Billing for CPT Transforaminal 64483, 64484 and Interlaminar Epidural 62323 together Unbundling
Apr26

Billing for CPT Transforaminal 64483, 64484 and Interlaminar Epidural 62323 together Unbundling

A Question from one of my Blog Readers: “So the question is – can you bill and report for CPT  Transforaminal 64483, 64484 with Interlaminar Epidural 62323 together on the same day, same session, same patient and the same Provider?”   Let’s begin this question by taking time to understand the code descriptor: Interlaminar Epidural… Please LOGIN HERE to view this content. Or, REGISTER HERE Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

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CPT 64490, 64493, 64495, 64633 – Billing and Coding for Facet Nerve Block and Nerve Ablation RFA
Apr22

CPT 64490, 64493, 64495, 64633 – Billing and Coding for Facet Nerve Block and Nerve Ablation RFA

CPT 64490, 64493, 64495, 64633 – Billing and Coding for Facet Nerve Block and Nerve Ablation RFA CPT CODE 64490 PARAVERTEBRAL FACET JOINT BILLING AND CODING WITH IMAGING GUIDANCE Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level 64491… Please LOGIN HERE to view this content. Or, REGISTER HERE Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

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Aetna Denied Claim for CPT Code Knee Injection Billing Code 20610 as Investigational
Apr20

Aetna Denied Claim for CPT Code Knee Injection Billing Code 20610 as Investigational

So here’s a question from one of my blog readers…. “Aetna rejected our claims for CPT 20610 (knee Injection) as “investigational”. Please let us know what we should do to make this claim get reimbursed.” ~ Barb from Florida Pain Practice My Recommendation: I have seen this denial so many times and what I have been advising the practice is by looking at Aetna’s Clinical and Reimbursement Policy. This is most likely due to your Diagnosis Code that does not meet the Medical Necessity guideline according to Aetna’s Policy. You can call Aetna and ask them about their policy, I am very sure they will guide you and they will direct you with that policy. When you have the guideline and policy, review your documentation and medical necessity. You can submit then a corrected claim or appeal the claim if your Diagnosis Code is not listed in one of the diagnosis that meets necessity per their policy. Let’s review the CPT 20610 changes in 2015.. Revised 20600 Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance New Code 20604 with ultrasound guidance, with permanent recording and reporting (Do not report 20600, 20604 in conjunction with 76942) (If fluoroscopic, CT, or MRI guidance is performed, see 77002, 77012, 77021) Revised 20605 Arthrocentesis, aspiration, and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow, or ankle, olecranon bursa); without ultrasound guidance New Code 20606 with ultrasound guidance, with permanent recording and reporting (Do not report 20605, 20606 in conjunction with 76942) (If fluoroscopic, CT, or MRI guidance is performed, see 77002, 77012, 77021) Revised 20610 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder hip, knee, subacromial bursa); without ultrasound guidance Key Points: Report 77002 if it’s Fluoro-guided Report Unilateral Modifiers (LT, RT) or Bilateral (-50) Report Specific (anatomical site) Diagnosis Codes Report EM with Modifier 25 if distinct and separately identifiable E/M encounter, above and beyond Report the drug used for injection (HCPCS Code) when required Proper Documentation is the ultimate key New Code 20611 with ultrasound guidance, with permanent recording and reporting (Do not report 20610, 20611 in conjunction with 76942) (If fluoroscopic, CT, or MRI guidance is performed, see 77002, 77012, 77021)   JOIN OUR UPCOMING WEBINARS ON INTERVENTIONAL PAIN MANAGEMENT LEARN MORE.  CLICK HERE.   searched keyword: Aetna Denied Claim for CPT Code Knee Injection Billing Code 20610 as Investigational Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

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Anesthesia Coding Billing Guideline that Crosswalks to Pain Management Procedures
Mar29

Anesthesia Coding Billing Guideline that Crosswalks to Pain Management Procedures

Here are the Anesthesia Coding Guidelines that Crosswalks to Pain Management Procedures: 64479 Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); cervical or thoracic, single level 64480 Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional level (List separately in addition to code for primary procedure) 64483 Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, single level 64484 Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional level (List separately in addition to code for primary procedure) 64490-64492 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic 64493-64495 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral 64633 Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint [when specified as radiofrequency facet neurolysis, cervical] 64634 Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint [when specified as radiofrequency facet neurolysis, cervical] 64635 Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint [when specified as radiofrequency facet neurolysis, lumbar or lumbosacral] 64636 Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint [when specified as radiofrequency facet neurolysis, lumbar or lumbosacral] Since all the above codes are image guided and are spinal procedures; the most appropriate Anesthesia codes will be: 01935 Anesthesia for percutaneous image guided procedures on the spine and spinal cord; diagnostic (Base Unit 5) **** for 64490-64495; 64640 01936 … therapeutic (Base Unit 5) 01992 – Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); prone position – Base Unit 5 (CPT 27096) Anesthesia Modifiers AA – Anesthesia services performed personally by an anesthesiologist. QZ – CRNA service without medical direction by a physician. Anesthesia Informational Modifiers QS – Monitored anesthesia care service. (Use with anesthesia procedure codes only, and report the actual anesthesia time on the claim.) P1 – A normal healthy patient P2 – A patient with mild systemic disease P3 – A patient with severe systemic disease Time Units for Anesthesia Codes that Crosswalk for Pain Management Procedures: Anesthesia time is defined as the...

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Billing SI Joint Injection 27096 without Imaging Guidance – Use Trigger Points Billing Code
Jan13

Billing SI Joint Injection 27096 without Imaging Guidance – Use Trigger Points Billing Code

CPT 27096 – Injection Procedure for sacroiliac joint, anesthetic/steriod, with image guidance (fluoroscopy or CT) including arthrography when performed. This code is ONLY use when performed with fluoroscopic or CT imaging guidance confirmation of intra-articular needle positioning. Many are still confused about how to bill for CPT 27096 SI Joint Injection (Sacroiliac Joint Injection) coding… Please LOGIN HERE to view this content. Or, REGISTER HERE Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

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2018 ICD-10 ICD 10 New Codes for Pain Management Billing Coding and Pain Medicine
Jan13

2018 ICD-10 ICD 10 New Codes for Pain Management Billing Coding and Pain Medicine

We have now the new codes for 2018 ICD-10 ICD 10 New Codes for Pain Management and Pain Medicine Practice Offices. So pay attention with this. Knowing these codes can impact your documentation and revenue cycle. 2018 ICD-10-CM Diagnosis Code R52  Pain, unspecified The 2018 edition of ICD-10-CM R52 became effective on October 1, 2017. Applicable… Please LOGIN HERE to view this content. Or, REGISTER HERE Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

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