vertebral Fracture Diagnosis Coding
Tip: Start by confirming the underlying cause. Osteoporotic vertebral fractures are al... Read more
Reader Question:
62311 or 62319? Watch for Length of Administration
Question: I need some guidance on the differences between 62311 and 62319. Both cod... Read more
Reader Question:
Submit 64490 for Intra-Articular TON Block
Question: What is proper billing for a right third occipital nerve block with a C2-... Read more
Reader Question:
Separate Primary Visit from Prolonged Service
Question: During a scheduled office visit of a new patient, our physician spent add... Read more
Reader Question:
Take Care When Counting Elements for E/M Status
Question: When coding E/M services, can we count the same element twice, for instan... Read more
You Be the Coder:
How to Report Needle Guidance With Nerve Block
Question: Our provider used both ultrasound guidance and electrical stimulation for... Read more
Code Update:
Add These J and S Code Changes to Your HCPCS Mix
Tip: Play close attention to morphine and propofol administrations.  The latest H... Read more
Here's Your Guide to What CMS Wants in Concurrent Care
Follow these 4 steps to help boost your bottom line.  It’s not uncommon for... Read more
Prepare Now for Extensive Diagnosis Changes for Painful Joints
Check out how much more detailed your choices will be in 2015.  A patient reporti... Read more
Reader Question:
Watch Place of Service for Correct Ultrasound Guidance Code
Question: Is it feasible to use ultrasound rather than fluoroscopy for guidance whe... Read more
Reader Question:
Rhizotomy Usually Means Anesthesia Code for Pain Management Provider
Question: What are the correct surgical and anesthesia codes for facet rhizotomy?&n... Read more
Reader Question:
Remember Debridement Is Part of Pulse Generator Removal
Question: Our pain management provider removed two leads and a pulse generator due ... Read more
Reader Question:
Multiple Add-Ons Can Be OK for Paravertebral Facet Joint Injections
Question: Our physician documented that he administered injections to the patient&r... Read more
Reader Question:
Continuous TAP Block Leads You to 'Unlisted' Code
Question: Our physician used a TAP (Transverses Abdominis Plane) block for postoper... Read more
Reader Question:
Be Cautious About Overusing ABNs
Question: I recently started working at a practice that I think overuses ABNs. Is there ... Read more
You Be the Coder:
Reporting J Codes for Pain Management Pumps
Question: I’m confused about how to bill J codes for pain management pumps. H... Read more
Procedure Focus:
Focus on 2 Areas to Have Easier Fluoro Guidance Coding With 64520
Tip: Don’t forget to pay attention to coding edits. Knowing whether you can sepa... Read more
News You Can Use:
Keep Up With Research Opportunities, Thanks to New Pain Database
Federal agencies pool their resources for your benefit.  If your physicians take ... Read more
Office Visits:
Don't Miss These Checkpoints if You Want to Collect Modifier -25 Pay
Remember Medicare has certain criteria to meet.  It’s not unusual for a pai... Read more
Prepare for Expanded Diagnosis Choices for RSD in 2015
Plus: Don’t miss the name change in the index.  When selecting a diagnosis ... Read more
Reader Question:
Understand the Lumbar Sympathetic/Chain Block Difference
Question: I have charts from one of our physicians for two different patients on th... Read more
Reader Question:
Approach Helps Guide Gelfoam Dural Repair Coding
Question: Our provider blocked a lumbar dural tear with a single piece of gelfoam. ... Read more
Reader Question:
E/M Service Includes Pain Outcomes Profile
Question: Our pain management physician heard at a conference that he could bill/co... Read more
Reader Question:
Include Modifier GC for on Teaching Physician Claims
Question: When a resident assists our surgeon in a teaching hospital, do we need to... Read more
Reader Question:
Keep Things in Order for Multi-Insurer Claims Reimbursement
Question: What is the best way to ensure proper billing when a patient is covered b... Read more
Reader Question:
Follow Up on V58.69 Denial for Urine Drug Screening
Question: Insurance companies have been denying our claims for new patient urine dr... Read more
Reader Question:
Telephone E/M Service Can Roll Into History or MDM
Question: We have a new patient that called his physician to discuss his visit that t... Read more
You Be the Coder:
Coding an SI Injection Without Guidance
Question: Our physician did an SI injection in the office without any image guidanc... Read more
Procedure Focus:
Pinpoint the Best Carpal Tunnel Codes by Focusing on 3 Areas
Heads up: Evidence of previous treatments are a part of successful CTS injection claims.... Read more
Office Procedures:
Brush Up On When You Might Code E/M With Injections
Modifier indicators are your key to success. It’s not uncommon for pain manageme... Read more
Carpal Tunnel Coding Will Get More Specific Under ICD-10
Check out your expanded options, beginning October 2015. When your pain management spe... Read more
Don't Miss Your Chance to Ease Your Stage 1 and 2 MU Deadline Stress
Proposed CMS rule could work in your favor. If your practice is anticipating a struggl... Read more
Reader Question:
Moderate Sedation Is Allowed With 99144, Discogram
Question: Can the physician who performs a discogram also provide anesthesia during... Read more
Reader Question:
Remember Modifier 52 for Unilateral Chemodenervation
Question: The physician performed chemodenervation to treat a patient’s migra... Read more
