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Neurology & Pain Management Coding Alert

Pain Management:
Stop Confusing Epidural Steroid Injections With Transforaminals
Pay special attention to whether fluoro guidance is separately billable.  The terms ... Read more
Neurology Focus:
Keep 3 Things in Mind Before Coding for Autonomic Testing
Tip: Be careful of which codes you can submit together.  Each code for autonomic ... Read more
Terminology Checkpoint:
Verify That You Understand Autonomic Testing Terms
Here’s your handy rundown of important terms.  In order to understand au... Read more
ICD-10:
Don't Feel Pinched by Sciatica Diagnosis Choices
Your options will get more specific under ICD-10.  When your physician diagnoses ... Read more
Reader Question:
Remember Modifier for Unilateral GON Block
Question: How should I code a left greater occipital nerve (GON) block? Washingto... Read more
Reader Question:
Use Notes to Justify 64999 for Percutaneous Balloon Decompression
Question: What is the correct CPT® code for percutaneous balloon decompression ... Read more
Reader Question:
Get Complete Diagnosis Info for TJM Coding
Question: Our provider included two diagnoses in the documentation for a temporoman... Read more
Reader Question:
Watch for Opportunities to Report Prolonged Services
Question: During a scheduled office visit of a new patient, our physician spent add... Read more
You Be the Coder:
Here's Your Definition for 'Split-Night Service'
Question: I’ve been hearing the term “split-night service” lately... Read more
ICD-10:
Turn to G47.30 to Rest Easy With Sleep Apnea Coding
Tip: Don’t forget to include other associated sleep conditions on your claim. So... Read more
Condition Focus:
Watch 3 Areas to Ease Your Dupuytren's Contracture Coding
Don’t forget E/M for office-based procedure. When your providers treat a patient... Read more
Terminology Check:
Remember What Dupuytren's Contracture Is
Condition affects millions of Americans. Dupuytren’s contracture is a painless t... Read more
News Flash:
Get the Latest Scoop on Hydrocodone Combo Prescriptions
Ensure that your providers meet these criteria for Rx.  States have very specific... Read more
Reader Question:
Here's How to Distinguish 77002 From 77003
Question: What is the difference between fluoro codes 77002 and 77003? Is the diffe... Read more
Reader Question:
Intra-Articular Facet Injection Might Include TON
Question: What is proper billing for a right third occipital nerve block with a C2-... Read more
Reader Question:
Include G0398 or G0399 on Your Claim for Home Sleep Study
Question: I am coding for a physician who is interpreting sleep studies. The physic... Read more
Reader Question:
Know Whether Payer Considers ANSAR Test Experimental Before Submitting 95943
Question: I am having a terrible time getting my ANSAR tests paid by Medicare. I&rs... Read more
Reader Question:
Start with POS, Then Figure RVU
Question: Using the RVUs provided for a particular code, how do I arrive at the appro... Read more
You Be the Coder:
Is T12-L1 Injection One or Two Levels?
Question: The procedure performed was “Right T12-L1 transforaminal epidural s... Read more
CPT® 2015:
Factor in These Spinal,Joint Procedure Changes for 2015
Don’t miss the new vertebroplasty, kyphoplasty choices. Pain management coders h... Read more
2015 Coding Update:
Stop Automatically Using Modifier 59 Anytime You Think It Might Apply
CMS introduces new options for some situations in 2015.  Modifier 59 (Distinct proce... Read more
ICD-10:
Follow 2 Steps to Make the Best Diagnosis Choice for Spinal Nerve Root Injuries
You have no options if your physician does not document the region of injury. Choosing... Read more
Reader Question:
Base Paravertebral Facet Joint Destruction on Levels, Not Nerves
Question: We used to bill radiofrequency ablation codes 64633, 64634, 64635, and 64... Read more
Reader Question:
64640 Covers Rhizotomy of Greater Occipital Nerve
Question: Our provider documented “therapeutic greater occipital nerve rhizot... Read more
Reader Question:
Ask Payer Whose Signatures You Need for Office NCS
Question: We are doing nerve conduction studies in our office. The neurologist supe... Read more
Reader Question:
27096 Covers SI Injection With Fluoro Guidance
Question: Our physician documented that he performed a left SI joint injection unde... Read more
You Be the Coder:
Coding for Unsuccessful Injection
Question: The physician attempted to inject L4 and was unsuccessful, but then successful... Read more
Neurology:
Get Easy Answers to 4 Common EEG Questions and Improve Your Claims Success
