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Pain Management Coding Alert

2019 Fee Schedule:
CMS Pauses Plan to Blend E/M Payments
Medicare offers a new payment proposal for 2021. In the annual CMS Medicare Physician Fee... Read more
Quick Q&A:
Arm Yourself With Extremity Count Before Coding These EMGs
EMG tests aren't just for CTS patients. Patients will often report to PM practices for ne... Read more
2019 Fee Schedule:
Telehealth, Virtual Care Getting More Recognition
Use these Medicare G codes for certain services. Coders who want to remain up-to-date on ... Read more
Reader Question:
Leave Pain Dx Off Tendinitis Claim
Question: During the course of an evaluation and management (E/M) service for a new patien... Read more
Reader Question:
Stay on the Beat With Circadian Rhythm Disorder Dx Chops
Question: I just started working at a PM clinic that performs sleep studies, and trying to... Read more
Reader Question:
Push Pause, Count Minutes Before Coding Repeat Shot
Question: A patient with complex regional pain syndrome (CRPS) I in her arm receives a the... Read more
Reader Question:
Use External Cause Codes When Called For
Question: A 9-year-old was playing on the monkey bars at a local park when he fell and hur... Read more
Q&A:
Use This Advice to Dodge EP Study Denials
Length of latency can key code selection. If a patient reports to your PM specialist for ... Read more
Case Study Corner:
Check Chemodenervation Smarts With This Scenario
Can you crack this coding conundrum? Coders for PM specialists will almost certainly come... Read more
ICD-10 Coding:
Back Up Your Disc Disorder Coding With This Advice
If you don't know what myelopathy and radiculopathy are, here's why you should. Patients ... Read more
Clip and Save:
Check Out This Tx List for Cervical Disc Disorder Px
Diagnostic testing, therapy, medication, among the top PM encounters. If a patient has, o... Read more
Reader Question:
Get Specifics for Autonomic Agent Shots
Question: Notes indicate that the PM physician performed a single autonomic nerve injectio... Read more
Reader Question:
Forget Some Office E/M Rules on ED E/Ms
Question:  Our PM specialist was called to the ED to see an established patient for a... Read more
Reader Question:
Keep CRNAs Out of LT Lineup
Question: Can we code a certified registered nurse anesthetist's (CRNA) service with a loc... Read more
Reader Question:
HIPAA Mandates 50 Years of Privacy for Deceased Patients
Question: Per the Health Insurance Portability and Accountability Act (HIPAA), should we m... Read more
You Be the Coder:
CT Guidance and Epidural Claims
Question: Notes indicate that the PM specialist performed an interlaminar lumbar epidural ... Read more
CPT® Coding:
Keep Up With Payer Policies on Face/Neck Chemodenervation
Whether a Dx is acceptable for procedure could depend on payer. Patients who report to th... Read more
ICD-10 Coding:
Check Out 1 Payer's Face/Neck Chemodenervation Code List
Here's why you need to know every payer's policy on paying 64612-64617. Choosing an accep... Read more
2019 MPFS:
Get Ready in Case E/M Changes Go Through for 2019 Fee Schedule
Here's how these new CMS-proposed rules might affect your practice. Evaluation and manage... Read more
Q&A:
Get Back to the Basics to Master Critical Care
Here's the lowdown on coding for the critically ill or injured. If a PM specialist is cal... Read more
Reader Question:
Details Help You Decide Between Achilles, Peroneal Tendinitis
Question: What is the difference between Achilles tendinitis and peroneal tendinitis? And ... Read more
Reader Question:
Consider Migraines a Related Dx
Question:  Our provider diagnosed a patient with chronic migraines and headaches r/t ... Read more
Reader Question:
Stay Positive on Negative ROS Coding
Question:  Can we count a “complete” ROS when the surgeon includes a statement su... Read more
Reader Question:
Use These G Modifiers for ABN Success
Question: I'm filing a claim that includes an advance beneficiary notice (ABN) for a Medic... Read more
You Be the Coder:
Get All the Info You Can on 'Involuntary Movement' Dx
Question: After performing a level-three evaluation and management (E/M) service for a new... Read more
ICD-10 Coding:
Determine CTS, Ensure Pay for Future Treatments
Most insurers require a CTS diagnosis before approving therapeutic measures. When you are... Read more
News You Can Use:
Medicare Carrier Loosening Some NPP E/M Rules
NGS will allow NPPs to code same-day E/Ms under certain circumstances. If you've heard of... Read more
Insider Info:
Get the Lowdown on These Common Epidural Injection Questions
Should you be coding for drug supply on injections? Find out. Patients reporting to your ... Read more
ICD-10 2019:
Use New Codes for Exploitation, Abuse
There's a code set for cyberbullying in the new ICD-10. The ICD-10 2019 code book will in... Read more
Reader Question:
TTS: Like CTS, but Different
Question: A new coder in our department told us that her previous practice treated patient... Read more
Reader Question:
Here's the Real Guidelines for Coding Virtual Visits
Question: How do we document email exchanges between a patient's guardian and our PM speci... Read more
