There are several types of nerve blocks for interventional PM. Patients reporting to the practice for long-term pain management often have to undergo several treatments in order to find the one that works for them. While the PM provider searches for the best treatment course for that patient, they might use interventional pain management for short-term alleviation of pain. These treatments cover a wide range of CPT® codes, including nerve blocks and pain pumps. Take a look at the ins and outs of coding nerve blocks and pain pumps for interventional PM patients. In a future issue, we’ll take a look at how to code other interventional PM techniques. Got Pain? Interventional PM Can Help According to Amy C. Pritchett, BSHA, CPC, CPMA, CPCI-I, CRC, CANPC, CASCC, CEDC, CCS, CMDP, CMPM, CMRS, C-AHI, ICDCT-CM, ICDCT-PCS, past president of the American Academy of Professional Coders chapter in Mobile, Alabama, conditions interventional PM techniques commonly treat include: While interventional PM is similar to prescriptions, physical therapy, and other methods to manage pain, interventional PM takes things a step further: It uses treatments such as nerve blocks and pain pumps to address the pain. So if conservative treatments for PM — such as pain management techniques attempted during an evaluation and management (E/M) service or physical therapy sessions — don’t work, interventional PM might be the next step. ESIs Top List of Nerve Block/Injection Procedures Interventional PM is often realized via injections/nerve blocks, which send strong medication directly to the patient’s nerve to ameliorate the pain. One of the most common interventional PM injections is an epidural steroid injection (ESI). According to Marilyn Torres, COC, CPC, CANPC, coding/billing supervisor at Meridian Medical Management in Belleville, New Jersey, you’ll report most ESIs with one of the following codes: So, let’s say the provider documents performing a caudal epidural nerve block with computed tomography (CT) for a patient with chronic low back pain. On the claim, you’d report 62323 for the block. Provider Could Choose Single-Nerve Blocks Your provider might also choose to address the patient’s pain with a single-nerve block, if they can directly identify the nerve that’s causing the patient’s pain. There are a multitude of codes you can use to represent a single-nerve block, as there are so many single nerves in the human body. In an effort to narrow down the scope of single-nerve blocks that your provider might use, check out this list of commonly used single-nerve block codes: Note: This is not a complete list of interventional PM single-nerve blocks, nor is it an approved list of interventional PM techniques. You should always code each claim according to the notes you get from the performing provider. Transforaminals Might Transform Pain The PM provider might also use transforaminal injections to provide interventional PM. During these injections, the provider delivers an anesthetic agent or steroid into a single cervical or thoracic level viatransforaminal epidural. Aubre (West) Hansen, CPC, Aubre has a accountcoding supervisor, anesthesia and pain medical coder at EMMI Physician Services, Inc. in Lakewood, Colorado, reports that her practice provides the following transforaminal injections, along with several other interventional PM treatments: Provider Might Target Facet Joints If the pain is more centralized in a facet joint, the provider might opt for a facet joint injections for interventional PM, Pritchett confirms. Some of the facet joint injection codes you might use include: Provider Might Prime Pain Pump for Patient Another option for interventional PM is pain pumps, also known as intrathecal pump implants. Once implanted, these pumps can deliver potent medications straight to the heart of the patient’s pain. Pain pumps can be more effective because they provide a steady stream of pain relief, as opposed to the inconsistencies often associated with treating pain with oral medications or single-shot injections. According to Pritchett, two of the most common pain pump procedures for interventional PM are 62350 (Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without laminectomy) and 62351 (… with laminectomy). Torres says she uses the following pain pump codes frequently to represent all phases of an interventional PM course of treatment: Warning: While the pain pumps might be more effective at providing interventional PM, this is a more involved and invasive procedure than E/Ms, epidurals, or nerve blocks. Therefore, you’re best off checking with each individual payer before reporting these codes. The payer might want proof that the provider attempted more conservative treatments for the patient’s pain before it will pay for a pain pump procedure.