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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
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
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
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
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
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
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
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
Explain Situations Clearly to Recoup Pay for 'Unlisted' Claims
Tip: Watch your units and modifiers.  Filing claims with an “unlisted&rdquo... Read more
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
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
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
Follow These 5 Scenarios to Better EEG Reporting
Hint: Documentation of extended or long-term recording makes a difference. EEGs are a ... Read more
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
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
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
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 spinal ... Read more
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