Reader Question:
CCI Knowledge Should Include Exclusive, Unlikely Edit Info
Question: What is the difference between mutually exclusive edits, and medically unlikely ... Read more
You Be the Coder:
Don't Double Dip on EEGs
Question: Notes indicate that the PM physician performed an extended electroencephalogram ... Read more
News You Can Use:
Here's the Good — and the Bad — of the 2019 MPFS Proposal
Conversion, flat E/M coding rates highlight CMS suggestions. CMS recently released its an... Read more
Injections:
Keep an Eye on Notes for Sure-Shot Epidural Injection Coding
Reminder: Cervical/thoracic, lumbar/sacral shots have separate codes. PM coders that file... Read more
E/M Coding:
Get Rules Straight for Providers Using 99211
You can report this E/M without a physician present … sometimes. The established patien... Read more
Reader Question:
Look for Liquid Buildup on Effusion Patients
Question: Our PM specialist performed a level-three evaluation and management (E/M) servic... Read more
Reader Question:
Check Sequence When Coding for CT With Contrast
Question: Notes indicate that the PM specialist performed a computed tomography (CT) scan ... Read more
Reader Question:
Keep Your Finger on Digital Neuroplasty Code
Question: I'm new to PM coding and I've been trying to get up to speed on the CPT® codes ... Read more
You Be the Coder:
Arthrocentesis Coding With Depo-Medrol
Question: A patient with a diagnosis of post-traumatic right knee osteoarthritis reports t... Read more
ICD-10-CM Update:
Myalgia, Muscular Dystrophy Get Specific in 2019
Start using ICD-10-CM 2019 codes on October 1, 2018. The final list of ICD-10-CM codes fo... Read more
E/M Coding:
Solve These Subsequent Care Scenarios
Let our experts help you evaluate and manage service level determinations. When a provide... Read more
Testing:
Follow This FAQ for Lowdown on MRIs
You need to consider anatomy, contrast material to nail these claims. Coding for your PM ... Read more
E/M Coding:
Note Clinical Staff Differences on Prolonged Services
Codes differ for certain providers when service is prolonged. When your PM practice sees ... Read more
Reader Question:
Employ Education to Cut PHI Breaches
Question: What can I do to make sure our practice stays current on best practices to avoid... Read more
Reader Question:
Stay on Beat with Rhythm EKGs
Question: I am unsure about some of the electrocardiogram (EKG or ECG) reporting rules. Co... Read more
Reader Question:
Choose TMJ Disorder Dx Carefully
Question: How should I report a diagnosis of temporomandibular joint (TMJ) disorder? Mont... Read more
You Be the Coder:
Ankle Pain Diagnosis Coding
Question: A patient reported to our practice complaining of pain in the right ankle region... Read more
Testing:
Keep EDX Tips on Hand for Optimal Coding
Remember; NCS/EMG combo could spell electrodiagnostic test. One of the tests your PM prov... Read more
CPT® Coding:
Avert Arthrocentesis/Aspiration/Injection Denials with these Tips
Anatomy is crucial to coding these claims. PM practices that perform arthrocentesis, aspi... Read more
Modifiers:
Recoup Unrelated E/M Pay with 24
Know surgical periods for services before considering modifier. How to use modifier 24 is... Read more
Case Study Corner:
Gain Modifier 24 Guidance Via this Scenario
Here's how unrelated E/Ms during postop periods can happen. It can be a little difficult ... Read more
Reader Question:
Separate Sequential, Concurrent IV Infusions
Question: What is the difference between an additional sequential intravenous (IV) infusio... Read more
Reader Question:
Use 'Other' Classification for this Spondylopathy
Question: The PM specialist performs a level-two evaluation and management (E/M) service f... Read more
Reader Question:
Know History for Accurate E/M Charts
Question: When coding a chart for an evaluation and management (E/M) service, how do we kn... Read more
You Be the Coder:
Coding for Concussions
Question: The PM specialist diagnoses a patient with a concussion. What is the best ICD-10... Read more
CPT® Coding:
Count Levels Before Taking Shot at these Facet Joint Injections
Cervical/thoracic, lumbar/sacral shots might be multi-code encounters. Patients reporting... Read more
Clip and Save:
Look to these Codes on Paravertebral Facet Joint Injections
Remember, not all payers have identical approved diagnoses. When a patient reports to the... Read more
FAQ:
Incident-to Savvy Can Boost Bottom Line
Medicare, some third-party payers will let NPP bill incident-to ... if rules are met. Pai... Read more
ICD-10 Coding:
Aim Straight on Stomach Pain Dx with these Tips
Supporting stomachache coding can be easy with the proper guidance. Patients reporting wi... Read more
Reader Question:
Remember Fracture History on Osteoporosis Dx
Question: The PM specialist treated a patient with osteoporosis. The patient doesn't have ... Read more
Reader Question:
Check Out these Knee-Related RA Codes
Question: I have encounter notes in front of me that indicate the provider treated a patie... Read more
You Be the Coder:
Go All the Way to 7 on Crush Injury Dx
Question: An established patient with an injured forearm reports to the PM specialist. The... Read more
