Advanced Search

Neurology & Pain Management Coding Alert

CPT 2005:
Look for New Central Motor EP, Imaging and Neurostimulator Codes
No grace period for the new year means that now's the time to learn about additionsCPT 200... Read more
Could New Acupuncture Codes Mean Reimbursement?
Neurology practices providing therapy services could possibly see more consistent reimburs... Read more
NCCI Says 'No' to Billing EEG With Physician Attendance
If you've been billing separately for the EEG when the neurologists provides EEG recording... Read more
CMS Puts the Squeeze on EMG Guidance With Botox Injections
For guidance with 64612-64614 and 64640, stick with 95870 onlyCMS has changed the rules fo... Read more
Coding 2 Services on the Same Day? Pick From 3 Modifiers
Proper application of -25, -51 and -59 means success for multiple procedures If you're rep... Read more
News in Brief:
Look for New Fluoro Guidelines, Relax About 2005 ICD-9 Codes
Amid all the changes for 2005 comes some comforting news: Improved reimbursement for fluor... Read more
Reader Question:
Append -21 Only to Level-5 E/Ms
Question: Our neurologist performed a level-three E/M service on a new patient last week. ... Read more
Reader Question:
Counseling Must Dominate to Use It for E/Ms
Question: Our neurologist saw a patient today for symptoms related to carpal tunnel. The p... Read more
Reader Question:
Turn to 70544/70545 for MRA of the Cranium
Question: What is the proper code for an MRA of the cranium?Nevada Subscriber Answer: CP... Read more
Reader Question:
At Least 15 Hours? Go With 95951
Question: How should we code if the neurologist provides monitoring for localization of ce... Read more
You Be the Coder:
Facet Injections Describe Neurolysis
Question: How should I code bilateral occipital neurolysis with cryoablation? Also, how sh... Read more
Are You Getting 93880/93882 Denials? Check 3 Things Before You Appeal
Here's when you can bill separately for duplex scan interps Just because your neurologist... Read more
Use E Codes to Unlock Workers' Comp Pay
WC insurers often require information about the accident or disease's cause Workers' comp... Read more
Select 99455-99456 - Not E/M Codes - for WC Evaluations
If your physician evaluates a patient for a workers' compensation claim, you should turn t... Read more
Include 90782 in E/M Visit
Payers won't allow separate payment for same-day injection Recently, a Washington subscri... Read more
Reader Questions:
Claim 'Attended' Study for Electrical Stimulation
Question: I've heard recently that Medicare will accept claims for electrical stimulation ... Read more
Reader Questions:
Consider Family Consult a Patient Service
Question: A patient comes in to discuss the care of  his wife, who is also a patient ... Read more
Reader Questions:
Include Digital Analysis in 95953
Question: May we report ambulatory EEG (95953) with digital analysis (95957) for continuou... Read more
Reader Questions:
Sleep Studies Require Constant Attendance
Question: Must a technician provide constant attendance if we are to bill a complete sleep... Read more
Reader Questions:
Report Range-of-Motion Testing per Limb
Question: Should I report 95851 once per extremity or once per session, regardless of the ... Read more
Reader Questions:
Medicare Provides Free Access to NCCI Edits
Question: I heard that Medicare posted the National Correct Coding Initiative (NCCI) edits... Read more
You Be the Coder:
How Should We Report Infraorbital Block?
Question: One of our physicians performed an infraorbital nerve block. What is the correct... Read more
Carpal Tunnel Case Study:
Step-by-Step Instructions for E/M and Testing Claims
Report signs and symptoms first and respect guidelines to get claims paid Carpal tunnel sy... Read more
Recognize the Limits of Diagnostic Testing for CTS
When you assign codes describing electrodiagnostic testing (such as NCS and EMG), you must... Read more
OIG Alert:
Make Sure That Consult Isn't a Transfer of Care (and Vice Versa)
Medicare paid $2 billion in 2000 for consultations (99241-99263), and in 2004 the Office o... Read more
Can You Distinguish Modifiers
Location modifiers increase specificity, but consult the fee schedule firstModifiers -LT a... Read more
Reader Questions:
Stay With 1 Unit of 95925/95926
Question: May I report one unit of 95925 for each site the neurologist tests?Idaho Subscri... Read more
Reader Questions:
Include 'Mini-Mental' Exams in E/M
Question: What is the proper code to report a mini-mental exam? I've heard that we should ... Read more
Reader Questions:
Choose From 3 Codes for Lumbar Plexus Block
Question: Which code represents a single lumbar plexus block administered for post-op pain... Read more
Reader Questions:
New Patient Not Based on Creating Medical Record
Question: When a patient presents to the office for the first time after one of our neurol... Read more
Reader Questions:
For Most Payers, You No Longer Need -51
Question: CPT includes a modifier (-51) for "multiple procedures." I never append this mod... Read more
Reader Questions:
Skip Anesthesia Codes for Conscious Sedation
Question: Especially when dealing with young children, our neurologist will administer con... Read more
You be the Coder:
Should We Append -52 to 95860?
