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Neurology & Pain Management Coding Alert

Coding Strategies:
3 Crucial Strategies Improve Your Sleep Study Reporting
Hint: Confirm the stage of sleep and parameters recorded. You can improve ... Read more
Know These 4 Sleep Monitoring Devices
Having a handle on the four types of sleep monitoring devices can help you finesse y... Read more
Pain Management:
Don't Get Tense Over Coding Dupuytren's Contracture
Tip: Narrow your choices by surgery, injection, or follow-up. Your injectio... Read more
Condition 101:
Dupuytren's Contracture Defined
Look to 728.6 for diagnosis. In Dupuytren's contracture (728.6, Contrac... Read more
ICD-10 Update:
Don't Let Epilepsy Reporting Make You Feel Jittery
Ensure documentation for treatment response to support descriptors. ICD-10 ... Read more
Reader Question:
128 Channel EEG May Mean Extensive Work
Question: If the provider billed for the interpretation of a 128 channel EEG tha... Read more
Reader Question:
64614 Applies to Multiple Gastrocnemius Injections
Question: The physician documented, "50 units of Botox was injected in two sites... Read more
You Be the Coder:
Count Extremity for EMG, Nerves for NCS
Count Extremity for EMG, Nerves for NCS Question: Our neurologist compl... Read more
Coding Tips:
Break Bundling Blues In Nerve Conduction Codes With These 5 Steps
Verify total nerves tested, get specific for preconfigured devices.If you find reporting n... Read more
Billing Corner:
Tactics Help Resolve Your Primary Vs Secondary Payer Challenges
Take timely corrective action if you discover an overpayment.Did you know that you're obli... Read more
Pain Management:
Latest Coding Edits Focus on Injections During Repair, Discography
Plus: Don't miss these important modifier changes for needle EMG. The most recent Correct ... Read more
Reader Question:
Know Additional Parameters in Polysomnography
Question: How do we report the EEG our neurologist does with polysomnography recording?Ala... Read more
Reader Question:
Yes, You Can Include Fluoro for Interlaminar Epidural
Question: Do payers allow you to report fluoroscopy in conjunction with an interlamin... Read more
Reader Question:
Verify Payer Preference, Type of Test Kit for 80101 Reporting
Question: Our pain management physicians perform random drug screenings, and I have a ques... Read more
You Be the Coder:
Target for Percutaneous Leads Points You to 64555 or Category III
Question: Our pain management specialist percutaneously implanted four trial subcutaneou... Read more
Coding Tips:
Steps Ease Your Nerve Conduction Studies Reporting
Key: Count required units and append modifiers to avoid denials.When reporting nerve condu... Read more
Need a Refresher on Nerve Conduction Basics?
Your neurologist will use nerve conduction studies (NCS) to test the function and electric... Read more
CPT® 2013:
Don't Miss the Updated Chemodenervation Codes -- Including One for Migraine Treatment
Plus: Many E/M and some pain pump codes cover more providers now.The American Medical Asso... Read more
Billing Corner:
Need Help Untangling Primary vs. Secondary Payer Challenges? Try These Tips
Know the coordination of benefits and what each payer pays.If you have questions about pri... Read more
Reader Question:
Don't Forget J Code and FB Modifier for Injections Administered
Question: The patient needs injections of vitamin B12 and carries her own medication to ou... Read more
Reader Question:
Identify EEG and ECG as Distinct Procedures
Question: Our clinician performed an EEG on a patient. He also documented that the patient... Read more
Reader Question:
For Same Region, Keep to Single 64421
Question: The physician documented that he performed blocks at T8, T9, T10, and T11. He co... Read more
Reader Question:
Check For Non-Duplication in Critical Care Services
Question: Our neurologist provided consultant services to a patient who was under critical... Read more
Reader Question:
Resort to 64999 for Lumbar Sympathetic Chain RF
Question: I've read that we should report 64999 for radiofrequency of the lumbar sympathet... Read more
You Be the Coder:
Correct Reporting for Q-EEG
Question: What is the appropriate code for quantitative electroencephalography (Q-EEG)? Al... Read more
Pain Management:
CCI 18.2 Reintroduce Possibility of Reporting TPIs with Epidural Injections
Latest edits also caution you about reporting injections with fluoro. You can now sometime... Read more
ICD-10 Update:
Focus on Age -- Not Severity -- for Alzheimer's Disease Reporting
Diagnosis codes differ for early vs. late onset of symptoms.When reporting Alzheimer's dis... Read more
Condition Spotlight:
Know The Basics Of Alzheimer's Disease
Here's where to draw the line between early and late onset AD.Alzheimer's disease (AD) is ... Read more
Billing Update:
3 Expert Answers Upgrade Your Primary/Secondary Payer Skills
Identify primary payer and confirm state requirements.Knowing how to handle primary and se... Read more
Reader Question:
Bill Professional Component for VEM Interpretation
Question: We performed video EEG in our office and the patient was retained for overnight ... Read more
Reader Question:
