Reader Question: Report 2 Options Guide Code Choice for Radiofrequency With 64640   (February 2012)

Question: How do we report radiofrequency ablation of ventral hernia incisional neuroma under IV sedation?Ohio Subscriber Answer: You report 64640 (Destruction by neurolytic agent; other peripheral nerve or branch) for a standard radiofrequency procedure. Whether you separately bill the sedation/block depends on the situation. Option 1: If the provider performs the block during the same session as the thermal radiofrequency, you cannot separately bill the block. Coding guidelines consider the block to be the “anesthesia” [...]

Coding Tips: Apply These Extra Tips for EEG Reporting Success   (January 2012)

Do not look at frequency and never miss a hidden bundle.In the last issue, we learned about capturing EEG recording time and appropriately reporting any extended recording. (See “Get Your Routine And Extended EEG Coding Into Gear With These Pointers” in Neurology and Pain Management Coding Alert, Vol. 13, No. 12).This month, we’ll show you how to report the digital analysis and time the physician attendance. We’ll also review how to identify Correct Coding Initiative [...]

Coding Strategies: Take The Pain Out Of Spinal Neurostimulator Reporting   (January 2012)

Trials and reprogramming can help you to recover your deserved payment for these services.Your chances of successfully reporting your neurologist’s spinal neurostimulator implant services will improve dramatically if you can capture all the steps in the operative note. Correctly assigning codes depends on identifying a typical sequence, which includes placing a trial electrode array/lead, removing it, implanting a permanent electrode array/lead and pulse generator, and lastly programming the generator system at regular intervals according to [...]

ICD-10 Update: 2 Codes Help You Capture Phantom Limb Pain   (January 2012)

Presence or absence of pain guides you to the right code for phantom limbIn 2013, you will need to gather more details about the presence or absence of pain when the patient complains of a phantom limb after an amputation. Whereas ICD-9 has a single code for phantom limb syndrome, ICD-10 elaborates the relation of phantom limb to pain and specifies two codes for the condition depending upon pain is present or not.ICD CodesICD-9 has [...]

You Be the Coder: Turn to 64640 for Radiofrequency Ablation   (January 2012)

Question: What CPT® code best represents radiofrequency ablation of a painful abdominal anterior cutaneous nerve at the site of a healed ventral hernia incision? Florida Subscriber Answer: CPT® includes several codes for varying specific somatic nerve destruction procedures. Currently there isn’t a specific CPT® code for the anterior abdominal cutaneous nerves. However, CPT® does provide 64640 (Destruction by neurolytic agent; other peripheral nerve or branch) for standard radiofrequency of other somatic nerves and/or branches. Tip: [...]

Reader Question: Unattended’ Is Key to Reporting 95953   (January 2012)

Question: I thought that we would report 95951 for 24-hour video EEG, but am reading that 95951 is a hospital-based code. Our office owns a video EEG. The patient takes it home and records for 24 hours, then returns for our physician to read and interpret. What code should we bill? Ohio Subscriber Answer: You’re correct that 95951 (Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, combined [...]

Reader Question: Double Check Documentation for 95903-95905 Billing   (January 2012)

Question: We submitted codes 95903 and 95905 for nerve conduction studies during the same patient encounter. The payer bundled 95905 into 95903, but still reimbursed separately for both codes. Why are these procedures bundled together, yet still payable? Wisconsin Subscriber Answer: First, take a close look at the codes you’re reporting: 95903 – Nerve conduction, amplitude and latency/velocity study, each nerve; motor, with F-wave study 95905 – Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude [...]

Reader Question: 93924 Most Likely Choice for Arterial Study of Extremity   (January 2012)

Question: What is the correct CPT® code for arterial Doppler study of bilateral extremity? Nevada Subscriber Answer: CPT® includes a range of codes that may be applicable depending upon the specific type of arterial Doppler study that was performed. Coding will vary depending on if the diagnostic test was a limited or complete study, if the study followed a treadmill stress test, and/or included the criteria for a Duplex scan. Check your provider’s documentation and [...]

Pay Attention To Programming 2012 Changes   (January 2012)

To avoid denials, make sure you’re up to date on these crucial 2012 programming changes. You should report codes depending upon the number of changes that were made in the pulse generator. You do not look at what the generator is capable of affecting. Changes may be done for pulse amplitude, pulse duration, train spacing, number of programs, number of channels, alternating electrode polarities, output modulation, cycling, impedance and patient compliance measurements. “If the generator [...]

Pain Management Strategies: Master Facet Joint Injection Essentials With These Tips   (December 2011)

Count each level and check for your payers’ preferences.When reporting facet joint injections, make sure you know the spinal levels that the pain management specialist treated and also what your payers’ preferences are for the maximum number and frequency of the injections that can be given. Whether the facet injections are diagnostic or therapeutic, you should count each level and/or both sides. Read on for more advice on reporting these common procedures.Don’t Let Intent Throw [...]