Pain Management Coding Alert

Trek Across Global Periods to Make 25/57 Decision
Here are the answers you need to decide between these two E/M modifiers. If your provi... Read more
ICD-10 Coding:
Use These Dx Tips for Skull Fracture Patients
Remember: ICD-10 requires lateral specificity. Coders that struggle with skull fracture ... Read more
Conduct Self-Audits, Help Yourself Spot Coding Flaws
Experts: Be sure to audit ‘low-hanging’ targets annually. Medical practice... Read more
Reader Question:
Method Matters When Choosing Infusion Code
Question: Encounter notes indicate that one of our nonphysician practitioners (NPPs... Read more
Reader Question:
Document Encounter Specifics to Duck Observation Denials
Question: We recently submitted a 99236 code for an observation service our PM phys... Read more
Reader Question:
Code Post-Op Pain With 99231 ... Maybe
Question: Our providers are now doing a different nerve block for postoperative pai... Read more
Reader Question:
Protect HIPAA From 'Social Engineering' Threat
Question: I recently heard about “social engineering” as a security thr... Read more
Reader Question:
Put 99291, +99292 to Work With 'Critical' Smarts
Question: CPT® states that a patient must be “critically ill or injured&r... Read more
You Be the Coder:
Motor/NCS Test Combos
Question: An established patient reports to the PM physician for a nerve conduction... Read more
CPT® 2017:
CPT® Creates Injection/Guidance Combo Codes
Experts: New codes should augur well for injection/guidance payment. Pain management ... Read more
Choose Between 59/X After Identifying Distinct Services
Modifier 59 or one of the X modifiers? Choice still payer-dependent. When deciding if... Read more
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Get HPI Info With This Template
Expert: Direct questions help to get to the heart of HPI details. Once the provider es... Read more
Reader Question:
ICD-10 Clears Up Zika Dx Question
Question: We don’t typically get patients with Zika virus, but the physician ... Read more
Reader Question:
Keep These 64447 Edits In Mind When Coding
Question: Our provider uses ultrasound guidance when adminis­tering a postoperative ... Read more
Reader Question:
Check for Modifier 51 Opportunities on Injections With Fluoroscopy
Question: Our physician recently performed multiple arthroscopic injections, and th... Read more
Reader Question:
Remember, PHI Takes Many Forms
Question: I’m pretty sure I know what types of information constitute protect... Read more
Reader Question:
Drop 1-Hour Rule on These Neurostimulator Tests
Question: Our physician recently performed a complex spinal cord neurostimulator te... Read more
Reader Question:
Consider Taking CPPM® Exam to Expand Skills Scope
Question: I work for a small practice where I do a little bit of everything; coding... Read more
You Be the Coder:
Coding Both Parts of EDX Test
Question: I have a confusing claim in front of me. Encounter notes indicate that th... Read more
Look Sideways to Get the Scoop on New ICD-10s
ICD-10 2017 codes full of bilateral options for various conditions. In late summer the... Read more
E/M Coding:
Put Time to Work for You With Counseling Exception Chops
Here’s why a note documenting counseling/coordination time could make your claim. ... Read more
Obtain BAAs from HIPAA-Accountable Entities
Not everyone who accesses PHI has to sign a BAA. When you’re working with medica... Read more
Reader Question:
Get in Touch With Differing Telemedicine Definitions
Question: Can we code for telemedicine services our physician or qualified nonphysi... Read more
Reader Question:
Provider Can Complete Established E/M Without Exam
Question: I have newly joined pain management coding. Recently, when reporting an E... Read more
Reader Question:
Coders, Beware of Coding 'Automatic' E/Ms
Question: I am having an issue with one of our physicians who wants to report almos... Read more
You Be the Coder:
Choosing Injection Guidance Code
Question: A new patient reported to our physician complaining of pain in his right ... Read more
Postoperative Care:
Make Postop Pain Management Work With These Tips
Make sure both providers sign off on these claims. At times, your pain management specia... Read more
Pain Management:
