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Neurology & Pain Management Coding Alert

CPT 2002 Brings Few, but Important, Coding Changes for Neurology
CPT 2002 was made available in November 2001. In an early release of new and rev... Read more
CCI Update:
Version 7.3 Brings Some Changes for Neurology
Version 7.3 of the Correct Coding Initiative (CCI) has been released on behalf of CMS by t... Read more
News Brief:
2002 ICD-9 Manual Now Available
The 2002 ICD-9 manual is now available. Revisions to the manual, first announced in CMS ... Read more
Reader Question:
Reviewing Radiological Tests
Question: If a neurologist orders a radiological test such as a CT scan or an MRI, and he ... Read more
Reader Question:
95920 With SSEP
" Question: When using 95920 with other codes, i.e., 95925 and 95926, and submitting them ... Read more
Reader Question:
Uni- or Bilateral CTS?
Question: Is there a way to indicate on the claim form whether carpal tunnel syndrome (C... Read more
Reader Question:
Documentation Requirements
Question: If an initial history and ROS have been documented, is it necessary to document ... Read more
Reader Question:
Neuromuscular Release
Question: How is neuromuscular release defined? How much time does it require, and what te... Read more
Reader Question:
Family Conference
Question: How should I code a family conference? For instance, a family member who is re... Read more
You Be the Coder:
Billing a Failed Procedure
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Adjust Your Reimbursement:
Proper Billing for Deep Brain Stimulator Reprogramming
Treatment for Parkinson's disease may include implantation of deep brain stimulators, wh... Read more
Stimulate Payment:
Append Modifier -50 to H-Reflex Study
Neurologists reporting H-reflex studies should append modifier -50 (bilateral procedur... Read more
Reader Question:
Telephone Calls
Question: My doctors insist that I charge for telephone calls even though Medicare wont ... Read more
Reader Question:
Digital EEG
Question: How should I code a digital ambulatory EEG with 21-32 leads for continuous mon... Read more
Reader Question:
Billing Injections
Question: We recently hired a PA who gives injections for headaches using Toradol, Imitrex... Read more
Reader Question:
Physician Presence During Drug Administration
Question: We are providing Solu-Medrol to patients in the office. Must the neurologist b... Read more
Reader Question:
Modifier -TC
Question: What are the guidelines for billing the technical component of diagnostic tests,... Read more
Reader Question:
Prolonged Services
Question: When billing Medicare, should I list 99359 separately for each unit, with modi... Read more
You Be the Coder:
Mini-Mental State Exam
Test your coding knowledge.  Determine how you would code this situation before l... Read more
Stay Alert When Selecting Diagnosis Codes for Sleep Studies and Polysomnography
Sleep studies and polysomnography help find the causes of potentially life-threa... Read more
CCI Update:
Latest Round of Edits Affects Neurology Billing
Version 7.2 of the national Correct Coding Edits (CCI), which became effective July ... Read more
News Brief:
Draft E/M Guidelines Scrapped
On July 19, 2001, Tommy Thompson, secretary of the Department of Health and Human Services... Read more
Reader Question:
Diagnosing Leg Weakness
Question: There is no diagnosis for leg weakness. If I look up paresis, ICD-9 refers me to... Read more
Reader Question:
Spinal Punctures
Question: How do lumbar puncture codes 62270 and 62288 differ?Wisconsin Subscriber  ... Read more
Reader Question:
Modifier -59 With F-Wave Study
Question: What is the proper use of modifier -59 for an EMG/NCS with F-wave study, senso... Read more
Reader Question:
EEG and Carotid Ultrasound Exams
Question: The neurologists in our group practice interpret EEG and carotid ultrasound ex... Read more
You Be the Coder:
Spastic Hemiparesis
