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Neurology & Pain Management Coding Alert

Procedure Focus:
Don't Miss This Guide to Neurolytic Destructions
  Start by understanding neurolysis. The descriptors for numerous CPT® c... Read more
ICD-10 Transition:
Check This Rundown of What CMS Guidance Does and Does Not Cover
Heads up: LCDs could change what you submit. Physician practices are barely beginning to ... Read more
ICD-10:
Polymyalgia Rheumatica Keeps a Single Diagnosis Code
Don’t combine the condition with giant cell arteritis. Polymyalgia rheumatica (P... Read more
Reader Question:
Look for New Paravertebral Thoracic Block Codes in 2016
Question: My physician documented that he placed a thoracic paravertebral block for... Read more
Reader Question:
Track Hours Rather Than Calendar Dates for 95951 Monitoring
Question: I have two questions about coding for EEG video monitoring using code 959... Read more
Reader Question:
Follow Site for Hemangioma Diagnosis
Question: What is the ICD-10 code for an L5 vertebral hemangioma? Missouri Subscribe... Read more
Reader Question:
Watch Your Diagnosis Choice With 95974 and 95816
Question: The neurologist reprogrammed a patient’s VNS. Later that day he did... Read more
You Be the Coder:
Know Whether to Double Your Kyphoplasty Diagnoses
Question: A patient underwent kyphoplasty, which we coded with 22514 and diagnosis M8... Read more
Neurology:
Ask 3 Questions Before Coding for Split Sleep Study
Plus: Watch date of service for reporting bundled codes such as 95811. When your neuro... Read more
Refresh Your Memory on Different Types of Sleep Apnea
ICD-10 provides very specific diagnosis choices. Sleep apnea is an involuntary stoppag... Read more
Pain Management:
Look to Levels Before Frequency When Coding Interlaminar Epidural Injections
Tip: Yes, you can code separately for fluoro guidance. Neurologists and pain management s... Read more
ICD-10:
M54 Now Holds the Answer for Your Neuritis, Radiculitis Claims
Heads up: Remember to do this if the patient condition includes radiculopathy.  N... Read more
Reader Question:
Brush Up on the 'X' Character in ICD-10
Question: How do we approach the usage of the “X” placeholder character... Read more
Reader Question:
Submit 64450 for Lateral Pectoral Nerve Block
Question: What is the correct procedure code for a lateral pectoral nerve block? ... Read more
Reader Question:
Watch for Details Like 'Radiculopathy' When Choosing Codes
Question: I have dictation that states the patient has cervical spondylosis without... Read more
Reader Question:
Base Fluoro Code on Site and Type, Not Equipment
Question: My doctor is doing joint injections under fluoroscopy and using C-arm gui... Read more
You Be the Coder:
Dig Into Your Options for Neck Sprain Diagnosis
Question: Our pain management specialist is treating a patient for neck sprain. Wha... Read more
CPT® 2016 Update:
Shift Away from Neurostimulator Time Designation
One change to neurostimulator coding you've become accustomed to in 2015 will be void in 2... Read more
Procedure Focus:
Know the Difference Between Occipital and Trigeminal Nerve Blocks
Educating yourself about anatomy can help you pinpoint codes. Trigeminal and occipital ne... Read more
ICD-10:
Check How You'll Report Neck Sprains and Strains Under the New Code Set
Hint: They’re not the same condition, despite what you might hear. Many people o... Read more
Reader Question:
Choose From Epidural Injection Codes for SNRB
Question: How can we report selective nerve root block? Does CPT® offer any def... Read more
Reader Question:
Learn About for CT/MRI Guidance With IDET
Question: What is intradiscal electrothermal annuloplasty (IDET)? Our physician pro... Read more
Reader Question:
Report Adductor Canal Block With 64447 or 64448
Question: What is the correct way to report an adductor canal block for pain manage... Read more
Reader Question:
Skip Prolonged Service With Telephone E/M Code
Question: Is it appropriate to report prolonged services codes in addition to a tel... Read more
Reader Question:
Know What a Lack of PFSH Might Cost You
Question: I have a claim in front of me that is giving me pause because I cannot de... Read more
You Be the Coder:
Get Paid for Trial Electrode Placement and Removal
Question: In a patient with bilateral leg pain, our surgeon placed two electrode ar... Read more
CPT® 2016:
Get Familiar With 13 New Codes for Sleep Apnea Treatment
Tip: Focus on the components in each descriptor. Your options for reporting neurostimu... Read more
Procedure Focus:
Understand What the New Nerve Stimulation System Codes Affect
Only look to use new codes for central sleep apnea.  You’ll have numerous new... Read more