Treat H-wave Stimulation as Electrical Stimulation
Question: How do we report when our physician prescribes an H-wave device for electrical s... Read more
Reader Question:
Report Numb Chin Syndrome as Sensory Neuropathy of Face
Question: What diagnosis code can we report for numb chin syndrome?Florida SubscriberAnswe... Read more
Reader Question:
Don't Miss a Diagnosis of Polyradiculopathy
Question: What diagnosis codes can we report for lumbosacral polyradiculoneuropathy and lu... Read more
Reader Question:
Keep a Count of Sites for EMG Reporting
Question: Our physician did nerve conduction studies and also performed EMG for many muscl... Read more
Reader Question:
Check 20552 -- and Maybe ABN -- for Non-Guided SI Injection
Question: Our pain management specialist administered a sacroiliac (SI) joint injection wi... Read more
Reader Question:
Is 64483 Not Allowed? Then Also Skip +64484
Question: Our physician performed two levels of lumbar laminectomy on a Medicare patient. ... Read more
You Be the Coder:
Don't Jump to 346.x for Headache
Question: A co-worker says we can submit "headache" and "migraine" on the same claim, but ... Read more
Pain Management:
Your 3-Step Guide to Submitting Successful TENS Claims, Despite CMS Snub
CMS stops TENS pay for most low back pain cases, but other payers might allow. CMSannou... Read more
Coding Tips:
Wake Up to Sound Payment for Sleep Study Services
Know what procedures can be reported separately, add appropriate modifiers.When performing... Read more
Diagnosis Coding:
ICD-10: Drill Down to Manifestations to Report Substance Use and Dependence Dx
Tip: Get Clarity on abuse vs dependence to get the correct code. Get ready to change your ... Read more
Pain Management:
Your 4-Step Guide to Submitting Successful TENS Claims, Despite CMS Snub
CMS stops TENS pay for most low back pain cases, but other payers might allow.Just because... Read more
Treatment Focus:
Here's How TENS Works
Looks for TENS when physicians treat a range of pain conditions.TENS -- transcutaneou... Read more
Reader Question:
Be Specific for Date of Professional Component
Question: What is the correct date of service for an EEG interpretation? The test was done... Read more
Reader Question:
Confirm if NP Has Billing Rights
Question: Is a nurse practitioner allowed to render service to a patient for CPT®'s ... Read more
Reader Question:
Report 64490 for T12-L1 Injection, But No Fluoro
Question: The physician advanced a 25 gauge spinal needle into the posterior aspect of the... Read more
You Be the Coder:
J3490 Could Be Best for Lidocaine Injection
Question: What is the best code to report for 1cc of 1 percent Lidocaine used for sacroili... Read more
Rely on 3 Modifiers to Conquer Challenging Lumbar Puncture Coding
Rely on 3 Modifiers to Conquer Challenging Lumbar Puncture Coding Complete documenta... Read more
Coding Tips:
Rely on 3 Modifiers to Conquer Your Lumbar Puncture Coding Challenges
Complete documentation is your best support to recoup pay for the additional effort and ti... Read more
Don't Leave Out Any E/M If Separately Identifiable
The 62270 and 62272 CPT® codes are considered to be minor surgical procedures in tha... Read more
ICD-10 Update:
Identify These Hidden Signs to Correctly Report Neurofibromatosis
Knowing the disease type will point you toward the right code.A diagnosis of neurofibromat... Read more
Pain Management:
Follow These 3 Steps to Capture Vertebroplasty Supervision
CT versus fluoro is your first coding clue.Radiological supervision is a vital component o... Read more
Reader Question:
Descriptor Differences in 95885 and 95887 Explained
Question: What is the difference in the terminology for 95885 "with related paraspinal are... Read more
Reader Question:
Check For Modifier 50 with 64614
Question: The neurologist performed chemodenervation in both of a patient's legs. Can we u... Read more
Reader Question:
Submit 95039 for Laser Touch One Neurostimulator 
Question: Our neurologist wants to confirm if we can charge for the Laser Touch One neuros... Read more
Reader Question:
95953 OK if You Meet the Halfway Mark
Question: Our technician began a 24-hour EEG, but the patient took off the machine after 2... Read more
Reader Question:
Understand Levels and Sites for 64633-64636 Coding
Question: Coding instructions in CPT® state that when you bill 64636 you should "cod... Read more
Reader Question:
Choose 20552 for Piriformis Injection, Not 64445
Question: I thought we could use 64445 for a piriformis muscle injection, but one of my co... Read more
You Be the Coder:
Examine Number of Nerves to Report 95900
Question: When we bill 95900, do we bill it once per nerve even if we're reporting for dif... Read more
6 Tips Help You Sidestep Spinal Puncture Denials
Intent and modifiers help to recoup your payment. Although apparently simple, the code... Read more
ICD-10 Update:
Tactics Take the Ache Out of Your Migraine Diagnosis Reporting
Key: Severity and chronicity take you to the right code.When reporting migraine, your best... Read more
Precise Definition of Status Migrainosus
The International Society for Headache describes Status Migrainosus as a "debilitating mig... Read more
What Is Aura?
