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Pain Management Coding Alert

Procedure Focus:
Build Your Knowledge of Neurolytic Destruction Options
Hint: Different techniques work for different conditions. The descriptors for numerous... Read more
ICD-10:
Separate Polymyalgia Rheumatica From Giant Cell Arteritis
Keep a single diagnosis code with the new system. Polymyalgia rheumatica (PMR) is not ... Read more
Reimbursement:
Don't Miss These Proposed 2016 Updates That Won't Happen
CMS changes its mind on some shifts. Focusing on the newly-implemented ICD-10 system a... Read more
Reader Question:
Gather Your Documentation for Modifier 52 Claims
Question: We recently submitted a claim for reduced services because the physician ... Read more
Reader Question:
Know When Double Diagnoses Apply to Kyphoplasty
Question: A patient underwent kyphoplasty, which we coded with 22514 and diagnosis ... Read more
Reader Question:
Check Injection Site for Correct Sinus Tarsi Code
Question: We recently received a denial when we reported a cortisone injection to t... Read more
Reader Question:
Append 52 for Unilateral Chemodenervation
Question: The physician administered unilateral injections to treat a patient&rsquo... Read more
Reader Question:
Keep Up With How ICD-10 Implementation Is Going
Question: We’re trying to implement ICD-10 correctly and include the proper d... Read more
You Be the Coder:
Correctly Convert Kenalog to Units
Question: Our physician used 2 mL of 0.75% Marcaine and 0.25mL of Kenalog for a tri... Read more
Procedure Focus:
Remember 4 Things Before Coding Interlaminar Epidural Injections
Tip: Pay more attention to levels than frequency. Pain management specialists frequently ... Read more
ICD-10 Implementation:
Let the Second Phase of ICD-10 Training Begin
Get your whole team involved to solidify your reporting. After waiting so many years f... Read more
ICD-10:
Look to Category M54 for Your Neuritis and Radiculitis Claims
Heads up: Your choices are more specific than in the past.  All your years of dia... Read more
Compliance:
Follow This Template to Create Your Own Breach Notification Letter
Being prepared can help you avoid fines for lax notification. No practice likes to thi... Read more
Reader Question:
Expand Your Options for Neck Sprain Diagnosis
Question: Our pain management specialist is treating a patient for neck sprain. Wha... Read more
Reader Question:
Report 64450 for Lateral Pectoral Nerve Block
Question: What is the correct procedure code for a lateral pectoral nerve block? ... Read more
Reader Question:
Dig for Details Like 'Radiculopathy' With Spondylosis
Question: I have dictation that states the patient has cervical spondylosis without... Read more
Reader Question:
Focus on Site and Type, Not Equipment, for Fluoro Coding
Question: My doctor is doing joint injections under fluoroscopy and using C-arm gui... Read more
Reader Question:
Get Familiar With ICD-10's 'X' Character
Question: How do we approach the usage of the “X” placeholder character... Read more
You Be the Coder:
Add New Options for Paravertebral Thoracic Block in 2016
Question: My physician documented that he placed a thoracic paravertebral block for post... Read more
CPT® Update:
Here's Your Rundown on the Latest CPT® Code Changes for 2016
Pay attention to how you’ll report paravertebral facet blocks. ICD-10 implementa... Read more
Procedure Focus:
Don't Let Occipital or Trigeminal Blocks Coding Give You a Headache
Focus on these differences to better pinpoint codes. Trigeminal and occipital nerve bl... Read more
ICD-10:
Split Out Neck Sprain and Strain Codes With ICD-10
Hint: They’re not the same condition, despite what you might hear. Many people o... Read more
ICD-10 Update:
Get the Scoop on How Well CMS's Early Testing Met Success
Plus: The claim’s other details are just as important as the diagnosis. As ICD-... Read more
Reader Question:
Know Whether You Can Submit CT/MRI Guidance With IDET
Question: What is intradiscal electrothermal annuloplasty (IDET)? Our physicia... Read more
Reader Question:
Choose Between 64447 and 64448 for Adductor Canal Block
Question: What is the correct way to report an adductor canal block for pain manage... Read more
