Pain Management Coding Alert

Q&A:
Make Connection With Surgeon on Postop Pain Management
Note from surgeon requesting PM help is useful info. When your PM practice is charged wit... Read more
E/M Coding:
CPT® Panel Planning Big Changes for 2021 E/Ms
If you're fond of 99201, get ready to be heartbroken. Outpatient evaluation and managemen... Read more
Compliance:
Use These Pointers to Sharpen ABN Smarts
Remember modifiers, or payer might forget about ABN. At times, pain management practices ... Read more
You Be the Coder:
Making Your Headache Diagnoses Count
Question: During a level-three evaluation and management (E/M) service for a new patient, ... Read more
Reader Question:
Reason for Infusion Helps Separate Codes
Question: Notes indicate that the physician provided 55 minutes of intravenous (IV) infusi... Read more
Reader Question:
Make Sure ESI Code Includes Proper Guidance
Question: What is the correct way to report a caudal epidural steroid injection (ESI) unde... Read more
Reader Question:
Get Specific With Chronic Pain Dx
Question: Encounter notes indicate that the provider treated a patient with “chronic pai... Read more
Injections:
Use This Advice to Avoid TPI Misfires
Misreporting these shots could trigger an audit. Patients will often require trigger poin... Read more
Quick Facts:
Here’s What to Do About TPI Muscle Groups, Drug Supply
 You should be able to code separately for TPI drugs. In an effort to code as comple... Read more
E/M Coding:
Be Careful With ‘Counseling Exception’ E/Ms
It's tricky to code based on time. Have you ever chosen an evaluation and management serv... Read more
You Be the Coder:
Ask These Questions Before Choosing Unequal Limb Dx
Question: An established patient reports to the PM specialist for an evaluation and manage... Read more
Reader Question:
Sort Myalgia Diagnoses From Fibromyalgia
Question: What is the difference between myalgia and fibromyalgia, and how do you choose a... Read more
Reader Question:
Do This to Keep Risk Calculations on the Level
Question: I'm trying to determine the level of risk in the following encounter: a patient ... Read more
Reader Question:
Getting Shin Splint Coding Right
Question: A new patient reported to the PM provider complaining of intense shin pain. Afte... Read more
Reader Question:
Remember: Different Infusions for Different Reasons
Question: Notes indicate that the physician provided 55 minutes of intravenous (IV) infusi... Read more
Reader Question:
Get on Same Page As Auditors With Patient Status Rules
Question: Our practice was recently audited, and an established patient visit was marked a... Read more
Testing:
Get the Most Out of Stenosis Checks
Many times, providers go beyond E/M for confirmation. Patients who report to the PM physi... Read more
CPT® Coding:
Look to Injections, PT for Spinal Stenosis Tx Codes
PM provider not likely to perform surgical stenosis treatments. A PM physician will often... Read more
Compliance:
Avoid Auditors With These Coding Tips
An ounce of prevention can make audits less likely. To paraphrase Paul Revere, it looks a... Read more
You Be the Coder:
Keeping Up With ICD-10 Terminology
Question: After a level-two evaluation and management (E/M) service for a new patient, the... Read more
Reader Question:
Make Sure External Morbidity Codes Are Secondary
Question: In the interests of painting the most complete diagnosis picture possible, our c... Read more
Reader Question:
Check Notes Carefully on Spinal CT Claims
Question: Encounter notes indicate that the provider performed a computed tomography (CT) ... Read more
Reader Question:
Keep Up With MBI Requirements for Medicare Px
Question: We have posted everything available from the Centers for Medicare and Medicaid S... Read more
Reader Question:
Avoid Working Overtime on OT Claims
Question: Is there a difference between coding for occupational therapy treatments an... Read more
ICD-10 Coding:
Dig Into Notes to Strike Migraine Coding Gold
Most, but not all, migraine codes require a sixth character. A patient has a migraine hea... Read more
Q&A:
Stay Sharp With Trigger Point Documentation Smarts
