Neurology & Pain Management Coding Alert

4 Guidelines Help You Bill Epidural Blocks
Look for documented location, depth and substance Do you have difficulty selecting the r... Read more
Make the Most of Block Billing
Follow these 4 tips for reporting E/Ms and associated procedures If you want to optimize ... Read more
Know Your Epidural Block Codes
Don't make choosing an epidural block code harder than it has to be. Typically, neurologis... Read more
Billing 'Starred' Procedures:
Get Paid for E/M Services During Global Periods
Did you know that you can bill for services, such as follow-up E/M care, that are part of ... Read more
Get the Answers to Your Consult and Referral Questions
Coding expert Nicoletti weighs in with her advice Don't allow your practice to lose money... Read more
5-Point Checklist Will Get You Paid When Using Modifier -22
If you're submitting claims for unusual procedural services without first determining how ... Read more
Tools You Can Use:
Nerve Block Decision Quiz
Looking for a quick way to choose the correct nerve block code? Take this easy decision qu... Read more
Reader Question:
Use 'M' Codes at Payer/Facility Request
Question: What are "M" codes? Should I use them?California Subscriber Answer: The M codes... Read more
Reader Question:
Don't Confuse 'XXX' and '000' Global Periods
Question: What's the difference between an XXX global period and a 000 global period?India... Read more
Reader Question:
Supervision Requirements Vary by Test, Locale
Question: Our practice wants to hire a neuro-physiologist who has a PhD, but not an MD, to... Read more
Reader Question:
Report 95957 With 95816/95819/95954 Only
Question: May I report sleep studies 95819/95951 with spike analysis 95957?Michigan Subscr... Read more
Reader Question:
Use E/M for Day-After Visit
Question: Our group of neurologists evaluates a patient on day one. The following day the ... Read more
Reader Question:
Don't Use -50 With 95870
Question: What is the best method to report 95870 in three muscles of each arm (bilaterall... Read more
Reader Question:
ED Codes Are Off-Limits for the Office
Question: Recently, an allergy patient presenting for evaluation of carpal tunnel experien... Read more
Reader Question:
Don't Risk Undercoding E/Ms
Question: I am trying to figure out an easy way to determine risk levels for the MDM compo... Read more
Reader Question:
Hold Claims for New Doctor
Question: We have a new doctor who does not have her Medicare or other provider numbers ye... Read more
You Be the Coder:
Reporting Multiple Evoked Potentials
Question: I reported 95925 x 4 with modifier -51 appended to the second, third and forth u... Read more
5 Tips to Improve Your EMG Reimbursement
Pinpointing muscles guarantees successIf choosing from the numerous electromyography (EMG)... Read more
How to Handle EMG 'Hard Copy' Requests From Payers
You should fight payer requests to provide so-called "hard-copy" results of electromyograp... Read more
Reporting an E/M With an EMG?
Have a documented requestIf you're charging an E/M service every time the neurologist cond... Read more
Reporting 'Rule Out' Diagnoses for Diagnostic Testing?
Signs and symptoms provide a better wayIf you're using "rule out" diagnoses to justify in-... Read more
Unconfirmed Diagnoses:
What You Should Never Do
You should never report an unconfirmed diagnosis to justify billing diagnostic tests (or a... Read more
Reader Questions:
90846 Describes Psychiatric Services Only
Question: May I report 90846 if the neurologist meets with a patient's family to discuss t... Read more
Reader Questions:
Use 95951 for 'up to' 24 hours
Question: How should I report a video EEG for less than 24 hours? Do I need to append modi... Read more
Reader Questions:
Multiple Units Are OK for Muscle Testing
Question: May I report 95851 x 2 for testing two different extremities? Indiana Subscriber... Read more
Reader Questions:
Use Modifier -50 or -RT/-LT, Not Both
Question: Can I code bilaterally when injecting both eyes for blepharospasm? Which is corr... Read more
You Be the Coder:
Is a Physician Required for NCS?