Reader Question:
Remember This Step Before Saying Goodbye to Medicare
Question: Our practice has chosen to opt out of Medicare. I heard that there’... Read more
Reader Question:
Watch Patient's Status in Conjunction With E/M
Question: My physician’s notes indicate an expanded problem focused history, a ... Read more
Reader Question:
Get Your Documentation in Order for Modifier 52 Claims
Question: We recently submitted a claim for reduced services because the physician ... Read more
You Be the Coder:
Select From These Codes for SNRB
Question: How can we report selective nerve root block? Does CPT® offer any def... Read more
CPT® Update:
Prepare Now for Significant Shifts to Some Injection Codes in 2016
Big changes will come for epidurals, paravertebral facet nerve destruction. The way yo... Read more
2016 Changes:
Don't Miss How RVU Reductions Might Hit Your Reimbursement
Plus – incident-to coding could also see updates. You might not mind moving into... Read more
ICD-10:
Report Cauda Equina Syndrome With G83.4, Starting in October
You won’t need to specify the presence of neurogenic bladder. Cauda equine synd... Read more
Reader Questions:
Multiple E/M Codes for Different Specialties Can Be OK
Question: Our practice has multiple specialties, including orthopedics, pain management,... Read more
Reader Questions:
Follow State Guidelines for 90-Day Med Supplies
Question: We have patients who have instructions from their employers to get a 90-day dr... Read more
Reader Questions:
Brush Up On the Difference Between 'New' and 'Established'
Question: What is the difference between a new and established patient, for office E/M c... Read more
Reader Questions:
Diagnosis 337.29 Is Your Best Starting Point for CRPS
Question: What diagnosis code should we report for CRPS of the chest wall? Texas Subs... Read more
Reader Questions:
Check MUEs Before Reporting Multiple Lines
Question: Medicare is denying our claims for bilateral carpal tunnel injections by sayin... Read more
Reader Questions:
Match RVUs for 62310 and 62311 to Correct Pay for 77003
Question: The RVUs for 62310 and 62311 were raised in 2015 to include payment for 77003,... Read more
You Be the Coder:
Selecting Your Code for Dorsal Root Ganglion RF
Question: I’m trying to code for a case with the following documentation: &ld... Read more
Descriptor Look-Over:
The Year's Halfway Over - Are Your Reading Arthrocentesis Descriptors Thoroughly?
Pay attention to whether the provider used ultrasound guidance. CPT® 2015 introduc... Read more
Procedure Focus:
Remember These 3 Things Before Coding Pump Refills
Hint: Knowing the reason for the procedure helps your cause. CPT® includes a wide... Read more
News You Can Use:
Don't Miss 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:
Kyphosis Will Bring Simple Diagnosis Shifts in October
Tip: Be specific about the cause and type of kyphosis. Kyphosis (also known as roundba... Read more
Reader Questions:
Turn to 64400 for Gasserian Ganglion Block
Question: Our pain management specialist administered a Gasserian ganglion block. W... Read more
Reader Questions:
Earn for CT/MRI Payment With IDET
Question: What is intradiscal electrothermal anuloplasty (IDET)? Our physician prov... Read more
Reader Questions:
Billing 77002 With 64420 or 6442? Check for Distinct Procedures
Question: Are we able to bill for fluoroscopic guidance separately for intercostal ... Read more
Reader Questions:
Injection Site Will Determine Neuroma Treatment Code
Question: Our physician administered a local injection of Ketamine (25 mg) to the p... Read more
Reader Questions:
Diagnosis 33.29 Is Best CRPS Option
Question: What diagnosis code should we report for CRPS of the chest wall?  ... Read more
You Be the Coder:
Look to These Codes When Removing Leads
Question: A Medicare patient wants us to remove his SCS leads and battery because the sy... Read more
Documentation:
Watch Your Units and Modifiers for 'Unlisted Procedure' Claims
The more information you can include, the better.  You never want to file a claim... Read more
Procedure Coding:
Does Your Documentation Support More Extensive Plantar Fasciitis Treatment?
