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Neurology & Pain Management Coding Alert

CPT® 2020:
‘Needle’ Codes Get Update Next Year
CPT® also deletes muscle testing codes. It's finally here — almost. CPT® recently an... Read more
E/M Coding:
Set Up for Success on Common Observation Scenarios
Do you remember the ‘8-hour rule'? When your provider performs an observation service f... Read more
News You Can Use:
Check Out These Fee Schedule Tidbits Before 2020
Anesthesia conversion factor will remain about the same. Changes are coming to certain re... Read more
You Be the Coder:
Finding the Proper Pathological Fracture Dx
Question: If a patient suffers from age-related osteoporosis with a current pathological a... Read more
Reader Question:
Make Sure to Keep 78, 79 in Different Buckets
Question: What is the difference between modifiers 78 and 79? Our PM physicians rarely per... Read more
Reader Question:
Follow This Advice on Refill/MDM Decision
Question: Can you count a routine prescription refill as a moderate level of risk whe... Read more
Reader Question:
Decipher Notes by Knowing Bilateral Synonyms
Question: An established patient who has a temporomandibular joint (TMJ) disorder rep... Read more
CPT® 2020:
Check Out the Coming EEG, E/M Changes
EEG technologists get their own codes. CPT® has released its final list of additions, de... Read more
Nerve Blocks:
Keep Coding Pain at Bay With Block Smarts
When provider performs GON nerve block, 64405 is your code. A patient has been experienci... Read more
Modifier Madness:
Here’s How 26, TC, Split Codes for Proper Reimbursement
Connect with TC provider on 26 claims to compare notes. Some coders will perform the majo... Read more
You Be the Coder:
EMG for MG Patients
Question: Notes indicate that the PM physician performed “needle EMG, 1 fiber.” The no... Read more
Reader Question:
Consider ‘Easy Bruising’ a Symptom
Question: Our provider recently mentioned “easy bruising” in his clinical notes. ... Read more
Reader Question:
Look North of 96000 for Boston Test Code
Question: The neurologist spent an hour administering the Boston Naming Test for the ... Read more
Reader Question:
Use TPI Codes for Shots Sans Guidance
Question: The physician performed a steroid injection procedure for the patient's sac... Read more
Reader Question:
Shoulder the Weight of Brachial Plexus Block Coding
Question: Our PM physician is treating a patient for postoperative pain after total should... Read more
Reader Question:
Coding Choices Sprout From Different Infusion Types
Question: Notes indicate that the physician provided 55 minutes of intravenous (IV) i... Read more
Compliance News:
Medicare Looking Into Acupuncture Coverage
Proposal would allow for narrow-scope study. After all these years, there might have been... Read more
NCCI Edits:
Big Bundles Arrive for New Nerve Destruction Codes
CCI closed several coding loopholes with new edits. The latest Correct Coding Initiative ... Read more
ICD-10:
Keep Atop Hydrocephalus Coding With This FAQ
Do you know what Dx represents unspecified congenital hydrocephalus? Patients reporting t... Read more
Reader Question:
Let Dictation Report Lead You to Diagnoses
Question: If you've got a report without a diagnosis that meets the CPT® code's Loca... Read more
Reader Question:
Mark Unspecified Meningitis With This Dx
Question: The provider performs a level-three evaluation and management (E/M) service... Read more
Reader Question:
Use Single-Level Epidural Code and Add-on … Sometimes
Question: The physician gave the patient a single-level cervical transforaminal epidu... Read more
You Be the Coder:
Check Your Postop Pain Coding Acumen
Question: An orthopedic surgeon performs total knee replacement on a patient, and the... Read more
ICD-10 2020:
Here’s the Dx Additions, Revisions You Need to Know
Remember that these 2020 codes take effect in 2019. Anyone who's played the diagnosis cod... Read more
CPT® 2021:
E/M Guidelines Splitting Into 3
CPT® hopes to add structure with new rules. Last month, we featured some information on ... Read more
Coding Quiz:
Consciousness Key in Concussion Coding
Check your concussion ICD-10 skills with these questions. When you're reporting your phys... Read more
Quick Facts:
Check Out This Primer on Coding TPI Muscle Groups, Drug Supply
Code separately for TPI drugs — provided you know how. To ethically max out your claim,... Read more
Reader Question:
MRI, Magnetic Resonance Angiography Have Different Diagnoses
Question: What is the difference between a magnetic resonance imaging (MRI) test and ... Read more
Reader Question:
Use New Test Codes With Caution
Question: How should I report neuropsychological test administration and scoring when... Read more
