Category: Coding Coach

Chemodenervation
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Chemodenervation

September 16, 2021 Question: A patient with multiple sclerosis came into our pain clinic with spasms to the left and right upper arms. The physician injected the following muscles using EMG guidance; Right upper limb; right biceps, pronator teres, brachioradialis, first dorsal interosseous, and extensor carpi ulnaris and left upper limb, right biceps and brachioradialis....

Billing Diagnostic Angiograms with an Intervention
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Billing Diagnostic Angiograms with an Intervention

September 16, 2021 Question: When are diagnostic angiograms and an intervention (angioplasty, stent, etc.) both billable? Answer: Diagnostic angiograms are separately billable during an intervention if no adequate or prior adequate angiogram exists. Code diagnostic angiograms only if: no previous angiogram is available, the prior angiogram is not adequate to diagnose the disease, or the...

Dry Needling
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Dry Needling

September 16, 2021 Question: Our pain management physician stated he performed a trigger point injection into 1 muscle. In reviewing the procedure note we find that the documentation supports dry needling was performed. Is CPT code 20552 (Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)) the correct code? Answer: No, you would not...

XTRAC Therapy
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XTRAC Therapy

September 16, 2021 Question: We have recently begun treating our psoriasis patients  using XTRAC laser therapy.  I have looked extensively and cannot find a CPT code for this procedure.  Can you help me? Answer: The XTRAC excimer laser is reimbursed by most payors for mild to moderate plaque psoriasis by most major insurance carriers. Some...

Laparoscopic or Open, How Can You Tell?
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Laparoscopic or Open, How Can You Tell?

September 16, 2021 Question: If a code does not specify whether the procedure described is laparoscopic or open, is it acceptable to use it if the procedure was performed laparoscopically? Answer: No. Laparoscopic codes will always have the term “laparoscopic” in the code description. If there is no laparoscopic code for a procedure you performed...

Counting Problems Addressed for Medical Decision Making
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Counting Problems Addressed for Medical Decision Making

September 16, 2021 Question: If a patient has one stable chronic illness and one acute uncomplicated illness without systemic symptoms, can we “up” the level of Problems Addressed to Moderate? Answer: No, sorry, unfortunately it doesn’t work that way.  The problems are not additive or cumulative.  One stable chronic illness and one acute uncomplicated illness...

Nerve Block
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Nerve Block

September 2, 2021 Question: My doctor did a regional thoracic nerve block. He performed three injections at three intercostals levels. How do I code that? Answer: You would report 64420 (Injection, agent (s) and /or steroid, intercostal nerve, single level) and 64421 x 2 for the two additional level. Each additional level is reported with...

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Coding Coaches