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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
Separate Polymyalgia Rheumatica From Giant Cell Arteritis
Keep a single diagnosis code with the new system. Polymyalgia rheumatica (PMR) is not ... Read more
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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