Category: CC-Physiatry/Pain

Billing Telehealth by Time
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Billing Telehealth by Time

April 2, 2020 Question: Can we bill telehealth visits by time alone? Answer: Yes, if indicated by the code billed. Telemedicine visits have the same documentation requirements as any face-to-face visit, according to the code the provider chooses. Of course medical necessity is the overarching criterion for all visits. *This response is based on the...

Billing for Fluoroscopy for Nerve Block
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Billing for Fluoroscopy for Nerve Block

March 19, 2020 Question: Can I bill fluoroscopy with 64505 for nerve block of the sphenopalatine ganglion, as imaging guidance is not separately billable for other nerve blocks? Answer: While there are some nerve blocks that don’t allow separate billing, 64505 does allow you to bill for image guidance and localization, as stated in the...

PA Performing Joint Injections
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PA Performing Joint Injections

March 5, 2020 Question: Can our PA perform joint injections for Medicare patients Incident-to the physician? Answer: This depends on the scope of practice for the PA in your state as well as whether the incident-to rules are met. If the physician determines the joint injection is indicate in the plan of care, and it...

Overreading a Diagnostic Imaging Study
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Overreading a Diagnostic Imaging Study

February 20, 2020 Question: I sent a patient out to the hospital for a CT scan and the patient brought in the actual images and the radiologist’s report for me to review. Can I charge 76140 (Consultation on X-ray examination made elsewhere, written report) when I personally interpret those images and write my own report?...

Modifier -52 or -53
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Modifier -52 or -53

January 9, 2020 Question: Physician was performing a spine injection and the patient chose to only have local anesthesia. During the procedure (before the medication was injected) the patient was uncomfortable and couldn’t tolerate the position, so the physician stopped the procedure. Would you use modifier -52 or modifier -53 for billing this? Answer: Since...

Coding Bilateral Percutaneously Placed Spinal Cord Stimulator Electrodes
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Coding Bilateral Percutaneously Placed Spinal Cord Stimulator Electrodes

December 5, 2019 Question: If bilateral spinal electrode are placed percutaneously, 63650, can both be reported? Answer: Yes, if two electrodes are placed, bilaterally, both may be reported.  See the CPT guidelines below. Reference: CPT Assistant June 1998 Codes 63650, 63655, and 63660 each describe the placement, revision, or removal of only one electrode catheter...

SI Joint Injection
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SI Joint Injection

November 14, 2019 Question: My MD performed an SI joint injection with ultrasound guidance in the office. What is the appropriate coding for this procedure? I have seen information regarding not using 27096 (SI joint injection) and using 20552 (trigger point injections) with 76942 (ultrasound guidance) instead. Which is correct? Answer: If using ultrasound instead...

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