Pain Management Coding Alert
E/M Service Includes Pain Outcomes Profile
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.
Pain Management Coding Alert
- Procedure Focus:
Focus on 2 Areas to Have Easier Fluoro Guidance Coding With 64520
Tip: Don’t forget to pay attention to coding edits. Knowing whether you can separately report [...] - News You Can Use:
Keep Up With Research Opportunities, Thanks to New Pain Database
Federal agencies pool their resources for your benefit. If your physicians take a special interest [...] - Office Visits:
Don't Miss These Checkpoints if You Want to Collect Modifier -25 Pay
Remember Medicare has certain criteria to meet. It’s not unusual for a pain management specialist [...] - ICD-10:
Prepare for Expanded Diagnosis Choices for RSD in 2015
Plus: Don’t miss the name change in the index. When selecting a diagnosis for reflex [...] - Reader Question:
Understand the Lumbar Sympathetic/Chain Block Difference
Question: I have charts from one of our physicians for two different patients on the same [...] - Reader Question:
Approach Helps Guide Gelfoam Dural Repair Coding
Question: Our provider blocked a lumbar dural tear with a single piece of gelfoam. Would you [...] - Reader Question:
E/M Service Includes Pain Outcomes Profile
Question: Our pain management physician heard at a conference that he could bill/code separately for POP [...] - Reader Question:
Include Modifier GC for on Teaching Physician Claims
Question: When a resident assists our surgeon in a teaching hospital, do we need to add [...] - Reader Question:
Keep Things in Order for Multi-Insurer Claims Reimbursement
Question: What is the best way to ensure proper billing when a patient is covered by [...] - Reader Question:
Follow Up on V58.69 Denial for Urine Drug Screening
Question: Insurance companies have been denying our claims for new patient urine drug screens when we [...] - Reader Question:
Telephone E/M Service Can Roll Into History or MDM
Question: We have a new patient that called his physician to discuss his visit that took [...] - You Be the Coder:
Coding an SI Injection Without Guidance
Question: Our physician did an SI injection in the office without any image guidance as the [...]
