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Neurology & Pain Management Coding Alert

CPT 2011:
Don't Miss New EEG, Joint Injection Guidelines That Kick In January 1
Revised directions for 64990 to 64995 change ultrasound, T12-L1 reporting. Remember to ch... Read more
News Brief:
Congress Passes 1-Year Medicare Pay Fix
New legislation helps you avoid the scheduled 25 percent drop in Medicare pay for 2011. T... Read more
Clarification:
CCI Edits Apply to Single MD During Procedure
PM/Anesthesia teams aren't affected by bundles. The latest edits from the Correct Coding ... Read more
Reader Questions:
20552, 20553: Paraspinal Muscle TPI
Question: My understanding is that the paraspinal muscle is a group of individual muscles... Read more
Reader Questions:
Look to 64640, J7335 for Capsaicin Patch
Question: Does Medicare cover the capsaicin patch? If so, how should we code it? Answer: ... Read more
Reader Questions:
327.23 Versus 780.57 for Sleep Apnea
Question: The physician diagnoses a three-year-old child with obstructive sleep apnea wit... Read more
Reader Questions:
Avoid a 'Finders Keepers' Overpayment Mentality
Question: We've discovered that a patient overpaid us on her copay. We collected $50, whi... Read more
Reader Questions:
Count Each Nerve for 64622
Question: Can you explain how to bill 64622? Do we report the code per level or per nerve... Read more
Reader Questions:
Determine Best Bet for Single Lumbar Plexus Block
Question: Our pain management specialist administered a single lumbar plexus block. How s... Read more
Reader Questions:
Use Care in Coding for E/M Plus Other Injections
Question: Our pain management specialist saw a patient with carpal tunnel syndrome for a ... Read more
Reader Questions:
62368 Reprogramming Makes E/M Necessary
Question: When we have a patient come into the office for refill and reprogramming of a p... Read more
You Be the Coder:
Correct Reporting for Neuromodulation
Question: The neurologist documented, "Trial of neuromodulation with spinal cord stimulat... Read more
Nerve Studies:
95900 to 95904: Know Which Nerve Conduction Study Code Is Right for You
Take the fear out of modifier 59 using the scenarios our experts reveal.Choosing the appro... Read more
Pain Management:
Don't Get Caught Groaning About Whiplash Treatment
Knowing how to submit claims correctly can ease your pain.Coding for whiplash diagnosis an... Read more
EHR:
Use Electronic Systems to Your Billing Advantage
Up-front costs could lead to savings in many areas.If you've considered switching to an el... Read more
Reader questions:
Verify Payer's EEG Frequency Limit
Question: Our neurologist wants to start ordering precautionary EEGs for a patient who has... Read more
Reader Questions:
Chemodenervation Diagnosis for Stroke Patients
Question: One of our patients had a stroke years ago and now needs Botulinum toxin injecti... Read more
Reader Questions:
96372 With 62310 or 62311? Know the Service First
Question: A patient visited our office for therapeutic injections of Toradol and Kenalog. ... Read more
Reader Questions:
Can Provider Change Tax ID?
Question: One of our physicians wants to stop billing under the group's tax ID and start b... Read more
You Be the Coder:
99291, 99292: Calculate Correctly
Question: The patient's chart includes the following statement: "Critical care time spent ... Read more
CCI:
0228T, 0230T Play Big Role in CCI 16.3 Edits
Report the other pain management procedure instead -- sometimes.The latest version of... Read more
ICD-9:
Prepare for Updated CVA Diagnosis Guidelines
Watch terms and deficits to choose legitimate codes.Updated ICD-9 guidelines went into eff... Read more
Pain Management:
Follow These FAQs to the Best Diagnosis for PM Patients
Tip: Don't limit yourself to just one ICD-9 code.If you don't know what differentiates an ... Read more
Reader questions:
64680 Covers Splanchnic Block
Question: Our pain management specialist administered a neurolytic celiac plexus block and... Read more
Reader questions:
J3490 Covers Tensilon Test Meds
Question: Our neurologist completed a Tensilon test, but I couldn't find the medication li... Read more
Reader questions:
Modifier TC Goes With EMG in Hospital
Question: We've been receiving denials when our physician completes an EMG in the hospital... Read more
Reader questions:
780.93, 331.83 Could Apply to Alzheimer's
Question: One of our commercial payers denies 331.0 as a diagnosis for Alzheimer's, statin... Read more
Reader questions:
The Scoop on 63030 With 63042, +63035
Question: I have several questions about billing with 63030. First, can we bill 63042 with... Read more
Reader questions:
Attach JW for Drug Wastage -- Sometimes
Question: How should I bill for wasted drug? My doctor of ten splits a single vial between... Read more
You Be the Coder:
J3490: Know Whether Separate Sodium Bicarbonate Is OK
Question: Our physician often uses sodium bicarbonate when performing a transforaminal or ... Read more
Pain Management:
Don't Miss Ancillary Procedures With Kyphoplasty, Vertebroplasty
Report radiologic supervision and interpretation but skip bone biopsies.When your pain man... Read more
News You Can Use:
OIG Still Targets Transforaminal Epidurals
Stay tuned for details on how to keep your claims clean.The Office of Inspector General (O... Read more
Compliance:
Quick Quiz: Do You Remember the 'Red Flags Rule' Requirements?
