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Radiology Coding Alert

Pain Management:

Prevent Denials By Applying UHC's Latest Thermal RFA Policy

Published on Fri Jul 09, 2010

This payer wants to see you report 77003 separately.If your practice participates with United HealthCare (UHC), you'll want to take note of UHC's recent policy update (number 2010T0107H) on ablative treatment of spinal pain. Although UHC has a limited coverage policy for a number of spinal pain and facet joint pain procedures (64622-64627), you have some chance of reimbursement if you know the rules.Ablation Method and Frequency MatterAmong the changes are a revised coverage policy for how often thermal radiofrequency ablation (RFA) can be performed and reimbursed. The policy states that thermal RFA is covered "when performed at three months or greater frequency, provided there has been a 50% or greater documented reduction in pain."Example: On May 15, 2010, a radiologist performs a repeat thermal radiofrequency (RF) ablation on the right L4 and L5 paravertebral facet joint nerves on a patient with right lumbar facet joint pain. You would report [...]
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