Question: When we report EMG code 95860 without testing the paraspinals, should we attach ... Read more
3 Tips Ensure Proper Reimbursement for Trigger Point Injections
Limit your claims to one unit of either 20552 or 20553 per patient encounter You'll repor... Read more
NCCI 10.2 Bundles Lidocaine Into Hundreds of Procedures
If you're billing J2001 with injections, the latest NCCI will get your attention If you s... Read more
Prepare Now for a New Diagnosis for Stroke and CVA
Come Oct. 1, you're going to have to apply a different diagnosis code for stroke patients.... Read more
Reader QuestioN:
You Can Appeal Modifier -25 Denials
Question: Whenever I use modifier -25 on an E/M service with a procedure code on the sam... Read more
Reader Question:
For Discontinued Lumbar Punctures, Append -53
Question: During a lumbar puncture, the patient's left leg became numb, and he had sever... Read more
Reader Question:
Report Botox Once per Procedure
Question: My neurologist performed a peripheral nerve branch chemodenervation with Botox... Read more
Reader Question:
Append -32, but Don't Expect More Money
Question: Our neurologist spends a lot of time on confirmatory consultations that insure... Read more
Reader Question:
Bundle 95900 and 95903 Except for Different Sites
Question: How should I code for recording of M-waves? Are these similar to F-waves? Ore... Read more
Reader Question:
Code Carefully and Negotiate to Offset Botox Costs
Question: Recently, our cost for Botox has increased to $448 per vial (plus tax), while ... Read more
Reader Question:
Don't Consider Time for Simple Versus Complex
Question: What role does time play when I choose between "simple "and "complex" codes fo... Read more
You Be the Coder:
You'll Need Location and Depth for 62280-62282
Question: How can I differentiate between injection/infusion codes 62280-62282? Specific... Read more
Think You Know the Correct ICD-9 Code for RSD Visits? Think Again
Hint: It's not always the 337.2x series Without proper ICD-9 coding, you cannot justify t... Read more
A Sure Way to Nail Down the Correct RSD Codes
Use our handy chart to quickly identify your patient's RSD services Because reflex... Read more
Debunk the 99211 Myth - It's Not Just for Nurses
If a visit warrants a low-level E/M, you can recoup an additional $20 or more If you're t... Read more
2005 ICD-9 Codes Bring New Narcolepsy, Fever Diagnoses
You should keep an eye open for new and revised ICD-9 codes for 2005, which become effecti... Read more
Reader Question:
Choose 99341 Series for Home Visits
Question: One of our neurologists occasionally visits patients at their homes to evaluat... Read more
Reader Question:
5th Digit for Hemiplegia Refers to Body
Question: When I code for a late effect CVA, hemiplegia (438.2x), does the fifth-digit d... Read more
Reader Question:
Don't Let Patient's Age Drive Diabetes Diagnosis
Question: The neurologist recently saw a 16-year-old patient with underlying diabetes. W... Read more
Reader Question:
No More Starred Procedures Means More Modifiers
Question: What's the practical significance of losing the "starred designation" in CPT 2... Read more
Reader Question:
Choosing 99291 Leads to Better Reimbursement
Question: Are there any advantages to choosing critical care codes rather than standard ... Read more
Reader Question:
The 'Global Fee' Applies for In-Office EEGs
Question: We have a small four-physician office and would like to perform EEGs in the offi... Read more
Reader Question:
Check Your Classification Before Selecting CRPS Diagnosis
Question: What is the proper diagnosis code for "complex regional pain syndrome"? I am u... Read more
You Be the Coder:
Do Consults Have Time Limits?
