Pain Management Coding Alert
Skip Modifier 26 When You Own X-Ray Equipment
Question: Our physician used X-ray equipment in the office to place the needle prior to a hip injection. No C-arm was used. In other words, our physician did not use fluoroscopy for additional guidance. Can we append modifier 26 when reporting this service?
New Hampshire Subscriber
Answer: If your office owns the guidance equipment, you shouldn’t append modifier 26 (Professional component) to the guidance code. Report the service X-ray with 73500 (Radiologic examination, hip, unilateral; 1 view) or 73510 (... complete, minimum 2 views), depending on the number of views. Include 20610 (Arthrocentesis, aspiration and/or injection; major joint or bursa [e.g., shoulder, hip, knee, subacromial bursa]; without ultrasound guidance) for the injection itself.
Remember: Your physician must document an interpretation report.
Pain Management Coding Alert
- Documentation:
Watch Your Units and Modifiers for 'Unlisted Procedure' Claims
The more information you can include, the better. You never want to file a claim [...] - Procedure Coding:
Does Your Documentation Support More Extensive Plantar Fasciitis Treatment?
Here’s how to justify every level of treatment. Heel pain affects nearly 2 million Americans, [...] - Anatomy Refresher:
Peel Back the Layers of Plantar Fasciitis
Knowing the structure helps you be a better coder. The more you know about plantar [...] - ICD-10:
Get Ready for Expanded Options When Reporting Spinal Stenosis in the Cervical Region
Check those details to narrow your ICD-10 choices. The majority of spinal stenosis cases affect [...] - You Be the Coder:
Know Your Options for Rectus Femoris Tendinitis Coding
Question: A patient has been diagnosed with rectus femoris tendinitis. What would be the best CPT® [...] - Reader questions:
Injection by PA Doesn't Automatically Mean 'Incident-to'
Question: The physician saw a new patient for evaluation in the hospital outpatient setting. He determined [...] - Reader questions:
Beware of the Bundle for Imaging and Epidural Procedures
Question: We would like to learn more about the inclusion of imaging guidance in the epidural [...] - Reader questions:
Stay Compliant By Checking OIG's Mid-Year Update
Question: A fellow practice manager recently told me that the Office of Inspector General (OIG) released [...] - Reader questions:
Skip Modifier 26 When You Own X-Ray Equipment
Question: Our physician used X-ray equipment in the office to place the needle prior to a [...]