Test your identity theft prevention skills with these questions.Even though the Red Flags ... Read more
Reader Questions:
Nerve Monitoring Can Check for Bell's Palsy
Question: Our neurologist conducts facial nerve monitoring to help diagnose Bell's palsy. ... Read more
Reader Questions:
Professional Component for Wada Test
Question: Our neurologist performs Wada tests in conjunction with the hospital's radiology... Read more
Reader Questions:
Check Instruction Before Submitting 98960
Question: My physician wants to teach his patients how to give themselves Imitrex injectio... Read more
Reader Questions:
'Diagnostic' and 'Therapeutic' Defined Question:
Question: Can you explain the difference between "diagnostic" and "therapeutic" injections... Read more
Reader Questions:
Pick 1 Code for Specified Organic Sleep Apnea
Question: What is organic sleep apnea? My physician has been using 780.57 to report sleep ... Read more
Reader Questions:
Break Down Bilateral Botox Billing
Question: Can we bill chemodenervation codes 64612-64614 bilaterally? If so, which modifie... Read more
Reader Questions:
Pay Attention to Individual State WC Rules
Question: We had a patient who was injured on the job (workers' compensation) in Virginia ... Read more
You Be the Coder:
Coding Shorter EEG Studies
Question: My neurologist performed an EEG with video monitoring for eight hours. How shoul... Read more
Diagnosis Coding:
Focus on 3 Questions When Coding Frequent Falls
Double check notes before falling for easy answers.The neurologist wrote "frequent falls" ... Read more
Help Your Patients Avoid Falls
The Joint Commission (the accrediting agency formerly known as JCAHO), launched a falls pr... Read more
Pain Management:
Levels Outweigh Frequency When Coding Interlaminar Epidural Injections
Tip: Yes, you can code separately for fluoro guidance.Neurologists and pain management spe... Read more
Reimbursement:
Timely Filing Keeps Payments Coming In
With the Medicare deadline cut from three years to one, using a chart can help.As the impa... Read more
Reader Questions:
Blink Test Diagnosis Depends on Perceived Problem
Question:What diagnoses can we use to support medical necessity for a blink test? Arizona ... Read more
Reader Questions:
Watch Bilaterals and Limits on 20550 With 64450
Question:Medicare denies our claims with codes CPT 20550 and 64450, stating that the numb... Read more
Reader Questions:
Navigate Modifiers for Tricky EMG Coding
Question:We have a claim calling for 95860 (once), 95903 (twice), and 95904 (four times). ... Read more
Reader Questions:
95951 Versus 95956 Hinges on Video
Question:What is the difference between the two EEG codes 95951 and 95956? Texas Subscribe... Read more
Reader Questions:
Look to 64400 for Supraorbital Injection
Question:What procedure code applies to a supraorbital nerve injection? Washington Subscri... Read more
Reader Questions:
Count Electrodes for Stimulator Implants
Question:What code should we submit for trial stimulator implantation? Should we bill for ... Read more
Reader Questions:
Get the Scoop on Billing Before Credentialing
Question:Our practice has a new physician coming on board to replace a retiring doctor. Wh... Read more
You Be the Coder:
Make the Choice for Visual Field Tests
Question: Can you tell me which codes we should choose from for visual evaluations and vis... Read more
CCI 16.2:
New Edits Switch Columns for Polysomnography, Needle EMG Pairs
Double check before separately reporting paravertebral facet injections.The latest Correct... Read more
Code Changes:
Add 4 Choices to Your Transforaminal Epidural Options
New Category III codes bring much-needed specificity.July brings announcements regarding n... Read more
Documentation:
Specify Pain Diagnosis for Better Reimbursement
Follow these 4 steps to help avoid audit woes.Picture this: Your neurologist treats a pati... Read more
Reader Questions:
Stick With 1 Sleep Study Code
Question: We perform sleep studies in our sleep disorder center; the physicians perform an... Read more
Reader Questions:
RF Mode Determines Lesioning Code
Question: How do we code radiofrequency lesioning of the greater occipital nerve?New York ... Read more
Reader Questions:
Follow Signature Rules or Risk Payments
Question: One of our physicians likes to sign everything with just his initials, or someti... Read more
Reader Questions:
Add Modifier 52 to Incomplete Study
Question: A patient came for a sleep study, but couldn't complete the test (she stayed for... Read more
Reader Questions:
Minutes Count for Tobacco Use Counseling
Question: Our physicians sometimes spend time counseling with patients about tobacco usage... Read more
Reader Questions:
Be Wary of Time When Discharging Patients
Question: Our neurologist spent more than 30 minutes examining a patient and giving instru... Read more
You Be the Coder:
Anatomy Offers Obturator Block Clues