Use This Arthrocentesis Q&A to Dodge Denials
Don’t forget about J code for drugs. Before choosing the proper code, there are ... Read more
E/M Coding:
Keep Incident-To, Split Visits Separate to Max Out Coding
Here’s why POS 11 is a pivotal piece of info on these E/Ms. If one of your physi... Read more
Reader Question:
Mind Globals When Coding Cath Follow-Ups
Question: Our physician completed a revision of a tunneled spinal epidural catheter... Read more
Reader Question:
Try These New Codes for Advance Care Planning
Question:  I’ve heard there’s been some recent reforms for reporting ad... Read more
Reader Question:
Get Elemental When Counting HPI
Question: Could you explain the basics of history of present illness (HPI) coding? ... Read more
Reader Question:
Keep Up With Stark Law, Prevent 'Self-Referral' Suspicions
Question: I overheard one of our nurse practitioners (NPs) say that someone at the ... Read more
You Be the Coder:
Coding For Sinus Tarsi Injections
Question: How do you code for sinus tarsi injection? Alabama Subscriber Answer:... Read more
ICD-10 Coding:
Dive Deep Into ICD-10 When Coding for Diabetic Neuropathy
Hint: Key on type of diabetes, complications. Pain management practices will often see pa... Read more
Nerve Studies:
Code Carefully When Considering Electrodiagnostic Testing
NCS + EMG might equal EDX suite. When your physician performs a nerve conduction study... Read more
Create Patient Termination Template to Avoid Compliance Headaches
Use certified mail to prove you’ve ended things with patient. When your medical pr... Read more
Reader Question:
Payer Policy Drives Modifier SA Decision
Question:  We employ a nurse practitioner (NP) at our office. When she provides sup... Read more
Reader Question:
Epidural Adhesiolysis Coding Hinges on Days, Not Adhesions
Question:  Our physician inserted a spinal epidural catheter to break spinal adhesi... Read more
Reader Question:
Leap These 'Unprocessable' Hurdles to Strengthen Coding
Question: I’m new to coding, having switched from our practice’s accoun... Read more
Reader Question:
ID All Business Associates to Stay Compliant
Question: I have read about business associate agreements (BAAs) in past issues of ... Read more
You Be the Coder:
Coding for Bilateral Anesthetic Services
Question: A surgeon completed bilateral knee replacements and asked us to administe... Read more
News You Can Use:
Be Ready for ICD-10 Changes Coming in October
Feds currently reviewing proposals for ICD-10 updates. While the ICD-10 authors haven&... Read more
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Post These Chronic Migraine Diagnosis Rules Where You'll Need Them
Remind coders what qualifies as ‘chronic.’ Pain management clinics see the... Read more
E/M Coding:
Count ROS Carefully to Arrive at Correct E/M Level
High-level E/Ms might be possible with complete ROS. One of the most important element... Read more
Reader Question:
Appending QW Indicates Office's Waived Status
Question: Our practice recently received its clinical laboratory improvement amendm... Read more
Reader Question:
Get Specific When Reporting Ankle Pain
Question: A patient presents with pain in the ankle, and the physician performs arthr... Read more
Reader Question:
More Injections Doesn't Always Mean More Pay
Question: If the physician gives two injections into the (same) knee in two separat... Read more
Reader Question:
Use This Coding Technique for Longer 1-Day Observations
Question: One of our physicians performed an observation service for a Medicare pat... Read more
Reader Question:
Repel PHI Hackers With Frequent Updates
Question: In the past year, we have had to deal with several Health Insurance Porta... Read more
Reader Question:
Take Steps, Be Prepared if OCR Comes Calling
Question: In addition to being the coding lead at our practice, I’m also part... Read more
Reader Question:
Use These Tips for Airtight Locum Claims
Question: Our practice recently hired a locum tenens (LT) physician to fill in for ... Read more
You Be the Coder:
Coding the Second Encounter for a Neck Strain Patient
Question: A patient visits the office for a second time. Notes indicate that the phys... Read more
Get Up to Speed on New G Code Edits
