Pain Management Coding Alert
Use Modifier 52 with Incomplete EEG
Question: One of our physicians performed an electroencephalogram (EEG) video monitoring for 16 hours and interpreted the results. I was going to report 95813, but it seems insufficient for the work. What code should I report? Tennessee Subscriber Answer: This is a tough question. You probably don't want to report 95813 (Electroencephalogram [EEG] extended monitoring; greater than 1 hour) because it doesn't represent video recording and interpretation. Potential option: You might want to report 95951 (Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, combined electroencephalographic [EEG] and video recording and interpretation [e.g., for presurgical localization], each 24 hours) with modifier 52 (Reduced services) appended. If you were reporting 95951-52, you'd have to include a detailed description of why the physician had to reduce the services. Even with that documentation, however, this coding option might not fly with payers. Do this: Before resubmitting the claim, you're probably best off contacting the payer, explaining the situation, and seeing how it would like you to code the EEG.
Pain Management Coding Alert
- E/M Coding:
NGS About to Up Some E/M Demands
Detailed exams are about to level up. Recently, the Medicare Administrator Contractor (MAC) National Government [...] - Postoperative Care:
Zero in on These Postop Pain Management Points
Documentation always helps postop pain reimbursement chances. If a surgeon places your provider in charge [...] - Ask an Expert:
Special Situations Dictate XP, XU Encounters
Here’s why you shouldn’t be using these modifiers regularly. While CPT® still has modifier 59 [...] - You Be the Coder:
Consider Patient Details When Choosing Falling Dx
Question: When our practice treats patients with a history of falling, what ICD-10 code(s) should we [...] - Reader Question:
Use Z Codes as Primary Dx ... Sparingly
Question: OK, settle a debate we’ve been having in the coding office. Some coders say Z [...] - Reader Question:
Use Modifier 52 with Incomplete EEG
Question: One of our physicians performed an electroencephalogram (EEG) video monitoring for 16 hours and interpreted [...] - Reader Question:
Call on These Pointers to Ace Phone E/Ms
Question: Can you explain when I can correctly report telephone evaluation and management (E/M) codes [...] - Reader Question:
Put Focus on Patient with Digital Coms
Question: We want to improve our practice website so it’s easier for our current patients to [...] - Reader Question:
Weigh the Good, and the Bad, of Patient Engagement Technology
Question: We’re starting to use more technology and online tools to engage our patients, but we’re [...] - Reader Question:
Steer Clear of Billing IM Injection with Additional Pain Meds
Question: We have a physician who wants us to bill separately for an IM injection with [...]