Question: What codes should we submit for an obturator nerve block and obturator muscle in... Read more
ICD-9 2011 Update:
Improve Your Seizure and Cognitive Testing Coding With New ICD-9 Codes
But you should keep using 724.3 for spinal stenosis.You're likely holding your breath in a... Read more
Coding Quiz:
Pinpoint the Correct CPT and HCPCS Codes and Avoid Denials
Remember the one code that can help your pre-configured NCS billing.January brought some c... Read more
Modifiers 101:
Proving Separate E/M Services Makes for Modifier 25 Success
Avoid overusing this modifier and soliciting an audit with four tips.If you find yourself ... Read more
Reader Questions:
Patient Must Be Asleep During EEG to Report 95819
Question: My neurologist administered an EEG that lasted for an hour. The notes from the e... Read more
Reader Questions:
Patient Becomes 'Established' After First Visit
Question: A patient came to our office and saw one neurologist, but when the patient came ... Read more
Reader Questions:
Intractable Seizure Dx Disappears After Surgery
Question: Our practice recently saw a patient who had been having intractable seizures. Th... Read more
Reader Questions:
Remember Not to Use Consult Codes With Medicare Rules
Question: A neurologist in our practice was called into a hospital for a consultation on a... Read more
Reader Questions:
Avoid Denials for False Duplicate Codes
Question: Our practice provides sleep lab services, but for business accounting reasons, w... Read more
You Be the Coder:
Counting Nerve Conduction Test Per Limb Will Bring Denials
Question: I coded my neurologist's diagnostic testing recently that included nerve conduct... Read more
Muscle Testing:
Use Caution With Separate Procedures on Muscle Tests
But multiple Dx codes can still give you options.Think you can only report one range-of-mo... Read more
Differentiate Range Of Motion Test Terminology
Don't let dysdiadochokinesia slow up your coding.In order to decipher your neurologist's n... Read more
Modifiers:
Stay on the Correct Side of Bilateral Procedure Rules
Rejoice in 150-percent payment for correct modifier 50 use.When your neurologist performs ... Read more
News You Can Use:
Split/Shared Visits Ease Consult Deletion Worries
Plus, you should report one inpatient care code per day, CMS reps say.With consultation co... Read more
Reader Questions:
Internist Might Report 95905
Question: A primary care referral source recently contacted our neurology practice to ask ... Read more
Reader Questions:
53 Represents Discontinued Spinal Puncture
Question: One of our neurologists scheduled a diagnostic lumbar puncture. He started the p... Read more
Reader Questions:
Have a Printout Ready for Proof of EMGs, NCSs
Question: I have one neurologist that generates an EMG report directly from his observatio... Read more
You Be the Coder:
Pick Out the Best Migraine Dx
Question: A new 49-year-old patient presents with recurring headaches. She reports that th... Read more
CCI 16.1 Update:
Identify Swapped Pairs to Ensure Correct EMG Modifier Placement
Make sure you know when to put a modifier on +95920, starting now. Each time the Correct ... Read more
Keep an Eye on Your Polysomnography Coding,Before OIG Does
Overusing Dx codes is just one way to attract an audit. The Office of the Inspector Gener... Read more
Don't Get Tripped Up by Unusual Discharge Scenarios
Report 99238 on date of service, even if patient doesn't leave that day. Discharging a pa... Read more
Reader Questions:
Tune in to Video-Conference Cat. III Code
Question: Our neurologist has agreed to be a specialty resource for a small rural hospita... Read more
Reader Questions:
Grab Dx Codes for Cohen's Syndrome Cases
Question: We had a patient present recently that our physician diagnosed as Cohen's Syndr... Read more
Reader Questions:
Use Modifier 22 for Extra Repetitive-Stim Time
Question: We've recently begun performing a test n our office that our neurologists are c... Read more
Reader Questions:
Gain Some Perspective on Alice in Wonderland Syndrome
Question: A claim just crossed my desk with a diagnosis of Alice in Wonderland syndrome. ... Read more
Reader Questions:
Work From Diagnosis for Non-Neuro Conditions
Question: At the request of an urologist, our neurologist consulted on an inpatient with ... Read more
Reader Questions:
Diagnoses Matter for Tarlov Cyst Referral
Question: Our neurologist saw a patient with a sacral Tarlov cyst. She is referring the p... Read more
You Be the Coder:
Decide If 96119 is Right for Neuropsych Test
Question: We do neuropsych testing with computer-based testing. When the patient comes fo... Read more
Avoid CVA Diagnosis Coding Pitfalls with 438.13, 438.14
You'll turn to a V code when your neurologist reports 'no effects,' however. When your ne... Read more
Overcome Critical Care Coding Challenges With 3 Tips
Avoid costly denials by knowing what's included with 99291. Your neurologist could be inv... Read more
Who's Eligible for Critical Care?
