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Pain Management Coding Alert

Modifiers:
Trek Across Global Periods to Make 25/57 Decision
Here are the answers you need to decide between these two E/M modifiers. If your provi... Read more
ICD-10 Coding:
Use These Dx Tips for Skull Fracture Patients
Remember: ICD-10 requires lateral specificity. Coders that struggle with skull fracture ... Read more
Compliance:
Conduct Self-Audits, Help Yourself Spot Coding Flaws
Experts: Be sure to audit ‘low-hanging’ targets annually. Medical practice... Read more
Reader Question:
Method Matters When Choosing Infusion Code
Question: Encounter notes indicate that one of our nonphysician practitioners (NPPs... Read more
Reader Question:
Document Encounter Specifics to Duck Observation Denials
Question: We recently submitted a 99236 code for an observation service our PM phys... Read more
Reader Question:
Code Post-Op Pain With 99231 ... Maybe
Question: Our providers are now doing a different nerve block for postoperative pai... Read more
Reader Question:
Protect HIPAA From 'Social Engineering' Threat
Question: I recently heard about “social engineering” as a security thr... Read more
Reader Question:
Put 99291, +99292 to Work With 'Critical' Smarts
Question: CPT® states that a patient must be “critically ill or injured&r... Read more
You Be the Coder:
Motor/NCS Test Combos
Question: An established patient reports to the PM physician for a nerve conduction... Read more
CPT® 2017:
CPT® Creates Injection/Guidance Combo Codes
Experts: New codes should augur well for injection/guidance payment. Pain management ... Read more
Modifiers:
Choose Between 59/X After Identifying Distinct Services
Modifier 59 or one of the X modifiers? Choice still payer-dependent. When deciding if... Read more
Clip and Save:
Get HPI Info With This Template
Expert: Direct questions help to get to the heart of HPI details. Once the provider es... Read more
Reader Question:
ICD-10 Clears Up Zika Dx Question
Question: We don’t typically get patients with Zika virus, but the physician ... Read more
Reader Question:
Keep These 64447 Edits In Mind When Coding
Question: Our provider uses ultrasound guidance when adminis­tering a postoperative ... Read more
Reader Question:
Check for Modifier 51 Opportunities on Injections With Fluoroscopy
Question: Our physician recently performed multiple arthroscopic injections, and th... Read more
Reader Question:
Remember, PHI Takes Many Forms
Question: I’m pretty sure I know what types of information constitute protect... Read more
Reader Question:
Drop 1-Hour Rule on These Neurostimulator Tests
Question: Our physician recently performed a complex spinal cord neurostimulator te... Read more
Reader Question:
Consider Taking CPPM® Exam to Expand Skills Scope
Question: I work for a small practice where I do a little bit of everything; coding... Read more
You Be the Coder:
Coding Both Parts of EDX Test
Question: I have a confusing claim in front of me. Encounter notes indicate that th... Read more
ICD-10:
Look Sideways to Get the Scoop on New ICD-10s
ICD-10 2017 codes full of bilateral options for various conditions. In late summer the... Read more
E/M Coding:
Put Time to Work for You With Counseling Exception Chops
Here’s why a note documenting counseling/coordination time could make your claim. ... Read more
Compliance:
Obtain BAAs from HIPAA-Accountable Entities
Not everyone who accesses PHI has to sign a BAA. When you’re working with medica... Read more
Reader Question:
Get in Touch With Differing Telemedicine Definitions
Question: Can we code for telemedicine services our physician or qualified nonphysi... Read more
Reader Question:
Provider Can Complete Established E/M Without Exam
Question: I have newly joined pain management coding. Recently, when reporting an E... Read more
Reader Question:
Coders, Beware of Coding 'Automatic' E/Ms
Question: I am having an issue with one of our physicians who wants to report almos... Read more
You Be the Coder:
Choosing Injection Guidance Code
Question: A new patient reported to our physician complaining of pain in his right ... Read more
Postoperative Care:
Make Postop Pain Management Work With These Tips
Make sure both providers sign off on these claims. At times, your pain management specia... Read more
