Wiki Pain management injections

[MARY K]

We are trying to define pain management tx for check in and scedulers. Does anyone out there know where we can find a definative answer to what is considered pain management tx. We know some insurance companies require an auth for epidurals and facet injections but not for joint injections. Looking for any site or info for this. I'ld like to say thanks in advance for any answers or suggestions.

 

[miabell]

I work for several pain doctors and a Pain ASC. Medicare and Medicare HMO's you would not need a pre- cert or auth you would just have to check your Medicare site for their LCD's. All Commercial carriers do request pre-certs and auth on all of the pain injection. The best thing to do is call to every time you receive an order from the physician. I hope this helps.

 

[MARY K]

Pain management

Thankyou for replying. But the insurance in ? Is a blue sheild product. The problem is this certain patient called for the orthpedic surgeon to inject shoulder and due to insurance sceduler told patient she needed an auth. We now know that this particular product is mainly referring to the flouro used during spine procedures.