Anesthesia Coding Alert

These common pain management procedures now include 3 popular G codes

The National Correct Coding Initiative (NCCI), version 11.2, edits effective July 1 included several changes that hit close to home for pain management groups: Trigger point injections and nerve blocks are just a few of the affected procedures that will change the way you report claims on a daily basis.  Check G Codes Against Tendon, TPI Procedures Earlier editions of NCCI paired three G codes with hundreds of surgical procedures. It is important that you take a look at the descriptors for those G codes again because they have taken center stage again and now involve tendon and trigger point injection and arthrocentesis. The G codes are: G0351 - Therapeutic or diagnostic injection (specify substance or drug); subcutaneous or intramuscular

G0353 - Intravenous push, single or initial substance/drug

G0354 - Each additional sequential intravenous push (list separately in addition to code for primary procedure). According to NCCI, the following listed codes include G0353 and G0354 when performed during the same session: 20550 - Injection(s); single tendon sheath, or ligament, aponeurosis (e.g., plantar "fascia")

20551 - ... single tendon origin/insertion

20552 - ... single or multiple trigger point(s), one or two muscle(s)

20553 - ... single or multiple trigger point(s), three or more muscle(s)

20600 - Arthrocentesis, aspiration and/or injection; small joint or bursa (e.g., fingers, toes)

20605 - ... intermediate joint or bursa (e.g., temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa)

20610 - ... major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa). At first glance it seems like bundling the G codes with these injection procedures might signal many changes, but that's not necessarily the case for anesthesia or pain management groups.

"The G codes do not apply to a trigger point injection or to nerve blocks. I've seen very few occasions when a G code would be reported for pain charges," says Joanne Mehmert, CPC, president of the consulting firm Mehmert and Associates in Kansas City, Mo.
 
"As far back as I can remember, we've never reported these codes together," adds Sherry Coughlin, billing manager with West Florida Anesthesia and Pain Management in Spring Hill. "These edits should not be anything new to billers or coders if they've been following NCCI for the last few years." 

Also in the latest version of NCCI, G0351, G0353 and G0354 have been bundled into, and are considered components of, the following percutaneous lysis of adhesions codes: 62263 - Percutaneous lysis of epidural adhesions using solution injection (e.g., hypertonic saline, enzyme) or mechanical means (e.g., catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 2 or more days

62264 - [...]