Question: If I perform an office consultation on a patient, how much time must elapse be... Read more
Are You Reporting Reduced and Discontinued Services Correctly?
Knowing whether the physician halted the procedure by choice or necessity makes the differ... Read more
Other Factors to Consider When Choosing Between -52 and -53
In addition to asking "Why did the physician halt the service?" consider these two questio... Read more
If You're Cutting Your Fees for -52 and -53, You're Losing $$$
If you're appending modifier -52 or -53 to a claim, you want to tell the payer why. I... Read more
3 Tips to Collect $75-$100 per Hospital Discharge Claim
Air-tight documentation will guarantee your 99238-99239 claims When the neurologist repor... Read more
Reader Question:
Report Initial Inpatient Consults for Nursing Homes
Question: Which codes should I use when the physician is called to the nursing home for a ... Read more
Reader Question:
Patient's Status Drives Component E/M Coding
Question: During an office visit, our neurologist performed an expanded problem-focused hi... Read more
Reader Question:
If Patient Switches to Your Office, Use 99201-99205
Question: When my neurologist covers for another local private-practice physician, I code ... Read more
Reader Question:
E/M Is Appropriate With Neuromuscular Testing
Question: May I report an E/M service along with 95831 for neuromuscular testing? Ohio Sub... Read more
Reader Question:
Avoid Confusing NOS and NEC
Question: What do " NEC" and " NOS" mean in ICD-9 coding? How should I choose between them... Read more
Reader Question:
Same-Day Consult Followed by Procedure? Use -25
Question: Our neurologist recently performed a consultation with findings that necessitate... Read more
Reader Question:
You Can Equate Selective Nerve Root and Epidural Injections
Question: What is the correct code for a selective nerve root injection? Nebraska Subsc... Read more
You Be The Coder:
Digital Analysis Doesn't Apply to 95953
Question: Can we charge for a digital analysis (95957) with an ambulatory EEG (95953)?Colo... Read more
Coding Experts Answer Your 6 Most Common Evoked Potential Questions
If you confuse monofilament testing with sensory EPs, you'll lose more than $60 per claim ... Read more
Everyone Can Win With After-Hours Codes
Gain an additional $50 for urgent visits and still save the payer money Payers frequently... Read more
Reader Question:
Reporting -TC in a Facility Setting
Question: When may we report the global fee for electrodiagnostic testing in a facility se... Read more
Reader Question:
Use Initial Impatient Consults for Nursing Homes
Question: Which codes should I use when the neurologist is called into a nursing home for ... Read more
Reader Question:
NP Services Can Stand Alone
Question: Which code should I use for an NP (nurse practitioner) visit if the neurologist ... Read more
REader Question:
Modifier -50 Is the Way to Go for Bilateral H-Reflex
Question: When reporting H-reflex studies (95934) on both sides of the body, should I appe... Read more
Reader Question:
Don't Expect Payment if Patient Isn't Present
Question: Can we bill an office visit (99211-99215) for a consult with a family member to ... Read more
Reader Question:
Check Your Digits Before Reporting Difficulty Walking
Question: I keep getting claims with 719.75 returned to me. What am I doing wrong?Pennsylv... Read more
You Be The Coder:
For Awake and Drowsy, Turn to 95816
Question: I perform all my EEGs in the local hospital. Which code should I use for reading... Read more
If You've Faced Avonex Denials in the Past, Now's the Time to Try Again
Revised CMS guidelines allow you to collect as much as $20 per injectionIf you've been get... Read more
Adjust Your Claims for SNF Patients -- or Lose $ Every Time
You must report the technical component of diagnostic tests to SNFsWhen skilled nursing fa... Read more
Want to Know Which Codes to Report Directly to SNFs? Here They Are
Medicare includes many services in its consolidated billing requirements: Here are the com... Read more
