Wiki Pain Management

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eguillot

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Is anyone else having problems with WellCare denying 99152 when billed with pain management codes? We have been getting many denials and we are wondering if anyone else is having this problem. Is there any other code that could be used?
 
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It looks like they made updates to their reimbursement policy




Anesthesia Policy: Anesthesia for Pain Management Injections
According to the American Society of Anesthesiologists and the International Spine Intervention Society, minor pain procedures such as epidural steroid injections, epidural blood patch, trigger point injections, sacroiliac joint injection, bursal injections, occipital nerve block and facet injections under most routine circumstances, require only local anesthesia.
  • Anesthesia and moderate sedation services billed with pain management services for a patient age 18 or older may deny unless a surgical procedure CPT code range 10021-69990 (other than pain management procedures) is also billed on the claim.
 
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