"Aura" is a term that describes the complex neurological symptoms that precede an attack o... Read more
Pain Management:
Follow 4 Strategies to Post-op Pain Management Coding Success
Hint: Stay away from reporting one service, even with thorough documentation.When your pai... Read more
Reader Question:
Avoid Modifiers to Report EMG with Nerve Conduction
Question: We have received a denial for codes 95860 (Needle electromyography; 1 extremity ... Read more
Reader Question:
Spinal CSF Leak May Be Nonspecific
Question: Which code in ICD-9 can we report for CSF leakage from the lumbar spine?  I... Read more
Reader Question:
Report Cerebellar Gangliocytoma as Benign Tumor
Question: How do we report Lhermitte-Duclos in ICD-9?Alaska SubscriberAnswer: You may repo... Read more
Reader Question:
Bill Blood Collection for Laboratory Testing
Question: One of our nurses asked if we can bill the insurance companies for a blood draw ... Read more
Reader Question:
Turn To Level, Not Session for 72285 and 72295
Question: The descriptors for codes 62290 and 62291 specify "each level." Should we report... Read more
You Be the Coder:
Submitting Lab Tests With MILD Procedure
Question: Our physician sometimes performs a MILD procedure at the hospital and sends the ... Read more
Coding Strategies:
Strengthen Your Skills To Bill E/M With Osteopathic Manipulation
Append modifier 25 only in cases where necessary.Billing for osteopathic manipulation can ... Read more
Pain Management:
Avoid Denials by Correctly Counting Injections for Spinal Radiofrequency
Plus: Verify how each payer wants bilateral procedures reported. Reporting spinal radiofre... Read more
Understanding Facet Joint Structure
Pay attention to nerves to correctly count joints.Each vertebra has a total of four facet ... Read more
ICD-10 Update:
Equip Yourself With ICD-10 Codes To Report Hydrocephalus
Look for accompanying conditions with spine bifida, reasons for congenital hydrocephalus.W... Read more
Reader Question:
Bill the SNF for Office Tests
Question: When our doctor orders a SNF (skilled nursing facility) patient to have diagnost... Read more
Reader Question:
Choose 36415 When Nurse Draws Blood
Question: Can our nurses bill the insurance companies for a blood draw in the office that ... Read more
Reader Question:
Each Unit of 95904 per Nerve Tested Can Add to Payment
Question: Our provider performed 95904 (Nerve conduction, amplitude and latency/velocity s... Read more
Reader Question:
Type of Guidance Determines 64483 or 02030T
Question: We submitted 64483 and 99144 for procedures during the same patient encounter, b... Read more
Reader Question:
Learn Whether Payer Wants -50 or Double 64640
Question: Our pain management specialist administered a phenol injection and performed rad... Read more
You Be the Coder:
Focus on the Right Number in Botulinum Toxin Coding
Question: Our physician is using Botulinum toxin to treat torticollis by injecting in mult... Read more
Coding Tips:
Keep Occipital Nerve Injection Headaches At Bay With These Strategies
Site of needle insertion is your key to select the right code.When your neurologist treats... Read more
Brush Up on These Anatomy Basics
Learn the occipital nerve origins: The three sets of occipital nerves are the greater occi... Read more
Follow Up on Nerve Blocks With These Tips
Do not forget that your clinician may perform the block to diagnose occipital nerve pathol... Read more
Auditing:
Check Your Injection and Bilateral Claims Before RACS Catch Up
Plus: Contractors are also auditing place of service, bilateral services, and consolidated... Read more
Billing Strategies:
3 Steps Smooth Your Success With Out of Network Payers
Be honest with your patients to ensure a smooth transition.More and more providers are que... Read more
Reader Question:
You May Bill 95900 and 95903 Together
Question: Can we bill 95900 and 95903 together for a patient when our physician does nerve... Read more
Reader Question:
ICD-10 is More Specific for Fibromyalgia
Question: Is there a specific code for fibromyalgia?Ohio SubscriberAnswer: You may best re... Read more
Reader Question:
Prolonged E/M is no Longer Restrictive to Physician Services
Question: How can we report prolonged face-to-face E/M services provided by our physician ... Read more
You Be the Coder:
Code for Both NCV and EMG When Done On Same Day
Question: How do we report when our physician performs two motor NCV and no F tests were d... Read more
Coding Tips:
Thinking Of Reporting 96116 With E/M Service? Read This First
Check the time and components to accurately code neurobehavioral testing.When you're codin... Read more
