Category: CC-Physiatry/Pain

Incident-To Billing
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Incident-To Billing

July 11, 2019 Question: Our physicians have instructed us to bill under a physician’s NPI number for all Advanced Practitioners (PA’s and NPs) for all patients for Medicare as we follow incident-to billing.  We have been submitting claims for all new and established patient visits regardless of whether there is a physician in the office. ...

E/M with Procedure
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E/M with Procedure

June 20, 2019 Question: Can you provide the CPT code for this procedure? Also can I report an E/M service for this patient encounter? Patient is a pleasant 60 year-old gentleman who presents in our office for a follow-up visit for left knee pain. He continues to have some left sided knee pain. We drained...

SI and Trigger Point Injections
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SI and Trigger Point Injections

June 6, 2019 Question: A patient comes to our office for a sacroiliac joint injection and is also requesting a cervical trigger point injections as he woke with a stiff neck.  The physician evaluated the patient and performed a right SI joint injection and also injected 4 spots along the left trapezius.  Fluoroscopy is used...

Nerve Repair
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Nerve Repair

May 23, 2019 Question: I know that CPT code 64910 is the code I report for a nerve repair of the spine.  My question is when performing this procedure on three levels how to I report this. Answer: You would report CPT code 64910 for each level.  Since the second and third levels are bundled...

Lumbar Sympathetic Plexus Block
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Lumbar Sympathetic Plexus Block

May 9, 2019 Question: I am new to pain management and am trying to find the correct CPT code for a lumbar sympathetic plexus block. Can you help? Answer: The correct CPT code is 64520 (Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic). *This response is based on the best information available as of 5/9/19.

Separate Procedure Definition
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Separate Procedure Definition

April 11, 2019 Question: What does “separate procedure” mean when it follows a CPT code description? Answer: Per CPT : Some of the procedures or services listed in the CPT codebook that are commonly carried out as an integral component of a total service or procedure have been identified by the inclusion of the term...

Transforaminal Epidural Injection
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Transforaminal Epidural Injection

March 28, 2019 Question: If I perform a transforaminal epidural injection of L4-L5 on both sides can I report CPT 64483 twice?  Also, when I use fluoroscopic guidance can I report that separately? Answer: If you perform a bilateral transforaminal epidural injection (64483) you can report CPT 64483 with Modifier 50 (bilateral procedure).  Some payors...

Botox Injection in the Hand
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Botox Injection in the Hand

March 14, 2019 Question: I am trying to find a CPT code for a Botox injection in the right hand, and found CPT code 64653.  Is this the code I should report? Answer: There is not a specific CPT code for a Botox injection (chemodenervation) of the hands.  You should report the unlisted code CPT...

Spinal Accessory Nerve Injection
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Spinal Accessory Nerve Injection

February 28, 2019 Question: What CPT code do I use to report a spinal accessory nerve injection? Answer: CPT code 64999 (unlisted) is reported for the injection of a spinal accessory nerve.  The CPT code previously used was CPT 64412 which was deleted in 2016. *This response is based on the best information available as...

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