Wiki new pain management doctor

Jennifer17

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I am and have been in orthopaedics for a very long time and now we will be hiring a pain management doctor which I know nothing about coding for. Does anyone have a superbill or anything with common codes or any advice on learning pain management - of course I will be looking into seminars also.

Thanks in advance
 
Below is list of pain management codes I found from the below link, I copy and pasted a lot of the codes from the link but there could other codes needed. I would look at the local coverage determination policies for Medicare carrier in your state and you can get familiar with the ICD-10 codes that meet medical necessity and the documentation requirements. Lately they seem to be update those policies more frequently and it is importantly to watch for draft policies and future changes. Additionally Aetna, Cigna, UHC, BCBS have policies that you want to be familiar with. Most of the policies describe the requirement of fluoroscopic guidance for facet, SI joint, and potentially epidurals, And typically do not cover their ultrasound guided counterpart.

http://thepainsource.com/cpt-codes-pmr-pain-management-billing-and-coding/


Joints and Bursa – Injection or Aspiration
◾Major joint/bursa: 20610 (knee, hip, shoulder, trochanteric bursa, subacromial bursa, pes anserine bursa)
◾Intermediate joint/bursa: 20605 (temporomandibular, acromioclavicular, wrist, elbow, ankle, olecranon bursa)
◾Minor joint/bursa: 20600 (fingers [PIP, DIP], toes)
◾Sacroiliac joint (SIJ) with fluoroscopy: 27096
◾Sacroiliac joint (SIJ) without fluoroscopy: 20552 (billed as a trigger point injection)
◾Genicular nerve blocks: 64450
◾Genicular nerve RFA: 64640
◾Carpal tunnel injection: 20526

Tendons, Ligaments, and Muscle Injections
◾Tendon sheath or Ligament: 20550 (iliolumbar ligament, trigger finger, De Quervain’s tenosynovitis, plantar fascia)
◾Tendon origin/insertion: 20551
◾Trigger point injection (1 or 2 muscles): 20552
◾Trigger point injection (3 or more muscles): 20553
◾Sacroiliac joint (SIJ) without fluoroscopy: 20552 (billed as a trigger point injection)

Nerve Blocks
◾Greater occipital nerve block: 64405
◾Lesser occipital nerve block: 64450
◾Other peripheral nerve: 64450 (I use this for superior cluneal nerve blocks, and genicular nerve blocks)
◾Other peripheral nerve: 64640 (used for S1, S2, S3 lateral branches during RFA)
◾Suprascapular nerve: 64418
◾Intercostal nerve (single): 64420
◾Intercostal nerve (multiple): 64421
◾Ilioinguinal and Iliohypogastric nerve: 64425
◾Trigeminal nerve (any branch): 64400
◾Sphenopalatine ganglion: 64505
◾Stellate ganglion (cervical sympathetic): 64510
◾Superior hypogastric plexus: 64517
◾Thoracic or lumbar paravertebral sympathetic: 64520
◾Celiac plexus: 64530
◾Plantar common digital nerve (Morton’s neuroma): 64455
◾Unlisted procedure: 64999

Epidural Steroid Injections (ESI)
◾
Interlaminar
◾Interlaminar – cervical or thoracic: 62310
◾Interlaminar – lumbar or sacral (caudal): 62311
Interlaminar-cervical or thoracic: 62318 Infusion greater than single calendar day
Interlaminar-Lumbar/Caudal 62319 Infusion greater than single calendar day


◾
Transforaminal
◾Transforaminal – cervical or thoracic (first level): 64479
◾Transforaminal – cervical or thoracic (each additional level): 64480
◾Transforaminal – lumbar or sacral (first level): 64483
◾Transforaminal – lumbar or sacral (each additional level): 64484

Facet Joint Procedures
◾
Intraarticular Joint or Medial Branch Block
◾Intraarticular joint or medial branch block (MBB) – cervical or thoracic (1st level): 64490
◾Intraarticular joint or medial branch block (MBB) – cervical or thoracic (2nd level): 64491
◾Intraarticular joint or medial branch block (MBB) – cervical or thoracic (3rd level): 64492
◾Intraarticular joint or medial branch block (MBB) – lumbar or sacral (1st level): 64493
◾Intraarticular joint or medial branch block (MBB) – lumbar or sacral (2nd level): 64494
◾Intraarticular joint or medial branch block (MBB) – lumbar or sacral (3rd level): 64495

Radiofrequency Ablation (RFA) / “Destruction” of Facet Joint
◾Radiofrequency ablation (RFA) – cervical or thoracic (1st joint): 64633
◾Radiofrequency ablation (RFA) – cervical or thoracic (each additional joint): 64634
◾Radiofrequency ablation (RFA) – lumbar or sacral (1st joint): 64635
◾Radiofrequency ablation (RFA) – lumbar or sacral (each additional joint): 64636

Vertebroplasty / Kyphoplasty

Vertebroplasty
◾Vertebroplasty – Cervicothoracic (1st level): 22510
◾Vertebroplasty – Lumbosacral (1st level): 22511
◾Vertebroplasty – Each additional level of the above: +22512

Kyphoplasty
◾Kyphoplasty – Thoracic (1st level): 22513
◾Kyphoplasty – Lumbar (1st level): 22514
◾Kyphoplasty – Thoracic or Lumbar (each additional level): +22515


Implantation of Spinal Cord Stimulator Percutaneous Leads and Generator
◾Percutaneous implant of electrode array: 63650 (includes 10-day global)
◾Insertion or replacement of pulse generator: 63685 (includes 10-day global)

◾
Implantation of Spinal Cord Stimulator PADDLE Leads and Generator
◾Laminectomy for implant of neurostimulator electrode, paddle: 63655 (includes 90-day global)
◾Insertion or replacement of pulse generator: 63685 (includes 10-day global)

◾
Removal of Leads/Generator (Explant)
◾Removal of spinal neurostimulator percutaneous array(s): 63661 (includes 10-day global)
◾Removal of spinal neurostimulator paddle electrode: 63662 (includes 90-day global)
◾Removal of pulse generator: 63688 (includes 10-day global)

Discogram / Discography
◾Discogram / Discography – Cervical/Thoracic (each disc): 62291
◾Supervision & interpretation of fluoroscopy – Cervical/Thoracic (each disc): 72285
◾Discogram / Discography – Lumbar (each disc): 62290
◾Supervision & interpretation of fluoroscopy – Lumbar (each disc): 72295
 
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