Pain Management:
Use This Arthrocentesis Q&A to Dodge Denials
Don’t forget about J code for drugs. Before choosing the proper code, there are ... Read more
E/M Coding:
Keep Incident-To, Split Visits Separate to Max Out Coding
Here’s why POS 11 is a pivotal piece of info on these E/Ms. If one of your physi... Read more
Reader Question:
Mind Globals When Coding Cath Follow-Ups
Question: Our physician completed a revision of a tunneled spinal epidural catheter... Read more
Reader Question:
Try These New Codes for Advance Care Planning
Question:  I’ve heard there’s been some recent reforms for reporting ad... Read more
Reader Question:
Get Elemental When Counting HPI
Question: Could you explain the basics of history of present illness (HPI) coding? ... Read more
Reader Question:
Keep Up With Stark Law, Prevent 'Self-Referral' Suspicions
Question: I overheard one of our nurse practitioners (NPs) say that someone at the ... Read more
You Be the Coder:
Coding For Sinus Tarsi Injections
Question: How do you code for sinus tarsi injection? Alabama Subscriber Answer:... Read more
ICD-10 Coding:
Dive Deep Into ICD-10 When Coding for Diabetic Neuropathy
Hint: Key on type of diabetes, complications. Pain management practices will often see pa... Read more
Nerve Studies:
Code Carefully When Considering Electrodiagnostic Testing
NCS + EMG might equal EDX suite. When your physician performs a nerve conduction study... Read more
Compliance:
Create Patient Termination Template to Avoid Compliance Headaches
Use certified mail to prove you’ve ended things with patient. When your medical pr... Read more
Reader Question:
Payer Policy Drives Modifier SA Decision
Question:  We employ a nurse practitioner (NP) at our office. When she provides sup... Read more
Reader Question:
Epidural Adhesiolysis Coding Hinges on Days, Not Adhesions
Question:  Our physician inserted a spinal epidural catheter to break spinal adhesi... Read more
Reader Question:
Leap These 'Unprocessable' Hurdles to Strengthen Coding
Question: I’m new to coding, having switched from our practice’s accoun... Read more
Reader Question:
ID All Business Associates to Stay Compliant
Question: I have read about business associate agreements (BAAs) in past issues of ... Read more
You Be the Coder:
Coding for Bilateral Anesthetic Services
Question: A surgeon completed bilateral knee replacements and asked us to administe... Read more
News You Can Use:
Be Ready for ICD-10 Changes Coming in October
Feds currently reviewing proposals for ICD-10 updates. While the ICD-10 authors haven&... Read more
Clip & Save:
Post These Chronic Migraine Diagnosis Rules Where You'll Need Them
Remind coders what qualifies as ‘chronic.’ Pain management clinics see the... Read more
E/M Coding:
Count ROS Carefully to Arrive at Correct E/M Level
High-level E/Ms might be possible with complete ROS. One of the most important element... Read more
Reader Question:
Appending QW Indicates Office's Waived Status
Question: Our practice recently received its clinical laboratory improvement amendm... Read more
Reader Question:
Get Specific When Reporting Ankle Pain
Question: A patient presents with pain in the ankle, and the physician performs arthr... Read more
Reader Question:
More Injections Doesn't Always Mean More Pay
Question: If the physician gives two injections into the (same) knee in two separat... Read more
Reader Question:
Use This Coding Technique for Longer 1-Day Observations
Question: One of our physicians performed an observation service for a Medicare pat... Read more
Reader Question:
Repel PHI Hackers With Frequent Updates
Question: In the past year, we have had to deal with several Health Insurance Porta... Read more
Reader Question:
Take Steps, Be Prepared if OCR Comes Calling
Question: In addition to being the coding lead at our practice, I’m also part... Read more
Reader Question:
Use These Tips for Airtight Locum Claims
Question: Our practice recently hired a locum tenens (LT) physician to fill in for ... Read more
You Be the Coder:
Coding the Second Encounter for a Neck Strain Patient
Question: A patient visits the office for a second time. Notes indicate that the phys... Read more
CCI:
Get Up to Speed on New G Code Edits