Question: May we bill for nerve conduction studies (NCS) when a nonphysician staff member ... Read more
Intraoperative Monitoring:
Why Just 95920 Isn't Enough
Have you got your intraoperative monitoring services coding under control? Maybe not, codi... Read more
Think Critical Care Is Too Complex? 4 Steps Make It Easy
How would you like to improve your E/M reimbursement by 50 percent or more when the neurol... Read more
Yes, You CAN Report Electrical Stimulation:
Here's How
If you've been providing electrical stimulation for patients with spinal cord injuries, he... Read more
Critical Care:
Don't Forget Separately Reportable Services
Are you reporting all separately reimbursable services when coding for critical care? Alth... Read more
Correction:
Use Q3025, Not J Code, for Avonex
The June 2003 edition of Neurology Coding Alert incorrectly stated that the appropriate su... Read more
Reader Question:
If You Move Both Electrodes, Report Another Study
  Question: The physician performs a nerve conduction study (95904) from digit II wi... Read more
Reader Question:
Be Cautious of Conscious Sedation
  Question: When providing MRIs, CT scans, etc., to children (or particularly uncoop... Read more
Reader Question:
Use 97532 for Cognitive Skills Training, 97533 for Sensory
  Question: A new provider recently joined our group practice and has begun to offer... Read more
You Be the Coder:
What if the Physician Provides the Technician?
Question: If a physician performs testing such as nerve conduction studies (NCSs) and need... Read more
Selecting Diagnoses for Pain Management? Heres What Never to Do, and What to Do Instead
What should you do if your neurologist provides pain management services for a patient w... Read more
What Makes a Consult Unique? 3 Words Tell the Story
Quick: What three requirements distinguish a consult (99241-99263) from other inpati... Read more
Confirmatory Consults Follow Different Request Criteria
Not every type of consult must meet the same requirements. Specifically, physicians provid... Read more
2004 Brings ICD-9 Codes for Muscle Weakness, Concussion
A new code will finally allow neurologists to specify a diagnosis of muscle weakness diagn... Read more
Reader Question:
Cranial Nerve Code Describes Laryngeal EMG
Question: What is the proper code for bilateral EMG of the laryngeal muscle?Montana Subs... Read more
Reader Question:
Unlisted-Procedure Code for Sphenopalatine Block
Question: We have begun providing sphenopalatine ganglion block. This is not an inject... Read more
Reader Question:
Left-Right Denervation Is Correct, Sometimes
Question: Are the -LT and -RT modifiers appropriate when reporting 64613? Arizona Su... Read more
Reader Question:
Separate Procedure Doesnt Mean Bill Separatel
Question: Is it appropriate to bill muscle testing (with supporting documentation) on th... Read more
You Be the Coder:
Whats the Best Code for IDET?
Question: What is IDET, and how should I code for it?Arizona Subscriber Answer: Intradi... Read more
Learn 4 Keys to Optimum Payment for Sleep Studies and Polysomnography
If you're frustrated with the payment you're receiving (or not receiving) for sleep stud... Read more
Be Sure to Choose a Payable Diagnoses for 95805-95811
Acceptable diagnoses for sleep studies and polysomnography (95805-95811 and 54250) differ ... Read more
Be Aware of Bundling Issues With 95805-95811
Sleep studies and polysomnography (95805-95811) bundle a number of important services beyo... Read more
Modifier -51 or -59? Heres How to Make the Choice
Physicians, coders and payers alike often have trouble distinguishing between modifiers -5... Read more
Reader Questions:
Starred Procedures Follow Special Rules
Question: Our office manager says we shouldnt bill a new patient visit (99201-99205) with ... Read more
Reader Questions:
Separate Nerves Means Separate Studies
Question: If our physician performed sensory nerve conduction studies (NCS) on both the ul... Read more
Reader Questions:
Use Modifier -50 With H-Reflex Studies
Question: When reporting H-reflex studies (95934-95936), I receive better reimbursement wh... Read more
Reader Questions:
Meet All Requirements for Critical Care
Question: What can you tell me about the codes for critical care? One of our neurologists ... Read more
You Be the Coder:
Is 99255 for Initial Consult Only?
