Category: CC-Physiatry/Pain

Radiofrequency Ablation
Post

Radiofrequency Ablation

August 25, 2022 Question: We have been reporting CPT code 64625 with 3 units when we perform a radiofrequency ablation of the nerves innervating the sacroiliac joint at levels S1. S2, and S3. We have gotten several payer denials recently. Are we coding correctly? Answer: No, CPT code 64625, Radiofrequency ablation, nerves innervating the sacroiliac...

Hip Injection
Post

Hip Injection

July 28, 2022 Question: I did a left hip intraarticular steroid injection and used fluoroscopic guidance. Can I report the guidance in addition to the procedure? Answer: Yes, you would report CPT code 20610 for the hip injection and 77002-26 for the fluoroscopic guidance. Make certain you use Modifier 26 when performing procedure is a...

Incident to Services
Post

Incident to Services

June 30, 2022 Question: We just recently began hiring PAs to see patient to assist our pain physicians. Our pain doctors want the PAs to see new patients and bill under their NPI number. We see a large population of Medicare patients and I am worried this could get us into trouble. Answer: For Medicare...

Remote Patient Monitoring
Post

Remote Patient Monitoring

June 2, 2022 Question: We are going to begin using remote therapeutic monitoring in our pain practice to monitor our patients pain functional status and compliance with exercise therapy. For the initial set up and education can our MA perform this service? Answer: Yes, the clinical staff may perform the initial set up, and education...

ER Visit Coding
Post

ER Visit Coding

May 5, 2022 Question: What code do use when our pain doctor sees a patient in the emergency department for a consultation at the request of the ED physician? Our pain doctor treated the patient and discharged the patient from the ED. Answer: Since the patient was not admitted your physician to the hospital you...

Billing for a Neurostimulator Implant
Post

Billing for a Neurostimulator Implant

April 7, 2022 Question: My physician billed implanted a neurostimulator into the sacral nerve for urinary incontinence. We billed CPT codes 64562 and 95972 for a Medicare patient. Medicare denied CPT 95972 for the analysis and programming. My physician says it should be paid and we should appeal. Can you provide advice? Answer: Based on...

Counting Problems Addressed for Medical Decision Making
Post

Counting Problems Addressed for Medical Decision Making

February 24, 2022 Question: If a patient has one stable chronic illness and one acute uncomplicated illness without systemic symptoms, can we “up” the level of Problems Addressed to Moderate? Answer: No, sorry, unfortunately it does not work that way. The problems are no additive or cumulative. One stable chronic illness and one acute uncomplicated...

Sign up for KZAlertsSign up for KZAlerts

Coding Coaches