Here’s how to differentiate ‘drowsy’ or ‘asleep’ choice. ... Read more
ICD-10:
2 Factors You Can't Afford to Miss in Your Vertebral Fracture Diagnosis Coding
Tip: Confirm underlying disease and site before you pick up the right code. Vertebral ... Read more
Pain Management:
Keep These 5 Tips in Mind Before Coding Post-op Pain Control Injections
Documentation of your provider’s role is crucial. Postoperative pain control is ... Read more
Reader Question:
T12-L1 Represents a Single Level Injection
Question: The procedure performed was “Right T12-L1 transforaminal epidural s... Read more
Reader Question:
Here's How to Distinguish 77002 From 77003
Question: What is the difference between the codes 77002 and 77003? Is it based on ... Read more
Reader Question:
Intra-Articular Facet Injection Might Include TON
Question: What is proper billing for a right third occipital nerve block with a C2-... Read more
Reader Question:
Check This Way to Code Both Components of EMG Service
Question: I work for a pain management clinic that’s beginning to do EMGs on ... Read more
Reader Question:
346.80 as Primary or Secondary Depends on Documentation
Question: Can we report ocular migraine as a primary diagnosis? Or do we need to fi... Read more
Reader Question:
Length of Catheter Use Differentiates 62311 From 62319
Question: I need some guidance on the differences between 62311 and 62319. Both cod... Read more
You Be the Coder:
Coding Needle Guidance With Nerve Block
Question: Our provider used both ultrasound guidance and electrical stimulation for... Read more
Pain Management:
Don't Miss the Latest HCPCS Changes to J and S Codes
Plus: Verify that your vial usage isn’t causing patient problems.  The late... Read more
Fee Schedule:
Check Out 5 Changes on the Horizon for 2015
CMS releases proposed rule, accepting comments through Sept. 2.  CMS issued a pro... Read more
Neurology:
Condition Focus: Get the Lowdown on Coding Multiple Sclerosis
Remember to report associated symptoms until final diagnosis is reached.  Approxi... Read more
ICD-10:
Painful Joints Don't Need to Mean Painful Diagnosis Coding
Here’s the rundown on how your joint pain diagnoses will be more detailed in 2015.... Read more
Reader Question:
Count Levels to Correctly Report +64494 and +64495
Question: Our physician documented that he administered injections to the patient&r... Read more
Reader Question:
'Unlisted' Is Your Only Choice for Continuous TAP Block
Question: Our physician used a TAP (Transverses Abdominis Plane) block for postoper... Read more
Reader Question:
95912/95886 Combo Doesn't Need a Modifier
Question: I am new to neurology coding and need some clarification on how to report... Read more
You Be the Coder:
How to Report J Codes for Pain Management Pumps
Question: I’m confused about how to bill J codes for pain management pumps. H... Read more
Reimbursement:
Follow These 4 Steps to Get Paid for Concurrent Care
Documenting separate diagnoses help all specialists involved.  It’s not unc... Read more
Pain Management:
Check Off 3 Items if You Want to Collect Modifier -25 Pay
Remember Medicare has certain criteria to meet.  It’s not unusual for a pai... Read more
News You Can Use:
New Pain Database Can Help Physicians Learn About Current Research
Federal agencies pool their resources for your benefit.  Pain management physicia... Read more
ICD-10:
Don't Miss Your Extra Diagnosis Option for Parkinson's Disease
ICD-10 will let you code with much more specificity.  Parkinson’s disease i... Read more
Reader Question:
Focus More on Anesthesia Than Procedure for Most Rhizotomy Cases
Question: What are the correct surgical and anesthesia codes for facet rhizotomy?&n... Read more
Reader Question:
Skip the Modifier With 95912/95886 Claim
Question: I’m new to neurology coding and need some clarification on reportin... Read more
Reader Question:
76942 With 76881 or 76882 Should Be Allowed
Question: Our neurologist sometimes performs an ultrasound diagnostic test on the s... Read more
Reader Question:
Test Administrator Is Key to Correct 96118, 96119 Choice
Question: What rules apply to billing 96118 and 96119? I haven’t found many d... Read more
Reader Question:
Yes, You Can Double Count Element for E/M Status
Question: When coding E/M services, can we count the same element twice, for instan... Read more
Reader Question:
Just Code Pulse Generator Removal, Not Debridement
Question: Our pain management provider removed two leads and a pulse generator due ... Read more
You Be the Coder:
The Difference Between Lumbar Sympathetic and Chain Block Coding