Reader Question:
Digital Block for Post-Op Relief Means 64450
Question: Our physician performed a digital nerve block on the patient’s righ... Read more
Reader Question:
Understand Condition Before Coding Iliotibial Band Injection
Question: What are the correct procedure and diagnosis codes for an iliotibial band... Read more
Reader Question:
Separately Code Multi-Level Transforaminal Injections
Question: The pain management specialist administered three transforaminal epidural... Read more
You Be the Coder:
Balloon Decompression for Trigeminal Neuralgia
Question: I’m trying to obtain preauthorization for percutaneous balloon deco... Read more
Procedure Focus:
Yes, You Can Separately Code Fluoroscopic Guidance With 64520 - Sometimes
Don’t forget to double check CCI edits. Every pain management coder runs into th... Read more
Check Out These 5 Steps to Modifier -22 Success
The modifier won't add extra pay, but the extra time involved could.  When your pain... Read more
Remember Your Spinal Regions When Coding for Radiculopathy
Heads up: You’ll have lots more diagnosis choices in 2015. Choosing your diagnos... Read more
Reader Question:
Report 62368 or 62370 Over 95991 When Possible
Question: We used to bill the 62368, 95991, and the appropriate J code for pump ref... Read more
Reader Question:
Choose Best Code for Follow-Ups, Not Just 99212
Question: We recently finished our first internal audit and found a potential issue... Read more
Reader Question:
Check Timing of Lumbar Pars Defect to Help Narrow Diagnosis
Question: I reported 64493 for a lumbar pars injection. The associated diagnosis is... Read more
Reader Question:
Start With 64400 for Trigeminal Nerve Injections
Question: Our pain management specialist documented “0.5 ML across the right and 0... Read more
Reader Question:
Consider This When Transitioning to New Software
Question: Our IT department decided to do a major software upgrade to ensure we sta... Read more
You Be the Coder:
Where to Find Post Meningitis Headache Diagnosis
Question: A patient developed pneumocephalus meningitis after an attempt to open a ... Read more
Get the Scoop on the Biggest Pain Management Changes Under ICD-10
Tip: Watch individual guidelines and ‘excludes’ to stay on the right track. ... Read more
CCI 20.1:
Here's Your Confirmation on How to Report Some Chemodenervation Services
Latest coding edits focus again on 64615 and 64616.   Being familiar with chemode... Read more
Modifier Coding:
Ensure You Follow This 'Do' and 'Don't' to Reach Modifier 25 Success
The key: Know that 'separate' designation is justified.  You might routinely turn to... Read more
Reader Question:
Resort to 64999 for Most Facet Joint Cyst Aspirations
Question: How would you code a left L5-S1 zygapophyseal (facet) joint aspiration fo... Read more
Reader Question:
Avoid Separate Script Refill Code With E/M Visit
Question: What code should we bill when the physician is only writing a prescriptio... Read more
Reader Question:
Remember 63650 Now Includes SCS Trial Lead L8680
Question: Does the stimulator trial lead (L8680) now get included in the implantati... Read more
Reader Question:
Submit Transforaminal Over Interlaminar ESI During Same Encounter
Question: Our physician wants to bill for an aborted interlaminar epidural steroid ... Read more
Reader Question:
Choose 62272 for Lumbar Drain Placement
Question: Our pain management specialist placed a lumbar drain and this was left in... Read more
You Be the Coder:
How Would You Code a Sinus Tarsi Injection?
Question: We recently received a denial when we reported a cortisone injection to t... Read more
Procedure Focus:
Focus on 3 Details to Boost Your Spinal RF Ablation Success
Tip: Don’t get hung up on counting nerves. Submitting clean claims for paraverte... Read more
Treatment News:
Don't Miss Opportunities When Your Patients Might Qualify for PILD Coverage
CMS decision could still allow you some leeway.  The “jury” regarding... Read more
Prepare for a Single ICD-10 Choice for Lumbar Spinal Stenosis – in Some Cases
Caveat: Extended bridge codes could be your best choice in some situations. When your ... Read more
Understand Where AMA and Medicare Differ on Vertebroplasty Coding
Tip: Double check vertebral locations before choosing additional codes.  The AMA ... Read more
Reader Question:
No, You Shouldn't Report 77003 as a Stand-Alone Fluoro Code
Question:  One of our patients had a spinal cord stimulator inserted in December 20... Read more
Reader Question:
Check Whether Breaking the 64493/01992 Edit for Separate Providers Is Legit
Question: Our pain management physician administered an injection (64493) and the C... Read more
Reader Question:
99144 Is Allowed With Epidural Injections
Question: One of our physicians adds 99144 to his billing sheet whenever he performs LES... Read more
Reader Question:
Correctly Count the Administration Units of J3301
Question: Dictation from an encounter states that the physician used 2 mL of 0.75% ... Read more
Reader Question:
Translate 'Atlanto-Occipital' or 'Atlanto-Axial' Joint as 'Paravertebral'
Question: Our pain management specialist performed the following procedures:  ... Read more
Reader Question:
Focus on Payer Preference for Hardware Injection Coding
Question: Is there an actual procedure code for a hardware injection? I bill 64999 ... Read more
You Be the Coder:
Verify When You Can Report Both 64642 and 64615
Question: I have a patient who suffers from migraines and receives treatment with B... Read more
Available Years:  2014