Reader Question:
Report Combo Codes When You Can
Question: A private payer has denied our claim for a pain management office visit for... Read more
You Be the Coder:
Reporting Local Anesthetic Shots
Question: An established patient with a history of carpal tunnel syndrome (CTS) reports to... Read more
ICD-10 Coding:
Obtain MS Confirmation on G35 Claims
Knowing what defines condition can help you code. Although ICD-10 coding for multiple scl... Read more
Q&A:
Get on Same Page As Surgeon on Postop Pain Management
Here's what to do when your PM practice takes over for another surgeon. Performing pain m... Read more
E/M Coding:
Near-Future E/M Coding Will Differ Drastically
CPT® panel rolls out ambitious 2021 plan. The way you code outpatient evaluation and man... Read more
Reader Question:
Use These Codes for Secondary Parkinsonism
Question: How does secondary Parkinsonism differ from Parkinson's disease, and what ICD-10... Read more
Reader Question:
Don’t Get Caught in Web of Cluster Headache Diagnoses
Question: During a level-three evaluation and management (E/M) service for a new patient, ... Read more
Reader Question:
Use Most Specific Chronic Pain Dx
Question: Encounter notes indicate that the provider treated a patient with “chronic pai... Read more
You Be the Coder:
Coding ESI With Guidance
Question: I'm trying to determine the level of risk in the What is the correct way to repo... Read more
Testing:
Sort EEG Types With This Expert Advice
Know the 4 states of consciousness. If your practice sees patients that require electroen... Read more
Injections:
Dodge TPI Misfires With This Advice
Report these shots wrong and you might trigger an audit. At just about any medical practi... Read more
E/M Coding:
Proceed With Caution When Considering ‘Counseling Exception’
It's tricky to code based on time. Have you ever chosen an evaluation and management (E/M... Read more
Reader Question:
Find All 3 Services to Code 63047
Question: Does 63047 require all three components, laminectomy, facetectomy, and foraminot... Read more
Reader Question:
Get the Right Dx for Shin Splints
Question: A new patient reported to the PM provider complaining of intense shin pain. Afte... Read more
Reader Question:
Know What Auditors Look for on Patient Status
Question: Our practice was recently audited, and an established patient visit was marked a... Read more
Reader Question:
I.D. Nerve Before Coding Occipital Stimulation
Question: Our pain management specialist placed a dual 8-electrode occipital stimulat... Read more
You Be the Coder:
Determining E/M Risk Level
Question: I'm trying to determine the level of risk in the following encounter: a patient ... Read more
Testing:
Scour Notes, Max Out Stenosis Checks
Did your provider go beyond E/M for confirmation? You might be able to code a procedure. ... Read more
CPT® Coding:
Check for Injections, PT for Spinal Stenosis Px
Treatments you'll see likely won't involve surgery. Your physicians may take necessary st... Read more
Q&A:
Keep Current With Razor-Sharp TPI Documentation Smarts
Take this expert advice on what to include to cement your TPI claims. Coding for trigger ... Read more
Reader Question:
Take a Second(ary) Look at External Morbidity Codes
Question: In the interests of painting the most complete diagnosis picture possible, our c... Read more
Reader Question:
Notes Are Key to Success on Spinal CT Claims
Question: Encounter notes indicate that the provider performed a computed tomography (CT) ... Read more
Reader Question:
Separate Systems and Areas on E/M Levels
Question: We are performing a voluntary self-audit of our evaluation and management (E/M) ... Read more
Reader Question:
Report These Hospital Codes With Care
Question: Can you use inpatient initial care codes 99221-99223 more than once in the same ... Read more
You Be the Coder:
The Eternal Quest to Stay Abreast of ICD-10 Terminology
Question: After a level-two evaluation and management (E/M) service for a new patient, the... Read more
FAQ:
Find Embolism Site for Sharp ICD-10 Coding
Do you know the symptoms for each type of cerebral embolism? Coders that have had to repo... Read more
Procedure Coding:
Get a Leg Up With Extremity Count on EMGs
Here's why you should think of EMG for a variety of diagnoses, not just CTS. Patients wil... Read more
ICD-10 Coding:
Note Documentation So Your Limb Pain Dx Isn’t Left Hanging
Incomplete Dx could mean denials. Whenever a patient has pain in any limb — arm or leg ... Read more
Reader Question:
Use This Code for Pain in the Neck … Usually
Question: When a patient reports to the physician complaining of neck pain, what is the co... Read more
Reader Question:
Interpreter Won’t Always Mean More MDM Points