Question: I have charts from one of our physicians for two different patients on th... Read more
Compliance:
Ensure That Your Electrodiagnostic Test Coding Passes OIG Scrutiny
Hint: Focus on their 7 ‘questionable billing practices’ to stay clear. ... Read more
Code Check:
Brush Up on Your Electrodiagnostic Test Codes
Here’s where to find what you need for NCS and needle EMG. Neurologists use neur... Read more
Guidance Coding:
See Your Way to Clearly Coding Guidance With 64520
Hint: Understanding the reason for fluoro is your best first step. Knowing whether you... Read more
ICD-10:
RSD Diagnoses Will Get Even More Specific Than They Are Now
Plus: You’ll find it listed under a different name.  When selecting a diagn... Read more
Reader Question:
Nurse Attendance Counts Toward 95956
Question: Our neurologist ordered a 24-hour EEG for a patient in ICU to rule out no... Read more
Reader Question:
Sometimes 20552 Applies Instead of 27096
Question: Our physician did an SI injection in the office without any image guidanc... Read more
Reader Question:
V58.69 Should Be Accepted for Urine Drug Screening
Question: Insurance companies have been denying our claims for new patient urine dr... Read more
Reader Question:
Place of Service Guides Ultrasound Coding for Epidural Placement
Question: Is it feasible to use ultrasound rather than fluoroscopy for guidance when ins... Read more
You Be the Coder:
'Split-Night Service' Defined
Question: I’ve been hearing the term “split-night service” lately... Read more
ICD-10:
Decide How to Fill Your Time Until New ICD-10 Implementation Date
Plus: SGR gets temporary fix.  Congress averted the 24 percent pay cut your pract... Read more
CCI 20.1:
Start Incorporating the Latest Coding Edits for 64615 Today
Plus: Watch the modifier change for some EMG/nerve injection services.   Neurolog... Read more
NPP Services:
Follow 3 Easy Steps to Keep Your NPP Coding Incident Free
Tip: Start by recognizing what constitutes incident-to circumstances. Billing Medicare... Read more
Reader Question:
Payer Might Not Allow 92546 Without Rotation Chair
Question: Our practice recently purchased VNG testing equipment to assess patient b... Read more
Reader Question:
Only Submit 95864 When There's No NCS
Question: We know that coding edits bundle 95913 and 95864. We read on a list serv ... Read more
Reader Question:
Count POP Scoring as Part of E/M Service
Question: Our pain management physician heard at a conference that he could bill/co... Read more
Reader Question:
62273 Doesn't Usually Apply for Gelfoam Dural Repair
Question: Our provider blocked a lumbar dural tear with a single piece of gelfoam. ... Read more
Reader Question:
Look at 756.11 or 738.4 to Support 64493
Question: I reported 64493 for a lumbar pars injection. The associated diagnosis is... Read more
Reader Question:
Explore Possibilities for Gait Training Denial
Question: My neurologist has been billing 97116 for gait training with no problem u... Read more
You Be the Coder:
Know How to Count Nerve Branches for NCS Counting
Question: When counting nerve conduction studies to choose the appropriate CPT®... Read more
Sleep Studies:
Rest Easier Knowing Where to Draw the Line Between Sleep Studies and Polysomnography
Hint: Focus on 3 factors to reach the best coding option.  Being faced with incre... Read more
Terminology Check:
Here's How Sleep Studies and Polysomnography Relate to Each Other
Eliminating one points you to the other. Sleep studies are tests that record what happ... Read more
ICD-10:
Don't Miss These 5 Top Changes for Pain Management Under ICD-10
Watching guidelines and ‘excludes’ will keep you on the right track. With ... Read more
Reader Question:
Stick With Modifier 51 Over 50 for Neurostimulator Electrodes
Question:  We’re billing out the following codes for a Medicare patient&rsquo... Read more
Reader Question:
Verify Actual Trigeminal Nerve Injections Before Reporting
Question:  Our pain management specialist documented “0.5 ML across the right... Read more
Reader Question:
Expect Denials if Claims Are Incomplete
Question:  Our practice has a few claims with missing or incorrect information. I&r... Read more
You Be the Coder:
327.23 and 780.57: Which Is the Better Sleep Apnea Diagnosis?
Question: Our physician diagnosed a seven-year-old child with obstructive sleep apn... Read more
Neurology:
Know the Top Areas the OIG Is Watching On Your Polysomnography Claims
Heads up: Get ready for increased audits of these procedures. The Office of Inspector ... Read more
Terminology Check:
What Is Polysomnography?