Here’s a look at the codes that now include specimen validity testing. Pain mana... Read more
Medicare Coding:
Keep Your Incident-to Coding Sharp or Face Lost $$
Know the rules before reporting NPP’s services under physician’s NPI. When... Read more
ICD-10:
Know These Terms, Ease Migraine Coding Pain
To get a full migraine Dx, you must know definitions of intractable, status migrainosus.... Read more
Reader Question:
Medicare Makes It OK to Use JW for Some Discarded Drugs
Question: Our pain management practice is losing quite a bit of money on discarded ... Read more
Reader Question:
If Necessary, 'Scare' Physicians into Signing on Dotted Line
Question: I’m having trouble getting my physicians to sign their claim forms.... Read more
Reader Question:
Opt for Consult Code When You Spot 'Request for Opinion'
Question: A new patient came to our practice to discuss whether she should start th... Read more
You Be the Coder:
Capturing '2-Sided' Injection Pay
Question: When I use code 62311, how do I capture the “bilateral” porti... Read more
Injections:
Tally TPI Target Muscles for Sure-Shot Coding
Any muscle group is a potential TPI candidate.  Pain management providers often per... Read more
ICD-10 Coding:
Focus on 4th Character, Mollify Migraine Coding Concerns
Here’s why character No. 4 is the linchpin to correct diagnosis choice. When yo... Read more
Electronic Health Records:
Act Before the Fact, Be Ready if EHR Fails
Here's how to prep for an EHR shutdown. If your electronic health record (EHR) system bec... Read more
Reader Question:
When Disaster Strikes, Have Modifier CR Ready to Go
Question: I’ve been reading through the latest CPT® book, and I happ... Read more
Reader Question:
Coach Up Staff With These Phone Tips
Question: We are a small practice, and everyone has to answer the phone from time t... Read more
Reader Question:
Opt for 'Unspecified' for Some Diagnoses
Question: If I find that a common ICD-9 code that I use doesn’t have a direct... Read more
Reader Question:
Relax, You Don't Need a Dozen Diagnoses for Each Claim
Question: We have primary diagnosis codes and secondary diagnoses codes that, when ... Read more
Reader Question:
Don't Let Tremor Coding Shake Your Confidence
Question: I hope you can shine some light on this as we have another dilemma today ... Read more
You Be the Coder:
Ease ESI Coding by Learning Injection Types
Question: I’m new to pain management coding, so am learning a lot about the d... Read more
ICD-10 Coding:
Look to F45.4- When Pain Is Tied to Psychological Factors
Best practice: Include a “causation statement” with your claim. When you&r... Read more
Critical Care:
Separate Services from Critical Care for Optimal Pay
Experts: You’ll often see these separately reportable services on 99291 claims. ... Read more
Compliance:
Give Patient a Heads Up With ABN If Medicare Might Not Pay
Also, check out how ABNs can lead to healthier patient relations. When patients report to... Read more
Reader Question:
Sidestep CTS Dx Miscodes Use With These Pointers
Question: Since ICD-10 premiered, I’ve been having some trouble choosing the ... Read more
Reader Question:
Remind Patients: An EOB Is Not a Bill
Question: We often get patients who call the practice with questions about their expl... Read more
Reader Question:
CPC License a Plus for New Coding Hire
Question: We are in the process of hiring a new full-time medical coder for our pra... Read more
Reader Question:
Calendar, Not Clock, Drives Observation Code Choice
Question: If we admit a patient to observation at 11 p.m. on Thursday and then rele... Read more
Reader Question:
Surgery Mix-up? You Might Need Modifier PC
Question: Some of the coders in the office were discussing a news story in which a pa... Read more
You Be the Coder:
ICD-10 Codes for Acute, Chronic Pain
Question: For diagnosis coding purposes, what is the difference between acute and chr... Read more
Procedure Focus:
Remember 3 Things to Simplify Your Paravertebral Facet Joint Injection Claims
Here’s what you need to know when coding intra-articular blocks. You probably se... Read more
ICD-10:
Crack the Cervical Disc Disorders Coding in ICD-10
Use the 4th character to help explain the condition. ICD-10 brings a wide selection o... Read more
Compliance:
Are You Ready for Even More EHR & HIPAA Compliance Scrutiny?