CPT® Preview:
Here's Your Sneak Peek at Injection Code Changes That Will Come in 2016
Epidural and paravertebral facet nerve destruction procedures will have big shifts. I... Read more
ICD-10:
Cauda Equina Shifts to a Single Code in ICD-10
Descriptor will no longer specify presence of neurogenic bladder. You might not see a... Read more
Reader questions:
Start With 337.29 for CRPS Diagnosis, if Possible
Question: What diagnosis code should we report for CRPS of the chest wall? Texas ... Read more
Reader questions:
Associated Diagnosis Could Be Your Key to Facet Injection Payment
Question: I’m having problems with one of my commercial payers denying facet in... Read more
Reader questions:
Remember to Multiply Units for J3301
Question: Our physician injected 40mg of Kenalog to treat extension tendonitis in t... Read more
Reader questions:
Choose 1 Nerve Conduction Study Code
Question: Medicare is denying our claims with codes 95910 and 95911, saying that we... Read more
Reader questions:
Verify Whether Payer Allows 95816 With 95974
Question: I work for a neurologist who reprogrammed a patient’s VNS (vagus ne... Read more
Reader questions:
Pay Attention to MUEs Before Reporting Multiple Lines
Question: Medicare is denying our claims for bilateral carpal tunnel injections by ... Read more
You Be the Coder:
Choose the Best Code for Dorsal Root Ganglion RF
Question: I’m trying to code for a case with the following documentation: &ld... Read more
Procedure Coding:
Ensure You're Paying Attention to the Arthrocentesis Descriptors
Hint: Focus on whether the provider used ultrasound guidance. CPT® 2015 introduced sever... Read more
News Flash:
Here's the Latest on ICD-10 Implementation Details
CMS makes some surprise announcements. CMS has let it be known that the Oct. 1, 2015,... Read more
ICD-10:
Focus On the Type to Set Your Cerebral Palsy Diagnosis
Watch when you have fewer choices than with ICD-9. Effective Oct. 1, 2015, a diagnosis... Read more
Condition Focus:
What Is Cerebral Palsy?
There might be more varieties than you realize. Cerebral palsy refers to non-progress... Read more
Reader Question:
Code 62370 Includes E/M Work
Question: A patient with a history of osteoporosis and multiple compression fractures came... Read more
Reader Question:
Calculate 97750 Coding in 15-Minute Increments
Question: How much time does our provider need to spend before qualifying for one unit o... Read more
Reader Question:
Verify Distinct Procedures Before Billing 77002 With 64420 or 64421
Question: Are we able to bill for fluoroscopic guidance separately for intercostal nerve... Read more
Reader Question:
Base Neuroma Treatment Code on Injection Site
Question: Our physician administered a local injection of Ketamine (25 mg) to the patien... Read more
Reader Question:
Report 64400 for Gasserian Ganglion Block
Question: What is the code for a Gasserian ganglion block? Pennsylvania Subscriber A... Read more
You Be the Coder:
Count Carefully for NCS Code Selection
Question: I’d like to have your input on coding a nerve conduction study. The... Read more
News You Can Use:
Brace Yourself for Possible Sleep Study Refunds to MACs
New OIG report has brought extra attention to services. Your sleep study documentation-or... Read more
Procedure Focus:
Pay Attention to the Purpose to Correctly Code Pump Refills
Reprogramming can help narrow your choices.  Reporting drug infusion pump services h... Read more
ICD-10:
Watch the Details for Coding Spinal Stenosis in the Cervical Region
ICD-10 will offer multiple stenosis options.  When your physician diagnoses spinal s... Read more
Reader Questions:
Rectus Femoris Tendinitis Has 3 Coding Options
Question: A patient has been diagnosed with rectus femoris tendinitis. What would be the... Read more
Reader Questions:
Watch the Bundle for Imaging and Epidural Procedures
Question: We would like to learn more about the inclusion of imaging guidance in th... Read more
Reader Questions:
CPAP Coding Must Be on Same DOS
Question: A patient had a sleep study done and came to the physician’s office afte... Read more
Reader Questions:
Watch Times When Resident Helps With Inpatient Consultations
Question: Our neurologists do inpatient consultations (especially the ICU) and spend a l... Read more
You Be the Coder:
Rely on These Codes for Removal of Leads
Question: A Medicare patient wants us to remove his SCS leads and battery because t... Read more
Procedure Coding:
Ensure Your Documentation Helps Gain Plantar Fasciitis Reimbursement
Documenting every detail helps justify every treatment along the way.  Heel pain aff... Read more
Anatomy Refresher:
Understand the Plantar Fascia's Tissues