Question: If I report 99255 more than once for the same patient (but on different days) Me... Read more
Learn the Basics of EMG Testing, and Flex Your Coding Muscle
Electromyographic (EMG) testing is a basic component of neurological pract... Read more
Remember Four Points for Nursing Facility Assessments
Comprehensive nursing facility assessments (99301-99303) do not always follow the sa... Read more
Use New V Codes Instead of Surgical Codes for Aftercare
If your neurology practice performs aftercare following surgery, you shouldn't... Read more
NCCI 9.1 Bundles Minor E/M Into 99265, but Nothing More
Despite more than 4,700 changes this quarter to the National Correct Codin... Read more
Reader Question:
Dont Charge E/M With Injection
Question: How should I report Avonex injections done in the office for Medicare pa... Read more
Reader Question :
EMG Coding Depends on Muscles Tested
Question: I'm confused about using 95860 versus 95870 for EMG testing of CTS. If the... Read more
Reader Question :
Use 95953 for 24-Hour EEG Monitoring
Question: Which is the correct code for digitally analyzed EEG monitoring? Should I ... Read more
Reader Question :
Medicare Wont Cover Electrosleep Therapy
Question: What is the appropriate code to report electrosleep therapy? Kentucky S... Read more
You Be the Coder:
Consult or Not?
Test your coding knowledge. Determine how you would code this situation ... Read more
Documentation Seals the Deal for Management of Neurogenic Pain
Patients with neurogenic pain (for example, trigeminal neuralgia or postherpetic neu... Read more
One Code Is All You Need for Late Effects of Stroke
Coding the late effects of a cerebrovascular accident (CVA, or stroke) differs from ... Read more
News You Can Use:
Medicare Payments on the Rebound
On Feb. 28, Medicare published an update to its final rule for the 2003 Physician Fee ... Read more
Reader Question:
New NPP Rules Affect Hospital, Not Office, E/Ms
Question: I've heard that CMS issued a memorandum regarding new nonphysician practit... Read more
Reader Question:
Prolonged Services OK for Unresponsive Patient
Question: If a patient has had a stroke and cannot communicate or is otherwise unrespo... Read more
Reader Question:
E/M Codes Provide Payment for t-PA
Question: We have been using a surgery code (37195) for the injection of t-PA for stro... Read more
Reader Question:
Test at Least Three Levels for 92585
Question: What distinguishes 92585 from 92586? Connecticut Subscriber Answer: Both 9... Read more
Reader Question:
95900/51785 for Sphincter and Pudendal EMG
Question: What are the correct CPT codes for pudendal nerve terminal distal latency st... Read more
Reader Question:
Use 95925 Only Once per Session
Question: I've heard conflicting advice regarding the use of 95925. May I report multi... Read more
You Be the Coder:
Report Unlisted-Procedure Code for QST
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Reimbursement Rules May Mean More Magnetoencephalography Reporting
Under revisions to the outpatient prospective payment system (OPPS), effective Jan. ... Read more
Its Easy to Apply Modifier -26 Like a Pro
If a physician conducts diagnostic tests or other services using equipment she doesn... Read more
Documentation Requirements Ease for Teaching Physicians:
By Eric Sandham,CPC
Under new Medicare rules, teaching physicians will find it easier to document servic... Read more
Reader Question:
CPT 90780/90781 Describe Solu-Medrol Infusion
" Question: How should I bill for administration of IV Solu-medrol in the office? Virgini... Read more
Reader Question:
Refer to AAEM Chart for Maximum Number of Tests
Question: What is the maximum number of tests a payer will allow to confirm a diagnosi... Read more
Reader Question:
Claim G Code for Medicare sNCT
Question: How should I bill Medicare for sNCT? Utah Subscriber Answer: Medicare has ... Read more
Reader Question:
Code 95933 Is Unilateral or Bilateral
Question: Should I append modifier -50 to 95933 when reporting orbicularis oculi (blin... Read more
Reader Question:
Reduced Services or Discontinued Procedure?
