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Anesthesia Coding Alert

Pain Management Corner:

Take Note of United HealthCare's Stance on Ablative Spinal Pain

Published on Sat May 08, 2010

Unfortunately, pulse radiofrequency still doesn't make the grade.If your pain management practice participates with United HealthCare (UHC), you'll want to take note of UHC's recent policy update (number 2010T0107H) on ablative treatment of spinal pain. Although UHC has a limited coverage policy for a number of spinal pain and facet joint pain procedures (64622-64627), you have some chance of reimbursement if you know the rules.Ablation Method and Frequency MatterAmong the changes are a revised coverage policy for how often thermal radiofrequency ablation (RFA) can be performed and reimbursed. The policy states that thermal RFA is covered "when performed at three months or greater frequency, provided there has been a 50% or greater documented reduction in pain." Example: On May 15, 2010, a pain management specialist performs a repeat thermal radiofrequency (RF) ablation on the right L4 and L5 paravertebral facet joint nerves on a patient with right lumbar facet joint [...]
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