Here’s a look at the codes that now include specimen validity testing. Pain mana... Read more
Medicare Coding:
Keep Your Incident-to Coding Sharp or Face Lost $$
Know the rules before reporting NPP’s services under physician’s NPI. When... Read more
Know These Terms, Ease Migraine Coding Pain
To get a full migraine Dx, you must know definitions of intractable, status migrainosus.... Read more
Reader Question:
Medicare Makes It OK to Use JW for Some Discarded Drugs
Question: Our pain management practice is losing quite a bit of money on discarded ... Read more
Reader Question:
If Necessary, 'Scare' Physicians into Signing on Dotted Line
Question: I’m having trouble getting my physicians to sign their claim forms.... Read more
Reader Question:
Opt for Consult Code When You Spot 'Request for Opinion'
Question: A new patient came to our practice to discuss whether she should start th... Read more
You Be the Coder:
Capturing '2-Sided' Injection Pay
Question: When I use code 62311, how do I capture the “bilateral” porti... Read more
Tally TPI Target Muscles for Sure-Shot Coding
Any muscle group is a potential TPI candidate.  Pain management providers often per... Read more
ICD-10 Coding:
Focus on 4th Character, Mollify Migraine Coding Concerns
Here’s why character No. 4 is the linchpin to correct diagnosis choice. When yo... Read more
Electronic Health Records:
Act Before the Fact, Be Ready if EHR Fails
Here's how to prep for an EHR shutdown. If your electronic health record (EHR) system bec... Read more
Reader Question:
When Disaster Strikes, Have Modifier CR Ready to Go
Question: I’ve been reading through the latest CPT® book, and I happ... Read more
Reader Question:
Coach Up Staff With These Phone Tips
Question: We are a small practice, and everyone has to answer the phone from time t... Read more
Reader Question:
Opt for 'Unspecified' for Some Diagnoses
Question: If I find that a common ICD-9 code that I use doesn’t have a direct... Read more
Reader Question:
Relax, You Don't Need a Dozen Diagnoses for Each Claim
Question: We have primary diagnosis codes and secondary diagnoses codes that, when ... Read more
Reader Question:
Don't Let Tremor Coding Shake Your Confidence
Question: I hope you can shine some light on this as we have another dilemma today ... Read more
You Be the Coder:
Ease ESI Coding by Learning Injection Types
Question: I’m new to pain management coding, so am learning a lot about the d... Read more
ICD-10 Coding:
Look to F45.4- When Pain Is Tied to Psychological Factors
Best practice: Include a “causation statement” with your claim. When you&r... Read more
Critical Care:
Separate Services from Critical Care for Optimal Pay
Experts: You’ll often see these separately reportable services on 99291 claims. ... Read more
Give Patient a Heads Up With ABN If Medicare Might Not Pay
Also, check out how ABNs can lead to healthier patient relations. When patients report to... Read more
Reader Question:
Sidestep CTS Dx Miscodes Use With These Pointers
Question: Since ICD-10 premiered, I’ve been having some trouble choosing the ... Read more
Reader Question:
Remind Patients: An EOB Is Not a Bill
Question: We often get patients who call the practice with questions about their expl... Read more
Reader Question:
CPC License a Plus for New Coding Hire
Question: We are in the process of hiring a new full-time medical coder for our pra... Read more
Reader Question:
Calendar, Not Clock, Drives Observation Code Choice
Question: If we admit a patient to observation at 11 p.m. on Thursday and then rele... Read more
Reader Question:
Surgery Mix-up? You Might Need Modifier PC
Question: Some of the coders in the office were discussing a news story in which a pa... Read more
You Be the Coder:
ICD-10 Codes for Acute, Chronic Pain
Question: For diagnosis coding purposes, what is the difference between acute and chr... Read more
Procedure Focus:
Remember 3 Things to Simplify Your Paravertebral Facet Joint Injection Claims
Here’s what you need to know when coding intra-articular blocks. You probably se... Read more
Crack the Cervical Disc Disorders Coding in ICD-10
Use the 4th character to help explain the condition. ICD-10 brings a wide selection o... Read more
Are You Ready for Even More EHR & HIPAA Compliance Scrutiny?
