Wiki MBB and RFA frequency

[lburns23]

Hello!

I know that the majority of payers will allow 2 RFAs per year for each level, and two MBB must be performed to verify the cause and efficacy to ensure the RFA is going to help.

My question is whether, after those 12 months, are we required to do a new MBB on a level if the patient is demonstrating the same pain pattern as before, or can we just move ahead with another RFA for the 12 month period?

Thanks!

 

[Melissa Harris CPC]

We generally move ahead with another RFA if it is the same pain and the prior RFA had the benefit stated in the insurance guidelines. We do have patient's come back after 2-3 years wanting another RFA and we then leave it up to the practitioner to make the decision. Some Workers Comp carriers do require a repeat confirmatory MBB, however.

Melissa Harris, CPC
The Albany and Saratoga Centers for Pain Management.

 

[lburns23]

Thank you, Melissa!