Neurology & Pain Management Coding Alert

Question: Our pain management physician heard at a conference that he could bill/code separately for POP scoring. I haven’t found anything to back that up. Is this right? If so, what would we report?

New Jersey Subscriber 

Answer: First, we’re assuming that by “POP” you’re referring to the Pain Outcomes Profile that assesses the patient’s pain intensity, functioning and effect.  

There are certainly codes for many different services, but we’re not aware of any CPT® or HCPCS code that specifically would be reported separately for physician interpretation of this type of outcomes measurement. The provider’s services more than likely would fall under the Medical Decision Making key component of the corresponding E/M service. Choose the appropriate code for the office visit from 99201-99205 (Office or other outpatient visit for the evaluation and management of a new patient …) for a new patient or 99211-99215 (Office or other outpatient visit for the evaluation and management of an established patient …) for an established patient.