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Carefully Establish Medical Necessity for Testing of Carpal Tunnel Syndrome
If carpal tunnel syndrome (CTS) is suspected but not confirmed, neurologists m... Read more
Tips and Guidelines for Successfully Billing Consults
Properly determining and reporting consultations remains a persistent ... Read more
Reminder:
Resubmit Same-Day E/M, Diagnostic Test Claims by Oct. 1
In October 2000, version 6.3 of the national Correct Coding Initiative (CCI) added more th... Read more
Insert:
Follow E/M Guidelines To Assign the Appropriate Consult Codes
 Consultation codes are chosen using the same criteria as other E/M codes. With the... Read more
Reader Question:
Reporting 95925-95926
Question: Using a dermatome-specific procedure, we evaluate eight to 10 nerves on the lowe... Read more
Reader Question:
Bilateral H-Reflex
Question: When coding for bilateral H-reflex studies in the hospital, should I report 9593... Read more
Reader Question:
Transcranial Dopplers With Carotid Ultrasounds
Question: We have been receiving denials from Medicare when we bill transcranial dopplers ... Read more
Reader Question:
Physician Supervision Requirements
Question: I am still confused by the new supervision requirements for electrodiagnostic st... Read more
Reader Question:
Greater Occipital Neuralgia
Question: Our neurologist often uses the diagnosis greater occipital neuralgia, but I ca... Read more
You Be the Coder:
Neurological Eye Treatments
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Medicare Carriers Instructed to Accept V Codes for Consults
The Centers for Medicare and Medicaid (CMS, formerly HCFA) has instructed all local Medi... Read more
New Guidelines for Clinical Trial Reimbursement
Clinical trials are important in the development of new treatments and medications a... Read more
Reader Question:
Consultation and Spinal Tap
Question: How should I code a spinal tap and consultation performed on the same day by t... Read more
Reader Question:
Determining Place of Service
Question: I read muscle and nerve biopsy pathological interpretations in my lab, which is ... Read more
Reader Question:
Multiple Botox Injections
Question: What is the proper way to code a Botox injection for an arm and a leg? Our Med... Read more
Reader Question:
Performing and Interpreting EMG Tests
Question: Can we code separately for the technician conducting the EMG and the neurologist... Read more
Reader Question:
Parental Consults
Question: A parent has an appointment to show our neurologist reports on tests conducted o... Read more
Reader Question:
Mini-Mental Exam
Question: When we do a mini-mental examination and use code 96115, can we also bill the ... Read more
You Be the Coder:
B-12 Injection
Test your coding knowledge.  Determine how you would code this situation before l... Read more
Document Reduced or Discontinued Services Thoroughly and Use Correct Code Modifiers
In certain circumstances, neurologists may find it necessary to al... Read more
Get Paid for Avonex Treatment By Coding for All Aspects
Neurologists who treat patients with Avonex must know the correct coding not onl... Read more
Reader Question:
Computerized EEG Analyses
Question: Our neurologist spends a lot of time on computerized analyses of EEGs, but... Read more
Reader Question:
Full and Limited EMGs
Question: We performed a full EMG on one extremity for radiculopathy and a limited EMG o... Read more
Reader Question:
Patient Brings Own Botox
Question: Our neurologist wants to give Botox injections for migraines to a patient who ... Read more
Reader Question:
Pineal Cyst Diagnosis
Question: Our neurologist is seeking a diagnosis code for a pineal cyst. I looked und... Read more
Reader Question:
99211 for Blood Pressure Check
Question: Can we use 99211 on a new "unestablished patient" if they are seen to get thei... Read more
Reader Question:
Short Procedure