There are more layers than you might realize.  The more you know about plantar fa... Read more
Documentation:
Explain Situations Clearly to Recoup Pay for 'Unlisted' Claims
Tip: Watch your units and modifiers.  Filing claims with an “unlisted&rdquo... Read more
ICD-10:
Let Spinal Location Guide Your Coding for Schmorl's Nodes
Hint: Additional choices will let you get more specific with ICD-10. About 30 percent ... Read more
Reader Questions:
Injection by PA Doesn't Automatically Mean 'Incident-to'
Question: The physician saw a new patient for evaluation in the hospital outpatient settin... Read more
Reader Questions:
Always Submit the Most Definitive Diagnosis Code
Question: Though there are many crosswalks from ICD-9 to ICD-10, there are many cod... Read more
Reader Questions:
Know the Guidelines for Reporting E/M With CPAP
Question: A patient had a sleep study done and came to our office afterwards. The neurolog... Read more
Reader Questions:
J8499 Covers Rizatriptan, But Don't Expect Payment
Question: I can’t find a code for the migraine medication Maxalt, aka Rizatriptan ... Read more
Reader Questions:
Depend on Payer for Bilateral Reporting Guidance
Question: I need advice on how to code for Medicare versus commercial payers when reportin... Read more
You Be the Coder:
Know Injection Site Before Choosing Procedure Code
Question: Our physician dictated the following: “patient has irritation of th... Read more
CCI 21.2:
Newest Coding Edits Have You Looking Closer at Joint Injections
Plus, steer clear of 77003 with common epidural insertions.  CCI 21.2 went into effe... Read more
Neurology Focus:
Keep This in Mind Before Billing ANSAR Testing
Payer policies are your key to reimbursement.  Autonomic nervous system (ANSA... Read more
Reimbursement:
Start Your 'Unlisted' Claims on the Right Path With These 3 Tips
Hint: The more documentation you can include, the better. Sometimes you have no choice... Read more
ICD-10:
Pay Attention to Chronic Fatigue Signs and Symptoms, But Don't Keep Reporting Them
Stick with a single code once your physician reaches a diagnosis. Chronic fatigue synd... Read more
Reader Questions:
Add +95886 for EMG of More Than Five Muscles
Question: The neurologist documented an EMG study the following way:  Muscle test... Read more
Reader Questions:
Diagnosis 355.9 Applies to Abdominal Nerve Entrapment
Question: What is the correct ICD-9 code for abdominal nerve entrapment used to treat pa... Read more
You Be the Coder:
Learn What to Report for Hypoglossal Nerve Stimulator
Question: Our neurologist is about to begin using a hypoglossal nerve stimulator fo... Read more
Neurology:
Follow These 5 Scenarios to Better EEG Reporting
Hint: Documentation of extended or long-term recording makes a difference. EEGs are a ... Read more
ICD-10:
Pick Apart the Long Descriptor to Successfully Report Whiplash
Remember to include the seventh character for even more specificity. Whiplash can be a... Read more
Injury Check:
Whiplash Doesn't Just Happen In Car Accidents
Also remember that neck ‘sprains’ and ‘strains’ aren’t syn... Read more
Compliance:
Use These Components to Build Your Strongest Compliance Plan
Plus: Experts say you need plans for both Medicare and Medicaid.  Compliance plans ... Read more
Reader Question:
Submit +64495 for Third and Additional Paravertebral Joint Levels
Question:  Our physician administers injections into paravertebral facet joints. Th... Read more
Reader Question:
Check 368.xx Family for Visual Disturbance Diagnosis
Question:  Can you advise me on how I would code a diagnosis for diffuse sensitivit... Read more
Reader Question:
Going Beyond the MUEs for 0282T
Question:  Code 0282T has an MUE of 1 and code 64555 has an MUE of 2. According to ... Read more
Reader Question:
Check for Bilateral Documentation of Selective Nerve Root Injections
Question: Our physician’s op note states that he administered four selective ... Read more
You Be the Coder:
Billing EEG With Hospital Visit
Question: Medicare denied our bill for an EEG when our physician read one in additi... Read more
Pain Management:
Follow 3 Steps to Clearly Document Chronic Opioid Therapy
Tip: Start with the 4 “A’s” at each visit.  Thorough documentat... Read more
Coding Update:
Don't Miss These 3 Updates to CCI Manual Instructions
Pay attention to arthrocentesis and kyphoplasty/vertebroplasty guidelines.  CMS has ... Read more
ICD-10:
Your Future Myasthenia Gravis Codes Will Be Direct Matches
Don’t overlook the possibility for newborns.  Myasthenia gravis is a chroni... Read more
Reader Question:
Only Report 95834 One Time
Question: What’s the maximum number of units we can bill for 95834?  M... Read more
