Wiki Pain Management

[andelacruz]

I have just started working int his field and would appreciate any help in resources that I can use.

 

[DCOMPauditor]

Hello

I've been in pain management for about 7 yeard now, so any questions, feel free to ask.

 

[jsgooch]

Let me know.. Pain mgmt here as well..
Thanks

 

[Walker22]

Me too! (4+ years)

 

[andelacruz]

Pain Mgmt

Thank you I do have a question in when the dr does a
27096-LT
64475_LT
64476-LT

Medicare alloed 75.78 and pd 60.62 on the 27096
allowed 200.02 and pd 160.02
and denied the 64476 my question is should they have applied the 59 modifier to 75 and 76??? Any thoughts ideas, whatever would be greatly appreciated!!!

Thank you
Nicole

 

[Walker22]

a mod-59 shouldn't be necessary as these procedures are not mutually exclusive. What was the denial reason for 64476?

 

[andelacruz]

Thanks for answering the denial reason is:

Claim lacks info which is needed for adjudication.

 

[Walker22]

That's typically unclear. I guess you will have to call them and find out what it really means. By the way, there is a pain management forum under the anesthesiology section. You will find a lot more people to answer your questions if you post in there

 

[Herbie Lorona]

Sometimes the Remark Codes give you more detail on what it is so look at the remark codes.

 

[evelasco]

Hi i'm not new in pain management but i'm new in asc and i have a doctr who is opening an asc he is a pain management . I'm kind of lost regarding the two claims i have to send one should be POS 24 TOS F with procedures and injectibles with no radiology what modifier do i use i know sg is not to be use any longer how about tc?
Then i have the profesional composent to send POS 24 TOS 2 with radioloy and procedure do i use PC or 26 on these?
Thank you for helping me>

 

[Walker22]

-26 on the professional claim and -TC on the ASC facility charge

 

[syprice]

Your 64476 is an add on code and never needs a modifier... Now with Medicare they may want to see documentation to get the add on code paid.

 

[syprice]

Thank you I do have a question in when the dr does a
27096-LT
64475_LT
64476-LT

Medicare alloed 75.78 and pd 60.62 on the 27096
allowed 200.02 and pd 160.02
and denied the 64476 my question is should they have applied the 59 modifier to 75 and 76??? Any thoughts ideas, whatever would be greatly appreciated!!!

Thank you
Nicole

Your 64476 is an add on code and never needs a modifier... Now with Medicare they may want to see documentation to get the add on code paid.