Question: If I stop testing (electroencephalography, electromyography, magne... Read more
You Be the Coder:
Monofilament Testing
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Analyze This:
Achieve Higher Reimbursement for Neurostimulator Programming
To receive just compensation, neurologists reporting analysis and/or programming o... Read more
Neurostimulator Analysis/Programming Codes
CPT provides the six codes listed below for neuro-stimulator analysis/reprogramm... Read more
Sample Neurostimulator Programming Worksheet
The most efficient way to document neurostimulator analysis/reprogramming is usi... Read more
Time Is on Your Side:
Keep an Eye on the Clock for Improved Reimbursement
Lengthy but low-level E/M visits or time spent reassuring and counseling patient... Read more
G Code Is Key for Medicare PET Scan Reimbursement
Although physicians wishing to bill Medicare for positron emission tomography (PET) ... Read more
Expect Lower Payments in 2003
CMS has announced a reduction in the national Physician Fee Schedule conversion factor... Read more
Reader Question:
Location Counts with Multiple Botox Injections
Question: Is modifier -50 or -51 appropriate when reporting multiple units of 6461... Read more
Reader Question:
New Studies May Require New Diagnosis
Question: What diagnosis codes are appropriate to bill for nerve conductions in a ... Read more
Reader Question:
Refile NCS Claims for Additional Reimbursement
Question: A colleague of mine recently informed me that Medicare is providing addition... Read more
Reader Question:
Do Not Bill Multiple Units for Inching
Question: What is the appropriate method to bill for "inching" (that is, multiple nerv... Read more
You Be the Coder:
How Is Established Defined?
Test your your coding knowledge.Determine how you would code this situation before l... Read more
Reporting Migraine Diagnoses and Services Doesn't Have to Be a Headache
Migraines are a common patient complaint, but establishing a definitive diagnosis ... Read more
Confirm the Facts Before Reporting 99271-99275
Providers often pay little attention to confirmatory consultation codes (99271-99275... Read more
CCI Update:
Version 9.0 (Mostly) Worry-Free
The most recent update (version 9.0) of the national Correct Coding Initiative (CCI)... Read more
Reader Question:
Pay Attention to Substance for Spinal Injections
Question: How do facet joint injections (64470-64476) differ from epidural blocks (6... Read more
Reader Question:
Unlisted-Procedure Codes Better Than
Question: If I want to report a certain procedure for which CPT does not include a spe... Read more
Reader Question:
Reporting Chronic Conditions
Question: May I appropriately report a chronic condition if a patient presents for a... Read more
Reader Question:
Report Signs and Symptoms Only When Relevant
Question: Should we still report signs and symptoms if testing has confirmed a definit... Read more
Reader Question:
Report Thoracic EMG Once Per Session
Question: Using electromyography (EMG), the neurologist tested the thoracic paraspinal... Read more
Reader Question:
Scan ICD-9 for an Appropriate Pain Diagnosis
Question: One of our neurologists often cites "chronic pain" as a diagnosis, but I can... Read more
You Be the Coder:
Use 95870 for Limited Muscle Studies
Test your coding knowledge. Determine how you would code this situation before looki... Read more
CPT 2003 Brings Evolutionary Not Revolutionary Changes for Neurology
CPT 2003 brings numerous text additions and code revisions but no major or u... Read more
Avoid OIG Scrutiny:
Master Work Plan Problem Areas
Because the U.S. Office of Inspector General (OIG) intends to scrutinize conso... Read more
News Brief:
OIG to Check SNF Billing and Incident-To
According to its recently released 2003 Work Plan, the U.S. Office of Inspector Ge... Read more
Reader Question:
Modifier -25 Is Key to Sleep Study and E/M
Question: May we report an E/M service on the same day as a sleep study (95805-95811... Read more
Reader Question:
Private Payers May Reimburse Telephone Codes
Question: Our physician spent 20 minutes during office hours on the phone providing advi... Read more
Reader Question:
Code All Services for In-Office Emergency
Question: Recently, an allergy patient presenting for evaluation of carpal tunnel expe... Read more
Reader Question:
Reporting EEG and Ultrasound Exam Interps
Question: The neurologists in our group practice interpret electroencephalograms (EE... Read more
You Be the Coder:
Report Post-Test Diagnosis
Test your coding knowledge. Determine how you would code this situation before looki... Read more
Available Years:  2003  2002  2001  2000  1999