CCI Edits:
Look for April Shower of CCI Bundle Changes
Care management, prolonged services get new edits. As of April 1, the latest version of t... Read more
ICD-10:
Count Time, Px Status to Nail Sequela Coding
These guidelines can aid your sequela character selection. PM practices see their share o... Read more
Mythbusters:
Dodge HPI Pitfalls with this List of Truths
HPI's philosophy counts on SOCRATES. PM coders that get confused when coming up with a pa... Read more
Reader Question:
Note Student Rule Change on E/M Documentation
Question: Our physicians often complain about having to re-document the elements of evalua... Read more
Reader Question:
Modifiers 24, 25 Are (Sometimes) Compatible
Question: Can you ever report modifiers 24 and 25 on the same claim? Oregon Subscriber A... Read more
Reader Question:
CMS Trying to Make EHR Regs Simpler
Question: What do I need to know about the MyHealthEData initiative recently announced by ... Read more
You Be the Coder:
Get NPI Right on Incident-to E/M
Question: An established Medicare patient with a plan of care in place to treat a chronic ... Read more
Injections:
Anatomy Keys Code Choice on Trigeminal, Occipital Nerve Blocks
Injection for lower jaw pain could be a TN block. When you're deciding which code to choo... Read more
Compliance:
Follow this FAQ Advice for ABN Success
ABN's your best friend if Medicare has a payment issue. If your practice is about to prov... Read more
E/M Coding:
Remember Different Payer Rules for Consults
Medicare doesn't recognize CPT® consult codes. When the PM specialist performs a consult... Read more
Reader Question:
Use Single Code for Joint Aspiration/Injection
Question: How do I code a scenario in which the provider performs a knee aspiration and th... Read more
Reader Question:
Count Extremities, Muscles Separately on Chemodenervation
Question: Encounter notes indicate that the PM physician performed a level-three evaluatio... Read more
Reader Question:
Take Right-Sided Pain Dx Coding to the Limit
Question: The PM specialist saw a new patient with a complaint of right-sided extremity pa... Read more
You Be the Coder:
Spinal RF Ablation Coding
Question: An established patient reports to the PM specialist for scheduled spinal radiofr... Read more
Terminology 101:
Take this Migraine Coding Advice, Strike Dx Gold
Knowing what indicates an 'aura' could solidify code choice. Patients who report to a PM ... Read more
Terminology 101, Session 2:
Add these Migraine Terms to Your Arsenal for Stronger Coding
Here's what defines an intractable migraine. There is language in the ICD-10 book that ca... Read more
E/M Coding:
Rely on ROS Smarts for Coding Acumen
Remember, ROS has 3 levels. The review of systems (ROS) is a key component to many evalua... Read more
Reader Question:
Get More Info for Evoked Potentials Code
Question: Notes indicate the PM physician performed an evoked potentials test. It was a sh... Read more
Reader Question:
Pay Attention to Detail for Limb Length Dx
Question: Notes indicate that the provider performed a level-three new patient evaluation ... Read more
Reader Question:
Find Injection/Infusion Evidence on Nerve Blocks
Question: After performing a level-four new patient evaluation and management (E/M) servic... Read more
Reader Question:
Pinpoint Px Condition with Anxiety/Depression Smarts
Question: Our PM physician treated a patient with insomnia and documented "anxiety depress... Read more
Reader Question:
Look for Previous Tx Evidence on CT Injections
Question: Three months ago, our provider saw a patient complaining of wrist pain, a burnin... Read more
You Be the Coder:
Remember, Different Types of Ab Pain Have Different Codes
Question: What is the correct ICD-10 code for upper-quadrant abdominal pain? Indiana Subs... Read more
Injection Coding:
Sharpen ICD-10 Smarts for Accurate TPI Coding
Drill down in notes, because there's no definitive list of TPI diagnoses. Patients in pai... Read more
Compliance:
Keep Locum Tenens Rules Handy for Fill-In Physicians
Replacement physicians often sub for providers on leave. Just about every PM practice has... Read more
News You Can Use:
HIPAA Clarification Aims to Stem Opioid Abuse
PHE stresses need for information-sharing knowledge. Recent federal determinations addres... Read more
Reader Question:
CMS Sets Out New Telehealth Guidance
Question: Can you tell me if there's anything new going on in telehealth coding for 2018? ... Read more
Reader Question:
Dodge High-Level Prolonged Services Myth
Question: Can you report prolonged services with any level of evaluation and management (E... Read more
Reader Question:
Heed this Advice for APN Coding
Question: We have two house-call teams of advanced practice nurses (APNs) who go to patien... Read more
Reader Question:
UHC Adds Modifier Requirement for these E/Ms
Question: Our practice has been told that there are new rules for nurse practitioners (NPs... Read more
You Be the Coder:
Choosing a Metatarsalgia Dx
Question: What are the ICD-10 options for reporting metatarsalgia? Florida Subscriber An... Read more
Available Years:  2018  2017  2016  2015  2014