You’d better be, because lots of times are on the OIG’s radar. If you thou... Read more
Reader Question:
64999 Is Probably Your Best Bet for Coccygeal RFA
Question: My physician is planning to do RFA (radiofrequency ablation) of the coccy... Read more
Reader Question:
Avoid Reporting 96372 With TPIs
Question: A patient came to our office with pain and spasms in the bilateral cervic... Read more
Reader Question:
Remember 64445 Represents Sciatic Nerve Block, Not Piriformis
Question: We normally bill 64445 for a piriformis nerve block, but Tricare does not... Read more
Reader Question:
Counting On Time for E/M Level Selection
Question: I have an encounter note in front of me that I cannot decipher. Notes ind... Read more
Reader Question:
Turn to 'Unlisted' for Sphenopalatine Lidocaine Administration
Question: Our pain management specialist is looking into administering Lidocaine th... Read more
You Be the Coder:
Correctly Calculate J3301 Units
Question: A patient presented with a bi-occipital headache with associated tenderne... Read more
Coding Edits:
Pay Attention to New Modifier Indicator Edits for Paraspinous Block Codes
CCI 22.0 edits can get tricky to keep straight. Version 22.0 of the Correct Coding Ini... Read more
ICD-10:
Are You Ready to Determine the Best Diagnosis for Diabetic Neuropathy?
ICD-9 had a lot of options, but ICD-10 has even more. If your physician treats a patie... Read more
Lab Testing:
Say Goodbye to G0431 and G0434 for Drug Test Coding
Be sure you’re prepared for multiple changes. 2015 was a year full of comments r... Read more
Reader Question:
Get Clear on the Difference Between 'Initial Treatment' and 'Onset'
Question: What is the difference between the “Date of the initial treatment&r... Read more
Reader Question:
Verify How Workers' Comp Handles ICD-10
Question: I have been told we shouldn’t use ICD-10 for workers’ compens... Read more
Reader Question:
Don't Fret Too Much Over Illegible Handwriting
Question: One of my physicians has handwriting so terrible that I’m afraid of... Read more
Reader Question:
Check Out the Excludes1 Guideline Update
Question: I heard that there were changes to the Exclude notes in ICD-10, but they ... Read more
You Be the Coder:
Understand Your Diagnosis Choices for Facet Syndrome
Question: Please guide us through the codes for facet syndrome in ICD-10-CM. Okla... Read more
Procedure Spotlight:
Get Familiar With Cryoablation and RF Lesioning Coding
Don’t forget about these neurolytic destruction options. Physicians can choose f... Read more
Reimbursement:
Don't Miss These Changes to POS Codes in 2016
An addition and revision will affect your outpatient claims. If your providers offer s... Read more
ICD-10:
Pay Attention to Spinal Region When Coding for Neck Sprain
Tip: The smallest details can make a difference. When you still coded with ICD-9, a si... Read more
Reader Question:
Think Twice Before Submitting 77002 With 64420 or 64421
Question: Are we able to bill for fluoroscopic guidance/placement separately for interco... Read more
Reader Question:
Learn What Separates Shared Visit and Incident-To
Question:  An established patient came to our office for a follow-up with our nurse... Read more
Reader Question:
Narrow Bupivacaine HCl Injection Choices to S0020 and J3490
Question: What is the best HCPCS code for a bupivacaine HCI injection (10 mL, single dos... Read more
Reader Question:
Verify Medical Necessity to Combat SCS Analysis Denials
Question:  A few months ago, Medicare started denying all our claims for spinal cor... Read more
Reader Question:
Skip Billing Hydration With Non-Chemo Infusion Codes
Question: It is possible to bill for non-chemo infusion 96365 and 96367 and hydration th... Read more
Reader Question:
Keep These Tips in Mind for Locum Tenens Selection
Question: One of our physicians will be taking a six-month sabbatical, so we need to hir... Read more
Reader Question:
Get Approval Before Filing Workers' Comp Claim With ICD-10
Question: I’ve heard that we shouldn’t use ICD-10 for workers’ compens... Read more
You Be the Coder:
Study What Differentiates M47.812 From M47.892
Question: Our physician documented cervical spondylosis affecting the C2-3 and C3-4 join... Read more