Don't Give Up Payment for Noncovered Procedures
Proper modifiers and a signed ABN can make the differenceIf you don't want to get caught a... Read more
The ABCs of ABNs
An advance beneficiary notice (ABN) is a written notice to a Medicare beneficiary that Med... Read more
Reader Question:
Turn to 95923 for Galvanic Skin Potential
Question: What is the proper code to report galvanic skin potential testing?Pennsylvania S... Read more
Reader Question:
New and Established Don't Affect Office Consults
Question: A new neurologist in our office saw an established patient who last appeared in ... Read more
Reader Question:
There's No Need for -50 on Blink Reflex Testing
Question: When we perform orbicularis oculi (blink) reflex by electrodiagnostic testing (9... Read more
Reader Question:
Find IDET Options in CPT and HCPCs
Question: What is the CPT Code for intradiskal electrothermal therapy (IDET)? Oklahom... Read more
Reader Question:
Base Dorsolateral Nerve Block on Injection Type
Question: What is the best CPT code for a dorso-lateral sacral nerve branch block?Virginia... Read more
Reader Question:
Avoid Modifier -50 for NCS
Question: May I apply modifier -50 to 95900 for bilateral testing of carpal tunnel syndrom... Read more
Reader Question:
Report Fluoroscopic Guidance Once per Session
Question: May I report multiple units of fluoroscopic guidance when administering facet bl... Read more
You Be The Coder:
Reporting Generalized Weakness
Question: Which ICD-9 code should I use for progressive generalized weakness only?Alaska S... Read more
4 Steps Will Improve Your NCS Reimbursement
Identify the nerves tested to ease the path, experts sayIf you find reporting nerve conduc... Read more
What's What? A Quick Guide to NCS Terminology
Motor NCS (95900 and 95903) describes stimulation at various points along a motor nerve co... Read more
Coding Basics:
Use Modifier -25 for Same-Day Procedure and E/M
4 steps put you on the path to better reimbursementModifier -25 (Significant, separately i... Read more
Checklist Eases Modifier -25 Claims
Appending modifier -25 (Significant, separately identifiable evaluation and management ser... Read more
Reader Question:
Report 64612 for Blepharospasm Injections
Question: How should I code for Botox injections to control blepharospasm?Idaho Subscriber... Read more
Reader Question:
Report 92950 for Resuscitation
Question: Our neurologist was making rounds at the hospital today when he responded to a "... Read more
Reader Question:
Hypertension Contributes to Management
Question: Our neurologist works with many diabetic and stroke patients, and I understand t... Read more
Reader Question:
Co-Management May Warrant Consult
Question: Can I report a consultation if the neurologist co-manages a patient's care?South... Read more
Reader Question:
Z-Joint Equals Facet Joint
Question: Our neurologist documented a "z-joint injection," but we couldn't find a code fo... Read more
Reader Questions:
Use Outpatient Codes for ED Visits
Question: Our neurologist was recently on-call for an emergency department. The ED physici... Read more
You Be The Coder - One Diagnosis or Two?
Question: If a patient has wrist pain and shoulder pain, should we report each diagnosis, ... Read more
3 Field-Tested Tips for Improving Your 'Unlisted-Procedure' Pay
Eliminate payer guesswork with clear documentation If you've ever filed a claim using an ... Read more
Get the Pay You Deserve for Long Visits
If the neurologist provides an extended E/M visit, you may be tempted to report prolonged ... Read more
Quick Quiz:
Test Your Prolonged Service Skills
You're fairly clear on prolonged services codes, but you'd like a little practice, right? ... Read more
If Prolonged Services Don't Apply, Try Modifier -21
Modifier -21 can allow you to recoup additional E/M reimbursement when the physician's ser... Read more
News Brief:
CMS Announces Increased 2004 Payment Factor of 37.3374
As promised, CMS has delivered a 1.5 percent increase in the Physician Fee Schedule for 20... Read more
Have You Gone Electronic?
