Category: Physiatry

New vs Established Patient
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New vs Established Patient

December 15, 2022 Question: I am a contracted physician with a group practice (Practice A) in our town. I have an opportunity to contract with another practice (Practice B) not in the same town, but near enough that my patients could see me in either location. My question has to do with the definition of...

E/M Visit During the Global Period
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E/M Visit During the Global Period

November 17, 2022 Question: Can I bill an office visit in the global period if the diagnosis is different from why I did the original procedure? Answer: Yes, as long as the diagnosis is not for a related issue (e.g., complication from the original procedure). The documentation must be clear that the condition is unrelated...

Radiofrequency Ablation
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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
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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
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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
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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
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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...

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