A Neurobehavioral Exam Refresher
Neurobehavioral exam is a battery of tests that include a series of questions or directive... Read more
ICD-10 Update:
ICD-10 Gets More Specific For Anatomical Location Of Cerebral Emboli
Look for infarction when reporting cerebral emboli.When 2013 hits, your cerebral embolism ... Read more
Pain Management:
Check New CCI Guidelines for Details on Post-Op Charges, Spinal Level Coding
Remember one important modifier for claims success.Information on new and revised procedur... Read more
Reader Question:
Look to Modifier JW for Drug Wastage -- Sometimes
Question: How should I bill for wasted drug? Our pain management physician often splits a ... Read more
Reader Question:
Coding 20550 With 64450? Watch Bilaterals and Limits
Question: Medicare denies our claims with codes CPT 20550 and 64450, stating that the num... Read more
Reader Question:
Code Epidurogram, But Not Usually Lumbar Epi
Question: The physician performed an epidurogram diagnostic study in conjunction with a fl... Read more
Reader Question:
Look For Sleep Time in Home Sleep Study Recording
Question: How do you report when the neurologist documents the home sleep studies along wi... Read more
You Be the Coder:
Choosing the Correct RF Lesioning Code
Question: How do we code radiofrequency lesioning of the greater occipital nerve? Minnesot... Read more
CPT® 2012 Update:
Strategies Perfect Your Bilateral Chemodenervation Coding In 2012
Hint: Keep a count on sides to ethically boost payment.Unlike last year, you can now poten... Read more
ICD-10 Update:
Watch These Changes for Non-meningitic Complications of Herpes Zoster
Report the myelopathy, ganglionitis, neuropathy, and unspecified neurological complication... Read more
ICD-9/ICD-10 Crosswalk
A one-on-one comparison of codes in ICD-9 and ICD-10 reflects the following changes in ICD... Read more
Apply These 5 Herpes Zoster Coding Examples
Think you know how to report your Herpes zoster diagnoses in ICD-10? Take a look at these ... Read more
CCI Changes:
Neurology Edits for CCI 18.0 Focus on New EP Studies, EMGs, and More
Don't let neurostimulator procedures with anesthetics trip your coding. Get ready ... Read more
Pain Management:
New CCI 18.0 Edits Point to Joint, Tendon Injection Changes
Hint: 20526 and 20527 override 130+ other codes.The latest Correct Coding Initiative (CCI)... Read more
Reader Question:
Technique Dictates 64505 or 64999 for Sphenopalatine Ganglion Block
Question: Our pain management specialist administered a sphenopalatine ganglion block. Doe... Read more
Reader Question:
Report Soft Tissue Hypersensitivity as Disturbed Sensation
Question: What is the diagnosis code for soft tissue hypersensitivity?New Jersey Subscribe... Read more
Reader Question:
Bill Bilaterally For 646113 And 64614
Question: Can we bill bilaterally for 64613 and 64614?Florida Subscriber Answer: According... Read more
Reader Question:
Report 2 Options Guide Code Choice for Radiofrequency With 64640
Question: How do we report radiofrequency ablation of ventral hernia incisional neuroma un... Read more
You Be the Coder:
Date of Service Guides Acceptance of 27096 With Fluoro
Question: Some of our payers deny 77003 when we bill it with SI joint injections during th... Read more
Coding Tips:
Apply These Extra Tips for EEG Reporting Success
Do not look at frequency and never miss a hidden bundle.In the last issue, we learned abou... Read more
Coding Strategies:
Take The Pain Out Of Spinal Neurostimulator Reporting
Trials and reprogramming can help you to recover your deserved payment for these services.... Read more
ICD-10 Update:
2 Codes Help You Capture Phantom Limb Pain
Presence or absence of pain guides you to the right code for phantom limbIn 2013, you will... Read more
Pay Attention To Programming 2012 Changes
To avoid denials, make sure you're up to date on these crucial 2012 programming changes. Y... Read more
Reader Question:
Unattended' Is Key to Reporting 95953
Question: I thought that we would report 95951 for 24-hour video EEG, but am reading that ... Read more
Reader Question:
Double Check Documentation for 95903-95905 Billing
Question: We submitted codes 95903 and 95905 for nerve conduction studies during the same ... Read more
Reader Question:
93924 Most Likely Choice for Arterial Study of Extremity
Question: What is the correct CPT® code for arterial Doppler study of bilateral extr... Read more
You Be the Coder:
Turn to 64640 for Radiofrequency Ablation
Question: What CPT® code best represents radiofrequency ablation of a painful abdomi... Read more
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