Some examples of patients who might receive neurocritical care E/M services include patien... Read more
Clip and Save:
Reach for the Right Chemodenervation Info
Use these three strategies for clean injection codes. Chemodenervation denials can happen... Read more
Reader Questions:
Untangle a TPA Coding Web
Question: Since Medicare has assigned a physician work value to tissue plasminogen activa... Read more
Reader Questions:
Know Who Should Admit an ED Patient
Question: A 46-year-old patient reported to our hospital's emergency department (ED) earl... Read more
Reader Questions:
Report Wastage on Toxin Injection
Question: My neurologist scheduled two patients back-to-back for botulinum type B injecti... Read more
Reader Questions:
Get Your Head Around Transcranial Doppler Testing
Question: My neurologist ordered a complete transcranial Doppler test (TCD) for a patient... Read more
Reader Questions:
Calculate EEG With Hours, Not Days
Question: Our neurologist performed an electroencephalogram (EEG) with video recording on... Read more
You Be the Coder:
Get the Digits Right for Separate Nerve Conduction
Question: My neurologist performed a sensory nerve conduction study on the right median s... Read more
Clarify Chemodenervation with J Code Help
You'll need more than 1 code to capture drug and injection reimbursement. If you've notic... Read more
Quick Quiz:
Do You Know the New Consult Rules? Find Out Fast
Test your 2010 consultation coding understanding with these questions. Consultation codin... Read more
Easily Navigate Category III Codes With 3 Tips
Start with these proven methods before settling on unlisted codes. While you may not alwa... Read more
Quick Quiz Answers:
Do You Know the New Consult Rules? Find Out Fast
Check your 2010 consultation coding moxie. Find out if you're set to properly code your n... Read more
Reader Question :
Code Epidurogram on Its Own
Question: My neurologist performed an epidurogram diagnostic study in conjunction with a ... Read more
Reader Question :
Stay Alert on Polysomnography Coding
Question: We recently opened a sleep lab, and performed an overnight sleep staging study ... Read more
Reader Question :
Get Started With PQRI Here
Question: My neurologist wants to participate in PQRI. What do we need to do in order to ... Read more
Reader Question :
Watch Test Time for IOM
Question: My neurologist performed intraoperative monitoring (IOM) inconjunction with upp... Read more
You Be the Coder :
Feel Your Way Through CTS Diagnosis
Question: My neurologist has a patient who presented with tingling and pain in her right ... Read more
Don't Get Tripped Up by Facet Joint CCI Bundles
Version 16.0 slaps new bundles on EMGs as well. Along with new CPT codes, as of Jan. 1 yo... Read more
Don't Overlook Deletions, Swapped Pairs Edits in CCI 16.0
Plus, more code pairs may be affected later in the year, so stay tuned. The story on Corr... Read more
Incorporate a New Modifier to Overcome Potential 99221-99223 Denials in the New Year
Plus, more code pairs may be affected later in the year, so stay tuned. The story on Corr... Read more
Reader Question:
Results Matter When Reporting 96110
Question: I've heard that in order for us to bill 96110, the report section should be inc... Read more
Reader Question:
Don't Code Oximetry Separately
Question: My sleep lab often performs oximetry monitoring. We charge for the facility fee... Read more
Reader Question:
Watch Technical Component on Outpatient EMG
Question: My sleep lab often performs oximetry monitoring. We charge for the facility fee... Read more
Reader Question:
Watch Technical Component on Outpatient EMG
Question: My doctor has started doing EMG procedures/tests in an inpatient hospital setti... Read more
Reader Question:
No Global Isn't an H&P Billing Green Light
Question: I understand that I cannot bill for an H&P if there is a global because it ... Read more
You Be the Coder:
Consider Condition Before Coding Critical Care
Question: My neurologist was performing a magnetoencephalogram and the patient went into ... Read more
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