Question: Our neurologist is monitoring for localization of cerebral seizures (95951) bu... Read more
You Be the Coder:
Oxygen Administration for Headaches
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Choose Correct E/M Levels for Established Migraine Patients
Neurology practices can lose reimbursement opportunities or set themselves up for audits ... Read more
Dont Leave Money on the Table When Coding for Neurostimulator Programming
Distinguishing between simple and complex neurostimulator programming codes (95970-95975)... Read more
CCI Edits Affect Neurostimulator Programming
As of CCI 7.1, HCFA has not eliminated the edit bundling 95974 (... complex cranial nerve... Read more
News Brief:
Supervision Requirements Outlined for Diagnostic Tests
HCFA has released Program Memorandum No. B-01-28, dated April 19, 2001, outlining the sup... Read more
Reader Question:
Mini-mental Tests
Question: One of our neurologists performs a mental assessment on patients if he suspects ... Read more
Reader Question:
Evoked Potentials
Question: A neurologist performs evoked potentials on patients. How many units of these c... Read more
Reader Question:
Medicare Waivers
Question: Our Medicare patients sign an advance beneficiary notice (ABN) that complies wi... Read more
Reader Question:
Coding for Surface EMGs
Question: What is the code for surface EMG? One of our neurologists performs this for move... Read more
You Be the Coder:
Manual Muscle Testing
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Time and Documentation Play Major Roles in Payment for Prolonged Services
Prolonged services codes (99354-99359) are a good option when seeking reimbursement for si... Read more
Fight Reductions and Denials For EMGs
When billing electromyograms (EMGs) (95860-95870) make it clear to carriers through detail... Read more
News Brief:
CCI 7.1 Neurology Update
Effective April 1, muscle testing codes 95831-95834 and range-of-motion measurement codes ... Read more
Reader Question:
Cross-Coverage
Question: My physician shares coverage with another neurologist. When he is on call and se... Read more
Reader Question:
Billing for a Broken Appointment
Question: Is there any way to bill the patient or insurance carrier for a broken appointme... Read more
Reader Question:
Negotiate with Hospitals
Question: A neurologist performs a nerve conduction study on a patient in the hospital as ... Read more
Reader Question:
After-hours Codes
Question: How do I get paid for after-hours visits?Illinois Subscriber Answer: Unfortunate... Read more
Reader Question:
Sacroiliac Joint Injections
Question: I need help with developing a charge for 27096. Our neurologist believes that ou... Read more
Reader Question:
t-PA Administration
Question: I recently learned that Medicare does not cover 37195 for IV t-PA administratio... Read more
Reader Question:
Injection Bundled into E/M Visit
Question: I spend a lot of time appealing denials for payment of 90782 when billed with an... Read more
Reader Question:
Hospital Discharge Codes
Question: A neurologist visited a patient in follow-up care and we billed 99231. Before mi... Read more
You Be the Coder:
Billing for an E/M with a Nerve Conduction Study
Question: If a new patient presents for a nerve conduction study and the neurologist does ... Read more
Fight Reductions and Denials For EMGs Part One of Two
Getting reimbursed for electromyograms (EMGs) studies of the limbs, 95860-95870, is often ... Read more
Accurately Assigning Assessment Levels Ensures Proper Coding and Patient Care
Gaining correct reimbursement for nursing facility assessments (NFAs) (99301, 99302 and 99... Read more
Reader Question:
Facet Joint Injection With Anesthesia
Question: How do I code a facet joint injection into the cervical spine for a patient who ... Read more
Reader Question:
On-call Services
Question: If your physician is on-call for another group and he sees a patient for the fir... Read more
Reader Question:
Can Massage Be Billed As 97140?