Question: We recently took on a new patient who is deaf. The patient came with a family me... Read more
Reader Question:
Don’t Get Caught Off-Guard With Spontaneous Rupture Dx
Question: Notes indicate that the provider performed an evaluation and management (E/M) se... Read more
Reader Question:
Use Add-on Smarts to Ease ESI Coding
Question: I have some questions about billing for epidural steroid injections (ESIs). Pati... Read more
Reader Question:
Go International With HIPAA Observance
Question: Our practice uses a small cloud services provider (CSP) based in Canada to store... Read more
You Be the Coder:
Trigeminal Neuralgia Treatment
Question: An established patient with trigeminal neuralgia reports to the physician compla... Read more
CCI Edits:
Get Familiar With New Arthrodesis Bundles
You can report 63047 and +63048 together … but be careful. As if you didn't have enough... Read more
E/M Coding:
Use Patient Status Smarts to Determine New/Established
The 3-year rule is vital, but it's not the only guideline for patient status. There's a m... Read more
Modifier Madness:
Correctly Use This Trio of Modifiers, Ensure Claim Success
When a claim comes back because of a modifier problem—be it the lack of a modifier, the ... Read more
Reader Question:
Code Muscle Tests After Counting Body Parts
Question:  The PM specialist performs manual muscle testing on three muscles in a pat... Read more
Reader Question:
Don’t Work Overtime on OT Coding
Question: When one of our providers performs occupational therapy, how should I report the... Read more
Reader Question:
Trauma Status Matters on Cuff Tear
 Question: The provider performs a level-three evaluation and management (E/M) servic... Read more
Reader Question:
Be Sure Combo Codes Are Applicable
Question: Notes indicate that the PM physician performed a short-latency somatosensory evo... Read more
You Be the Coder:
Making a Catheter Code Choice
Question: How should I report a catheter implantation for long-term medication administrat... Read more
2019 Fee Schedule:
CMS Moves to Reduce Practice Paperwork
‘Patients over Paperwork' will be a federal focus in 2019. CMS started its “Patients ... Read more
CCI Edits:
New Neurostimulator Edits Bundle More Into Procedure Codes
Remember: Always check the modifier indicator. Now that the Correct Coding Initiative (CC... Read more
2019 Fee Schedule:
Get Used to Telehealth, Virtual Care Codes
G codes revealed for certain services. Coders want to stay current on all the coding chan... Read more
Reader Question:
Proceed With Caution on Previous Catheter Removal
Question: What CPT® code should we report if the neurologist removed a previously placed ... Read more
Reader Question:
Remember All Elements When Choosing EEG Code
Question: The physician performed electroencephalography (EEG) video monitoring on a ... Read more
Reader Question:
Keep Updated on New Codes, Resources
Question: After a level-three evaluation and management (E/M) service for a new patient, t... Read more
Reader Question:
Discern Office From Inpatient Consult With This Info
Question: What is the difference between an office consultation and an inpatient consultat... Read more
You Be the Coder:
E/M + X-ray in Same Encounter
Question: An established patient reports to the PM specialist complaining of severe rib pa... Read more
2019 Fee Schedule:
CMS Pauses Plan to Blend E/M Payments
Medicare offers a new payment proposal for 2021. For neurology and pain management coders... Read more
ICD-10 Coding:
Don't Let Disc Disorder Dx Confusion Back You Into a Corner
Here's why you should learn the basics of myelopathy and radiculopathy. When it comes to ... Read more
Clip And Save:
Treatments Vary for Cervical Disc Disorder Px
Diagnostics, therapy, medication admin top services for these conditions. If a patient is... Read more
Reader Question:
Drop Pain Dx When Provider Reaches More Definitive Dx
Question: During the course of an evaluation and management (E/M) service for a new patien... Read more
Reader Question:
Make Laterality Call Before Choosing Monoplegia Code
Question:  Which ICD-10 code should we report monoplegia of a lower limb? Tennessee ... Read more
Reader Question:
Stay on the Beat With Circadian Rhythm Disorder Dx Chops
Question: I just started working at a PM clinic that performs sleep studies, and trying to... Read more
Reader Question:
Make Px Condition Clearer With External Cause Codes
Question: A 9-year-old was playing on the monkey bars at a local park when he fell and hur... Read more
You Be the Coder:
Pause, Count the Minutes Before Coding Repeat Shot
Question: A patient with complex regional pain syndrome (CRPS) I in her arm receives a the... Read more