Sylvia Posted Fri 08th of March, 2019 12:52:29 PM
WE are having a difficult time collecting for Pain management procedure for anesthesia codes 01202,01992 , , they all ask for medical necessity, and after we appeal and send documentation, still wont pay, any suggestion.
SuperCoder Answered Mon 11th of March, 2019 08:51:05 AM
Kindly sent us the pain management code that you are billing with the above mentioned anesthesia codes. Thank you.
Sylvia Posted Tue 12th of March, 2019 13:44:32 PM
cpt we use for Pain Management are 64483, 64484 ,62325
SuperCoder Answered Wed 13th of March, 2019 09:49:20 AM
As per documentation
01935 (diagnostic) for example used in myelography or discography
01936 (therapeutic) for example used in vertebroplasty, kyphoplasty or chemonucleolysis
These two codes can be used for many procedures but for CPTs 64483 and 64484, 01935 or 01936 would be the correct anesthesia codes unless anesthesiologist or CRNA provides anesthesia for diagnostic or therapeutic nerve blocks or injections, and a different provider performs the block or injection.
Code 64483 (Injection[s], anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance [fluoroscopy or CT]; lumbar or sacral, single level) crosses to anesthesia code 01936 (Anesthesia for percutaneous image guided procedures on the spine and spinal cord; therapeutic) because the provider administers a transforaminal injection under fluoroscopic guidance. The descriptor explains exactly what happens in a transforaminal injection.
Note: When the CPT® code descriptor for 64483 changed to include fluoroscopic guidance, the correct cross-code changed from 01992 (Anesthesia for diagnostic or therapeutic nerve blocks and injections [when block or injection is performed by a different provider]; prone position) to 01936. Note that before reporting 01936 you would need documentation that one provider administered the block and another performed the procedure. Feel free to ask for any further query.