Here’s how to justify every level of treatment.  Heel pain affects nearly 2... Read more
Anatomy Refresher:
Peel Back the Layers of Plantar Fasciitis
Knowing the structure helps you be a better coder.  The more you know about plant... Read more
ICD-10:
Get Ready for Expanded Options When Reporting Spinal Stenosis in the Cervical Region
Check those details to narrow your ICD-10 choices.  The majority of spinal stenosis ... 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... Read more
Reader questions:
Beware of 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:
Stay Compliant By Checking OIG's Mid-Year Update
Question: A fellow practice manager recently told me that the Office of Inspector G... Read more
Reader questions:
Skip Modifier 26 When You Own X-Ray Equipment
Question: Our physician used X-ray equipment in the office to place the needle prio... Read more
You Be the Coder:
Know Your Options for Rectus Femoris Tendinitis Coding
Question: A patient has been diagnosed with rectus femoris tendinitis. What would be ... Read more
Reimbursement:
Follow These 3 Tips to File Successful 'Unlisted' Claims
The better your provider’s documentation, the better your chances at payment. Su... Read more
Back to Basics:
Get the Scoop on 3 Everyday Questions From NGS
Tip: Document pain level as part of ROS. A recent “Part B Ask the Contractor&rdq... Read more
ICD-10:
Verify the Spinal Location to Choose Your Schmorl's Node Diagnosis
Heads up: Get ready for more choices with ICD-10. “Schmorl’s nodes” ... Read more
Reader questions:
Get Payer Advice for Reporting Bilateral GON Block
Question: I need advice on how to code for Medicare versus commercial payers when r... Read more
Reader questions:
Injection Site Can Point You to Procedure Code
Question: Our physician dictated the following: “patient has irritation of the ... Read more
Reader questions:
Submit J8499 for Migraine Medication Rizatriptan
Question: I can’t find a code for the migraine medication Maxalt, aka Rizatri... Read more
Reader questions:
Include Modifier 32 for Mandated Service
Question: A 40-year-old male came into our office with a work-related back injury. ... Read more
Reader questions:
Search for the Most Definitive Diagnosis, Even With ICD-10
Question: Though there are many crosswalks from ICD-9 to ICD-10, there are many cod... Read more
Reader questions:
Clear Documentation Can Support Multiple 99212's
Question: I code for a practice that includes multiple specialties (pain management... Read more
You Be the Coder:
Take Care When Coding Same-Side Facet Joint Injections
Question: Our specialist administered several facet joint injections and appended mod... Read more
CCI 21.2:
Don't Miss the Latest Coding Bundles for Joint Injections and Fluoro Guidance
Plus, watch whether the service supports ‘breaking’ the edit.  Severa... Read more
News You Can Use:
The SGR Formula Will Be History - But ICD-10 Is "Go"
Plus: Payment boosts are coming in July.  President Obama has signed HR 2 into la... Read more
ICD-10:
Be Aware of What R53.82 Will - and Won't - Include for Chronic Fatigue Syndrome
Remember when to stop reporting associated signs and symptoms.  Chronic fatigue s... Read more
Documentation:
Meet These 7 Criteria to Prepare for ICD-10 Documentation Changes
Hint: Experts recommend quick turn-arounds for completing records. With ICD-10 impleme... Read more
Reader Questions:
Watch the Clock to Draw the Line Between 62311 and 62319
Question: What are the major differences between two catheter use codes 62311 and 62319? C... Read more
Reader Questions:
Assess the Possibilities for Post-op Adductor Canal Block
Question:  How do you code an adductor canal block continuous catheter for post-op pa... Read more
Reader Questions:
Coding for Consult Hinges on 'Request for Opinion'
Question: A new patient came to see a physician in our practice to discuss whether ... Read more
Reader Questions:
Steer Clear of 77003 With 62310-62319 for Medicare Patients
Question: There is so much confusion regarding billing 62310 and 62311 with 77003. So... Read more
Reader Questions:
Payer Rules Help Guide Modifier 51 Use
Question: I have heard our coders saying that they don’t need to attach modif... Read more
You Be the Coder:
Pinpoint the Best Diagnosis for Abdominal Nerve Entrapment
Question: What is the correct ICD-9 code for abdominal nerve entrapment used to treat... Read more
Medication Therapy:
Don't Miss the Required Documentation for Long-term Opioid Treatment
Starting with the basics should be your foundation for each visit. Thorough documentat... Read more
Compliance:
Protect Your Practice - and Your Patients - by Watching 5 HIPAA Trends
Be warned: Tougher audits could be coming your way. Codes and modifiers aren’t the ... Read more
ICD-10:
Longer Descriptors Will Mean Better Whiplash Reporting, Come October
Extended 7-digit codes will bring even more specificity. Millions of people suffer nec... Read more
Terminology Check:
Remember Many Scenarios Can Lead to Whiplash
Also learn the difference between neck ‘sprains’ and ‘strains’.&... Read more
Reader Questions:
Verify Whether Selective Nerve Root Injections Are Bilateral
Question: Our physician’s op note states that he administered four selective nerve... Read more
Reader Question:
Keep 4 Points in Mind for Post-op Pain Management Injections