Question: We get denials for 97124 for massage. Is it okay to bill some insurers for this ... Read more
Reader Question:
Unexplained High Blood Pressure
Question: We had a new patient come in suspecting that he was suffering from carpal tunnel... Read more
Reader Question:
Discontinued EEG, EMG, MRI
Question: If a procedure such as an EEG, EMG, MRI, etc. is discontinued due to lack of pat... Read more
Reader Question:
Workers Compensation Report
Question: Our neurology office performs many workers compensation evaluations. I was recen... Read more
Reader Question:
HCPCS Codes Billed to DME Provider
Question: It is my understanding that durable medical equipment (DME) codes beginning with... Read more
Reader Question:
Prolonged Services
Question: I recently received a denial from Medicare for 99356 billed on the same day as... Read more
You Be the Coder:
Range of Motion
Question: Can you use 95851 to bill two units for two different extremities?Texas Subscrib... Read more
Raise Your Revenue with Correct Coding Techniques for Nerve Conduction Studies
Many carriers do not understand that multiple nerves may need to be tested in a nerve con... Read more
Increase Pay Up with Proper Coding for EEG Studies
(Editors note: This is part two of a two-part article. The first section can be found in t... Read more
ICD-9 Codes That Support Medical Necessity
Below is a partial list of ICD-9 codes from a sampling of local medical review policies th... Read more
HCFA Suspends Significant Portion of CCI 6.3
According to HCFA Program Memorandum B-01-09 dated Feb. 8, 2001, HCFA has temporarily su... Read more
Reader Question:
Fluoroscopic Guidance
Question: When using fluoroscopic guidance with more than one injection site, such as in f... Read more
Reader Question:
Global Billing for 95920 and 95925
Question: We need help billing the global services for 95920 and 95925. We pay a technicia... Read more
Reader Question:
Meet and Greet with Neurologist
Question: A family wanted to meet the neurologist before bringing their cerebral palsy-dia... Read more
Reader Question:
Constant Attendance
Question: To bill for a complete sleep study, does a technician have to provide constant a... Read more
Reader Question:
Medical Testimony Coding
Question: An attorney requested our neurologists opinion regarding an automobile accident.... Read more
You Be the Coder:
Mini-mental Status Examination
Question: What is the correct way to bill for a mini-mental status examination (MMSE)? A n... Read more
New Botox Coding Opens Door to Added Reimbursement
CPT 2001 instituted several changes in coding for Botulinum Toxin Type A (Botox) including... Read more
2001 Critical Care Codes Improve Pay Up for Neurology Practices
Critical care services have been redefined in CPT 2001. These codes (99291 and 99292) can ... Read more
CCI Update:
Edits Reversed for Nerve Blocks and Injection Code 20550
On Jan. 17, 2001, in a letter to the Washington office of the Association of Neurological ... Read more
Increase Pay Up with Proper Coding for EEG Studies
The proper coding for an EEG depends on several factors, including the length of time du... Read more
Reader Question:
95933 Blink Reflex
Question: Our neurologist performed an orbicularis oculi (blink) reflex by electrodiagnost... Read more
Reader Question:
Codes 93880 and 93886
Question: Does Medicare cover 93880 and 93886 with a diagnosis of 290.0?California Subscri... Read more
Reader Question:
EMG/Nerve Conduction Studies
Question: I am billing our carrier for EMGs and nerve conduction studies and am unsure of ... Read more
You Be the Coder:
Conscious Sedation
Question: Our neurologists bill for conscious sedation of children during MRIs, CT scans, ... Read more
Neurologists Benefit From New Medicare Policy Increasing RVUs For Hospital Care Codes
Effective Jan. 1, 2001, Medicare has revised its payment policy for observation and inpati... Read more
Five Steps to Appeal Common Neurology Practice Denials
Insurance denials for services provided are a frequent occurrence for neurology practices,... Read more
Get Paid for Patient Cognitive Skill Training With New Codes
Prior to 2001, neurologists who worked with patients recovering from brain injuries or ps... Read more
Reader Question:
Intraoperative Monitoring With 95822
Question: We perform EEG monitoring for neurosurgical procedures such as the clipping of s... Read more
Reader Question:
Billing for 90846
Question: Can a neurologist code 90846 when he or she meets with family (in the hospital o... Read more
Reader Question:
MRA of the Cranium
Question: How is an MRA of the cranium coded?California Subscriber Answer: The new codes... Read more
Reader Question:
Teaching Neurologist and H-reflex
Question: If a teaching neurologist writes, Seen and examined by me, H-reflex by me, can h... Read more
You Be the Coder:
EMG Full Limb vs. Limited Study
Question: How can I tell whether to bill a full limb or a limited study EMG?Michigan Subsc... Read more
Available Years:  2001  2000  1999