Reader Question:
Steer Clear of 77003 With Epidurals 62310-62319 for Medicare
Question: There is so much confusion regarding billing 62310 and 62311 with 77003. So... Read more
Reader Question:
Submit J3490 for Valproate Sodium
Question: I can’t find a J code in the HCPCS book for a 500 mg vial of Valpro... Read more
Reader Question:
Remember the Rules for New Vs. Established Status
Question: A new patient was referred to our office for a nerve conduction velocity ... Read more
Reader Question:
Unused Meds Don't Always Qualify for Modifier JW
Question: Can we bill for pump medications that were ordered and not used due to th... Read more
Reader Question:
Choose 64450 for Genicular Nerve Injection
Question: Our physician injected multiple branches of the genicular nerve (superior... Read more
Reader Question:
Think 'Chemodenervation' for Botulinum Toxin Injection
Question: Our physician documented that he administered botulinum toxin trigger poi... Read more
Reader Question:
Privacy Agreement Covers Text Reminders
Question: We have one of those text and email appointment-reminder systems in place... Read more
You Be the Coder:
Coding for Shorter Video EEG
Question: How would we code an EEG video monitoring of less than six hours? CPT®... Read more
Drug Screenings:
2015 Lab Section Overhaul Means Changes to Your Drug Test Coding
Get the scoop on new code choices from CPT® and HCPCS. Drug test codes undergo man... Read more
Lab Modifiers:
Here's Your Refresher on Modifier QW Usage
Be aware of how it can affect your reimbursement. Modifier QW (CLIA waived test) is an... Read more
ICD-10:
Prepare Now for Different Reporting Tactics for Sleep Apnea
Heads up: You'll need multiple codes to help specify the type of apnea. Coding for sleep ... Read more
Reader Question:
List Neurological Condition Diagnosis Before Suspected Problem
Question: My neurologist saw a patient in the ICU for delirium associated with acut... Read more
Reader Question:
Remember Modifier 26 for Hospital EEG Reading
Question: I just received a denial from Medicare stating that the EEG reading is in... Read more
Reader Question:
Verify That Modifier 59 Is Still the Best Choice
Question: Our pain management specialist frequently performs arthrocentesis with a ... Read more
Reader Question:
Append Modifier 52 for Pain Pump Revision
Question: Programmable infusion pump codes are for implantation/replacement or remo... Read more
Reader Question:
Reporting 92545 With 92540 Means Denial
Question: My provider documented codes 92540, 92543, 92545, and 92546 for billing. ... Read more
Reader Question:
Pay Attention to Guidance Choices With New Joint Injection Codes
Question: The new joint injections codes 20604, 20606, and 20611 specify an injection... Read more
Reader Question:
Set Your Own Fee for J3030
Question: Our neurologist wants to begin administering Imitrex injections (code J30... Read more
You Be the Coder:
Billing 77003 With 62310-62319 in 2015
Question: I have read that Medicare increased the fee schedule for 2015 so that ima... Read more
Coding Tips:
Follow 5 Steps to Ensure You Cover All Aspects of Spinal Catheter Coding
Hint: Code for tunneled vs non-tunneled approach; check for follow-up. Coding for spin... Read more
ICD-10:
Keep Abreast of What CMS Plans for Future ICD-10 Testing
Here’s your chance to see how prepared you are for the new system.  With th... Read more
Practice Management:
Boost Your Office Efficiency by Focusing on 2 Software Factors
Tip: Verify that you can set up multiple accounts for pain management patients.  ... Read more
Reader Question:
Turn to 'Unlisted' for Spinal Hardware Injection
Question: How do we code for the spinal hardware injections? Kentucky Subscriber ... Read more
Reader Question:
Be Clear on Electrode Array Counts
Question: Our physician’s operative report reads “bilateral 4-lead subc... Read more
Reader Question:
Details Will Guide Your Synovial Cyst Diagnosis Coding
Question: Our doctor is doing a synovial cyst aspiration at L4-5. I’ve always... Read more
Reader Question:
Ongoing Lumbar Drain Check Means E/M Codes
Question: Our pain management physician inserted a lumbar drain and wants to leave ... Read more
Reader Question:
Get Familiar With Other Names for 'RSD'
Question: Which diagnosis applies to sympathetically maintained pain? Is it the sam... Read more
Reader Question:
Don't Change Your Coding Approach for Free-Running EMG Test
Question: What are the correct codes for interpretation of an intraoperative, free ... Read more
You Be the Coder:
Don't Mix Up Your Modifiers for Bilateral Injections
Question: We have been facing challenges for reporting bilateral procedures like inje... Read more