Wiki NEW 2023 PAIN MGMT HCPCS G3002 G3003

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cherylbr

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Has anyone received any information on the documentation requirements and the proper claims submission for the new 2023 Pain management HCPCS codes G3002, G3003.

It appears as these codes are for accumulation of services provided monthly.

Am I understanding these correctly?

Any information on this would be greatly appreciated.

Thank you,
Cheryl
 
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There has been a article related to this in the Orthopedic Coder's Pink Sheet, published Dec 21, 2022.
Hope this may help you.
 
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cherylbr said:
Has anyone received any information on the documentation requirements and the proper claims submission for the new 2023 Pain management HCPCS codes G3002, G3003.

It appears as these codes are for accumulation of services provided monthly.

Am I understanding these correctly?

Any information on this would be greatly appreciated.

Thank you,
Cheryl
Click to expand...
Hi there. That's correct. As is the case with other care management services the codes describe total time spent on one or more of the described services during a calendar month.

The billing provider must perform at least 30 minutes in a calendar month for the primary code and 15 for the add-on code. CMS did not place a limit on the add-on codes. In addition, the patient must consent to the service in advance and the first visit must be in-person and last at least 30 minutes.

In talking with a few people about this service, the big difference between this and other CM services is the work must be done by the provider. There isn't a clinical staff option.

Hope this helps.
 
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The Orthopedic Coder's Pink Sheet (published 12/21/22) is showing Not Found. Does anyone have a copy of this article?

Question regarding G3002: My understanding that this is billed once a month in the same month that the patient is treated however, can E&M code be billed as well during the same month?
 
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k8mbee said:
The Orthopedic Coder's Pink Sheet (published 12/21/22) is showing Not Found. Does anyone have a copy of this article?

Question regarding G3002: My understanding that this is billed once a month in the same month that the patient is treated however, can E&M code be billed as well during the same month?
Click to expand...
Yes, you can report an E/M visit or other services during the same month, and even the same day, so long as there's no overlap.
 
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@lgardner thanks for the NAMAS article - I found it helpful.
For one of my practices, we have an NP who treats a lot of chronic female pelvic pain and asked about using these codes. My research into the codes and the way we practice is that it would actually hurt financially to use these codes in many situations. For example - pt has an office visit every month that includes management of her chronic pelvic pain (35 minutes of clinician time is noted.) Assuming the requirements of documentation are there, I can bill G3002 OR 99214. I suppose there are some circumstances these new codes would be helpful, but it's not in mine.
Also - it's carrier judgment for coverage which in my experience means most commercial carriers will not cover.
 
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