You’d better be, because lots of times are on the OIG’s radar. If you thou... Read more
Reader Question:
64999 Is Probably Your Best Bet for Coccygeal RFA
Question: My physician is planning to do RFA (radiofrequency ablation) of the coccy... Read more
Reader Question:
Avoid Reporting 96372 With TPIs
Question: A patient came to our office with pain and spasms in the bilateral cervic... Read more
Reader Question:
Remember 64445 Represents Sciatic Nerve Block, Not Piriformis
Question: We normally bill 64445 for a piriformis nerve block, but Tricare does not... Read more
Reader Question:
Counting On Time for E/M Level Selection
Question: I have an encounter note in front of me that I cannot decipher. Notes ind... Read more
Reader Question:
Turn to 'Unlisted' for Sphenopalatine Lidocaine Administration
Question: Our pain management specialist is looking into administering Lidocaine th... Read more
You Be the Coder:
Correctly Calculate J3301 Units
Question: A patient presented with a bi-occipital headache with associated tenderne... Read more
Coding Edits:
Pay Attention to New Modifier Indicator Edits for Paraspinous Block Codes
CCI 22.0 edits can get tricky to keep straight. Version 22.0 of the Correct Coding Ini... Read more
Are You Ready to Determine the Best Diagnosis for Diabetic Neuropathy?
ICD-9 had a lot of options, but ICD-10 has even more. If your physician treats a patie... Read more
Lab Testing:
Say Goodbye to G0431 and G0434 for Drug Test Coding
Be sure you’re prepared for multiple changes. 2015 was a year full of comments r... Read more
Reader Question:
Get Clear on the Difference Between 'Initial Treatment' and 'Onset'
Question: What is the difference between the “Date of the initial treatment&r... Read more
Reader Question:
Verify How Workers' Comp Handles ICD-10
Question: I have been told we shouldn’t use ICD-10 for workers’ compens... Read more
Reader Question:
Don't Fret Too Much Over Illegible Handwriting
Question: One of my physicians has handwriting so terrible that I’m afraid of... Read more
Reader Question:
Check Out the Excludes1 Guideline Update
Question: I heard that there were changes to the Exclude notes in ICD-10, but they ... Read more
You Be the Coder:
Understand Your Diagnosis Choices for Facet Syndrome
Question: Please guide us through the codes for facet syndrome in ICD-10-CM. Okla... Read more
Procedure Spotlight:
Get Familiar With Cryoablation and RF Lesioning Coding
Don’t forget about these neurolytic destruction options. Physicians can choose f... Read more
Don't Miss These Changes to POS Codes in 2016
An addition and revision will affect your outpatient claims. If your providers offer s... Read more
Pay Attention to Spinal Region When Coding for Neck Sprain
Tip: The smallest details can make a difference. When you still coded with ICD-9, a si... Read more
Reader Question:
Think Twice Before Submitting 77002 With 64420 or 64421
Question: Are we able to bill for fluoroscopic guidance/placement separately for interco... Read more
Reader Question:
Learn What Separates Shared Visit and Incident-To
Question:  An established patient came to our office for a follow-up with our nurse... Read more
Reader Question:
Narrow Bupivacaine HCl Injection Choices to S0020 and J3490
Question: What is the best HCPCS code for a bupivacaine HCI injection (10 mL, single dos... Read more
Reader Question:
Verify Medical Necessity to Combat SCS Analysis Denials
Question:  A few months ago, Medicare started denying all our claims for spinal cor... Read more
Reader Question:
Skip Billing Hydration With Non-Chemo Infusion Codes
Question: It is possible to bill for non-chemo infusion 96365 and 96367 and hydration th... Read more
Reader Question:
Keep These Tips in Mind for Locum Tenens Selection
Question: One of our physicians will be taking a six-month sabbatical, so we need to hir... Read more
Reader Question:
Get Approval Before Filing Workers' Comp Claim With ICD-10
Question: I’ve heard that we shouldn’t use ICD-10 for workers’ compens... Read more
You Be the Coder:
Study What Differentiates M47.812 From M47.892
Question: Our physician documented cervical spondylosis affecting the C2-3 and C3-4 join... Read more
Available Years:  2016  2015  2014