Knowing the service your neurologist provides helps you code more accurately. Polysomn... Read more
Pain Management:
Don't Destroy Your Chances of Reimbursement for Spinal RF Ablation
Watching details can make all the difference in your claims. It’s an ever-presen... Read more
ICD-10:
Turn to G Category for Most Polysomnography Diagnoses, Come October
ICD-10 will keep many familiar descriptors the same. As mentioned in “Know the T... Read more
Reader Question:
Verify Service Before Appending Modifier TC
Question: Is it correct to bill a technical component with 95819? If so, how do we handl... Read more
Reader Question:
UTI Can Be Connected to Neurological Problems
Question: Our neurologist completed a consult on a patient with the diagnosis septi... Read more
Reader Question:
64999 Could Be Best for Facet Joint Cyst Aspiration
Question: How would you code a left L5-S1 zygapophyseal (facet) joint aspiration fo... Read more
Reader Question:
Omit 72275 If All Services Aren't Met
Question: I get confused about which services we can bill along with a transforamin... Read more
Reader Question:
77003 Cannot Be a Stand-Alone Fluoro Code
Question: One of our patients had a spinal cord stimulator inserted in December 201... Read more
Reader Question:
Only List 95937 Once for Neuromuscular Junction Testing
Question: Our neurologist completed a repetitive nerve stimulation test with ADM st... Read more
You Be the Coder:
Reporting 64642 and 64615 Together
Question: I have a patient who suffers from migraines and receives treatment with Botox.... Read more
CCI 20.0:
Report Chemodenervation Ahead of 1000s of Other Procedures When Following CCI
Plus: Consultations and transitional care management also take the back seat. New Corr... Read more
Treatment News:
Don't Miss Medicare's Final Decision on PILD Reimbursement - and When Patients Might Qualify for Coverage
Plus: Learn about new treatment options for uncontrolled seizures. A Jan. 14, 2014, de... Read more
Neurology:
Focus on 4 Quality Measures for Sleep Apnea Patients
Our 3-step plan will help simplify PQRS reporting. The 2014 PQRS (Physician Quality Re... Read more
ICD-10:
Lumbar Spinal Stenosis Codes 724.02 and 724.03 Will Funnel to Same ICD-10 Choice
Pay attention to extended bridge codes in some situations. Your physician diagnoses lu... Read more
Reader Question:
Know Who Can Perform Nerve Conduction Studies
Question: I’m looking for guidelines regarding who is a qualified healthcare provi... Read more
Reader Question:
Keep 95937 to Single Line Item on Claim
Question: The neurologist completed repetitive nerve stimulation tests with ADM stimulat... Read more
Reader Question:
Consider Script Refill Part of E/M
Question: What code should we bill when the physician is only writing a prescription? ... Read more
Reader Question:
Don't Save 99212 for Only Follow-Ups
Question: We recently finished our first internal audit and found a potential issue: One... Read more
You Be the Coder:
Breaking the 64493/01992 Edit for Separate Providers
Question: Our pain management physician administered an injection (64493) and the CRNA p... Read more
CPT® 2014:
Catch the Chemodenervation Corrections to CPT® Coding Descriptors
Plus: Get clear on ‘qualified health care professional’ definition. The Am... Read more
AMA Symposium:
Get the Lowdown on New Guidelines for Chemodenervation and Intraoperative Neurophysiology
Hint: It’s all about counting muscles or time units. Attendees at the American M... Read more
ICD-10:
Spasmodic Torticollis Diagnosis 333.83 Makes an Easy Shift to G24.3
Don’t forget to include an E code when necessary. Spasmodic torticollis (ST) &nd... Read more
Reader Question:
Same Day Service Is OK for 76942 With 76881 or 76882
Question: If our provider performs an ultrasound guided procedure (76942) on the same da... Read more
Reader Question:
Code 63650 Will Include SCS Trial Lead L8680 for 2014
Question: Does the stimulator trial lead (L8680) now get included in the implantation (6... Read more
Reader Question:
Skip 62368 With 95991 and J Code
Question: We used to bill the 62368, 95991, and the appropriate J code for pump refills.... Read more
Reader Question:
J3301 Represents Single Unit Administered
Question: Dictation from an encounter states that the physician used 2 mL of 0.75% Marca... Read more
Reader Question:
Watch Medical Necessity Before Billing 95812 With 95819
Question: Does my provider need to document certain things to prove medical necessity be... Read more
Reader Question:
99144 Can Be OK With Epidural Injections
Question: One of our physicians adds 99144 to his billing sheet whenever he performs LES... Read more
You Be the Coder:
Threshold for Video EEG Reporting
Question: How long do we actually need to videotape the patient during a 95 hour video E... Read more
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