Question: We’ve recently begun to receive claims for payment for 01402 and 62... Read more
Reader Question:
J3030 Isn't on Fee Schedule -So Set Your Own
Question: Our physician wants to begin administering Imitrex injections (code J3030... Read more
You Be the Coder:
The Correct Way to Bill More Paravertebral Joint Injections
Question: Our physician administers injections into paravertebral facet joints. The inje... Read more
Coding Update:
Don't Miss How Your Drug Test Coding Will Change in 2015
Here’s your scoop on new code choices from CPT® and HCPCS.  Drug test c... Read more
Lab Modifiers:
Know How Modifier QW Can Affect Your Reimbursement
Quick refresher on QW criteria.  Modifier QW (CLIA waived test) is an informational ... Read more
ICD-10:
Watch for Cervical Conditions That May Not Offer One-To-One ICD-10 Match
The initial code you find might not be the best cross-over. When your pain management ... Read more
Compliance:
See How Meaningful Use Changes Could Affect Your Practice
Caveat: But don’t expect to escape payment penalties if you’re noncompliant. ... Read more
Reader Question:
Pain Pump Revision Claim Needs Modifier 52
Question: Programmable infusion pump codes are for implantation/replacement or remova... Read more
Reader Question:
Modifier 59 Might Work – But Don't Forget X{ESPU} Options
Question: Our pain management specialist frequently performs arthrocentesis with a ... Read more
Reader Question:
Watch Your Guidance Choices for New Joint Injection Codes
Question: The new joint injections codes 20604, 20606, and 20611 specify an injecti... Read more
Reader Question:
Decide for Yourself About Upfront Collection Policy
Question: Our practice is considering collecting deductibles upfront if a patient n... Read more
Reader Question:
Yes, Even Small Practices Need a Complete Security Risk Analysis
Question: As a very small healthcare provider, do we really need to conduct an in-depth ... 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:
Ask 'Tunneled or Non-tunneled?' to Start Your Spinal Cath Coding
Following these 5 steps will ensure you cover all the bases. Coding for spinal cathete... Read more
Software Shopping:
Keep These Factors In Mind When Considering New Software
Remember, the best options will help boost your office efficiency.  You can improve ... Read more
ICD-10:
Discover Wider Options for Neck Sprain and Strain Coding
You won’t rely on a single catch-all diagnosis after Oct. 1. Neck sprains and strai... Read more
Reader question:
Watch Those Modifiers When Reporting Bilateral Injections
Question: We have been facing challenges for reporting bilateral procedures like in... Read more
Reader question:
'Unlisted' Is Your Best Choice for Spinal Hardware Injection
Question: How do we code for the spinal hardware injections? Kentucky Subscriber ... Read more
Reader question:
Don't Forget the Other Names for 'RSD'
Question: Which diagnosis applies to sympathetically maintained pain? Is it the sam... Read more
Reader question:
No CF Changes Yet – But Don't Hold Your Breath
Question: I haven’t seen or heard much about reimbursement cuts this year. Wi... Read more
Reader question:
Be Careful About 24 for Hospital Visits During the Global
Question: If my doctor performs a procedure with a 90-day global period and he has su... Read more
Reader question:
A Single Code Might Suffice for Arthrocentesis and Injection
Question: If our physician is performing an arthrocentesis procedure and injects a ... Read more
You Be the Coder:
How to Correctly Code for Ongoing Lumbar Drain Check
Question: Our pain management physician inserted a lumbar drain and wants to leave ... Read more
Spinal Procedures:
Don't Be Fooled: ESIs and Transforaminals Aren't the Same
Here’s how to stop letting the similar names muddy your coding. The terms “ep... Read more
ICD-10:
Get the Lowdown on How Disc Displacement and Degeneration Will Change
Hint: Your coding will all depend on spinal regions. When you transition to ICD-10, yo... Read more
Billing Focus:
Check These 3 Areas to Help Define 'New Medical Condition' for Incident-To Billing
Ask whether it’s chronic, acute, or recurrent. Incident-to billing can boost you... Read more
Reader Question:
Ensure Documentation Supports 64999 for Percutaneous Balloon Decompression
Question: What is the correct CPT® code for percutaneous balloon decompression ... Read more
Reader Question:
Encourage Details for Best TJM Diagnosis Coding
Question: Our provider included two diagnoses in the documentation for a temporoman... Read more
Reader Question:
Know What It Takes to Report Prolonged Services
Question: During a scheduled office visit of a new patient, our physician spent addit... Read more
Reader Question:
Understand 'Subarachnoid' and 'Epidural' for Correct 62280-62282 Choice
Question: How can I differentiate between injection/infusion codes 62280-62282? Spe... Read more
Reader Question:
Consider 721.3 for Lumbar Facet Osteoarthritis Diagnosis
Question: When researching codes for lumbar facet osteoarthritis, I found 721.3 and... Read more
Reader Question:
Get Familiar With 'Unspecified' and 'Other Specified' ICD-10 Terms
Question: I have seen lots of great ICD-9 to ICD-10 crosswalks, but it seems like t... Read more
You Be the Coder:
Correct Way to Report a Unilateral GON Block
Question: My pain management physician administered a block to the left greater occip... Read more