CMS final rule mandates e-claims Have you begun submitting your Medicare claims electroni... Read more
Reader Question:
Modifier -52 Isn't Required for 95860
Question: When reporting EMG 95860 without testing of paraspinals, should we attach modifi... Read more
Reader Question:
Report Initial Hospital Care for Admits Only
Question: I was recently called to the hospital to take over the care of a patient when ... Read more
Reader Question:
Pay Close Attention to LMRP for Facet Joints
Question: Our Medicare payer is rejecting all claims for facet joint injections. Any idea ... Read more
Reader Question:
Append -53 for Interrupted Lumbar Puncture
Question: A physician attempted a lumbar puncture on a patient. During the procedure, the ... Read more
Reader Question:
Access 95920 and Baseline Study for Intraoperative Monitoring
Question: How should I report intraoperative monitoring?Washington Subscriber Answer: The... Read more
You Be the Coder:
Defining an 'Extended' EEG
Question: What is the difference between EEG codes 95812/95813 and 95816-95828? Specifical... Read more
Botulinum Toxin:
How to Avoid Confusing Type A and Type B
Look for special Myobloc code and diagnosis requirements, experts say Many coders hav... Read more
Don't Forget EMG Guidance With Myobloc Injections
Most payers allow electromyographic (EMG) guidance with Botox injections to ensure the pro... Read more
Fee Schedule Update:
You May See a 1.5% Payment Increase for 2004
Once again for 2004, Congress has passed legislation that reverses a threatened reduction ... Read more
Improve Your 'Late Effects' Coding? Here's How
More detail means claims success If you're overlooking late effects when assigning ICD-9 ... Read more
Reade Question:
Report 99255 Just Once Daily
Question: If I report 99255 more than once for the same patient on different days, Medicar... Read more
Reader Question:
Bill On-Call Visits as 'Established'
Question: Our physician is "on-call" for another neurologist. If he sees one of the neurol... Read more
Reader Question:
Use Separate Diagnosis for Concurrent Care
Question: Our neurologist is one of several doctors managing a diabetic patient in the hos... Read more
Reader Question:
Facet Joint Injection Has Global Period
Question: Our neurologist performed a facet joint injection (64622, Destruction by neuroly... Read more
Reader Question:
Stick With G Codes for sNCT
Question: Which codes should I report for sensory nerve conduction threshold tests (sNCTs)... Read more
Reader Question:
Isaac's Syndrome: Motor Neuron Disease
Question: Is there a specific diagnosis code for Isaac's syndrome?Texas Subscriber Answer... Read more
Reader Question:
Medicare Won't Recognize 'After Hours'
Question: A Medicare patient knocked on the door on a Friday when the office was closed. H... Read more
You Be the Coder:
How Many Muscles for 95870?
Question: When testing paraspinal muscles corresponding to an extremity, should I report 9... Read more
Don't Allow Bundled Injections to Decrease Your Reimbursement
Documentation and modifiers are crucial, experts say Did you know that Medicare bundles m... Read more
Correction:
Use 95951 for 'up to' 24 Hours
The answer to the reader question "Use 95951 for 'up to' 24 Hours" (Neurology Coding Alert... Read more
Want to Avoid OIG Scrutiny?
Shore up your diagnostic testing claims, medical necessity in 2004 You've assigned the ri... Read more
New Words, Same Meaning:
Trigger Point Codes Undergo Changes for 2004
For 2004, CPT has slightly refined the language used in the descriptors for tendon sheath ... Read more
No More Seeing Stars in CPT:
'Starred Procedure' Guidelines Dumped for 2004
Although the AMA's elimination of "starred procedures" for 2004 may have little effect whe... Read more
Fee Schedule Update:
CMS Has a Change of Heart on Proposed 'Mass Adjustment'
Good news for your neurology practice: Your physicians won't have to cough up overpayments... Read more
CMS Makes It Easier (and Cheaper) to Get NCCI
Tired of shelling out hundreds of dollars a year to stay current on changes to the Nationa... Read more
Reader Question:
Assign 'Other Unspecified' for Obstructive Apnea
Question: What is the appropriate ICD-9 code to describe obstructive sleep apnea for sleep... Read more
Reader Question:
Use 64470 Range for Medial Branch Blocks
Question: Which code should we report for a medial branch block?New Jersey Subscriber Ans... Read more
Reader Question:
Bill Attended Sleep Studies Only
Question: Must a technician be in constant attendance to bill for a complete sleep study? ... Read more
Reader Question:
Report Only One Unit of Evoked Potentials
Question: May I report multiple units of 95925-95927 if I test multiple sites?New York Sub... Read more
Reader Question:
Don't Use 64640 Indiscriminately
Question: May we report 64640 for Botox injections? We now use 64612 for facial, 64613 for... Read more
You Be the Coder:
F-Wave Without NCS
Question: How should I report F-wave study only? The physician did not perform nerve condu... Read more
Available Years:  2004  2003  2002  2001  2000  1999