Take this expert advice on what to include to cement your TPI claims. Coding for trigger ... Read more
Modifiers:
Make Friends With Modifier 25 to Stave Off Denials, Audits
Use these FAQs to get the lowdown on this much-used modifier. If you think your modifier ... Read more
Reader Question:
Lack of CC Can Cause Coding Confusion
Question: An established 66-year-old patient presented to our provider. She did not s... Read more
Reader Question:
Pain in the Neck? Use These ICD-10 Codes
Question: When a patient reports to the PM physician complaining of neck pain, what i... 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:
Use These Tips for Spontaneous Rupture Dx
Question: Notes indicate that the provider performed an evaluation and management (E/... Read more
Reader Question:
Check for Arthrography Before Choosing X-ray Code
Question: Notes indicate that the PM physician performed a knee X-ray along with an ankle ... Read more
Reader Question:
Make ESI Coding Easy With Add-on Smarts
Question: I have some questions about billing for epidural steroid injections (ESIs). Pati... Read more
Reader Question:
HIPAA Knows no Borders
Question: Our practice uses a small cloud services provider (CSP) based in Canada to store... Read more
You Be the Coder:
Answer Branch Question Before Choosing Destruction Code
Question: An established patient with trigeminal neuralgia reports to the PM physicia... Read more
Add-On Codes:
Use Add-Ons to Count EMG/NCS Combo
You'll need 2 codes, and 2 documented orders, for these tests. When your PM specialist pe... Read more
Modifier Madness:
Take this Advice on These ‘5-’ Modifiers for Coding Success
Here's a primer on 51, 54, 57. Have you ever had a claim come back because of the lack, o... Read more
E/M Coding:
Separate New/Established Patients With These Pointers
If you only know the 3-year rule, time to go back to school. One of the most prevalent my... Read more
Reader Question:
Get Anatomy Right on Finger Arthroplasties
Question: Notes indicate that the PM physician performed arthro­plasty of a patient's fin... Read more
Reader Question:
Check Trauma Status on Cuff Tear
Question: The provider performs a level-three evaluation and management (E/M) service for ... Read more
Reader Question:
Complexity Drives Occupational Therapy Coding
Question: When one of our providers performs occupational therapy, how should I report the... Read more
Reader Question:
Avoid Billing Workers’ Comp for Some E/Ms
Question: A 66-year-old Medicare patient came into our office after injuring an arm a... Read more
You Be the Coder:
Use Combination Codes When Applicable
Question: Notes indicate that the PM physician performed a short-latency somatosensory evo... Read more
2019 Fee Schedule:
CMS Taking Steps to Reduce Provider Paperwork Burden
‘Patients over Paperwork' gets serious in 2019. In 2017, CMS started its “Patients ov... Read more
ICD-10 Coding:
Notes Are Key to Limb Pain Dx That Won’t Leave You Hanging
Denials likely to head your way without detailed Dx. If a patient has pain in any limb ... Read more
E/M Coding:
Stay Sharp on PFSH to Master E/M History
PFSH rules dictate what constitutes each history element. Correctly documenting a patient... Read more
Reader Question:
Stay Abreast of New Codes
Question: After a level-three evaluation and management (E/M) service for a new patient, t... Read more
Reader Question:
Check for Laminectomy Before Making Catheter Code Choice
Question: How should I report a catheter implantation for long-term medication administrat... Read more
Reader Question:
Get Enough Consult Info to Discern Office From Inpatient
Question: What is the difference between an office consultation and an inpatient consultat... Read more
Reader Question:
Fatten Bottom Line With Streamlined Appeals Process
Question: We were a solo practice for about 15 years, and the founding physician's wife wa... Read more
Reader Question:
Count Body Parts on Muscle Testing
Question:  The PM specialist performs manual muscle testing on three muscles in a pat... Read more
You Be the Coder:
Try Coding This E/M + X-ray Scenario
Question: An established patient reports to the PM specialist complaining of severe rib pa... Read more