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...
December 19, 2019 Question: One of our Providers recently completed Trigger Point injections to Bilateral Thoracic Paraspinals and Bilateral Trapezius in the same setting for a patient. When we bill for this procedure do we count each side (Left and Right) of these procedures as a muscle group to be billed out as 20553 OR each area...
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...
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...
October 31, 2019 Question: Would you mind giving your opinion? I saw a patient from urgent care yesterday with no formal referral order put in. But the patient says they sent her over and the Urgent Care nurse practitioner note says “follow up” with our service in the plan. My billers are telling me...
October 17, 2019 Question: Our physicians have instructed us to bill under a physician’s NPI number for all Advanced Practitioners (PAs 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....
October 3, 2019 Question: We get calls from patients to renew their medications. When the patient comes to office to pick up prescription, can we bill for a nurse visit with 99211? Answer: No. CPT makes it very clear that picking up a prescription does not constitute a billable E/M service. *This response is based...
September 19, 2019 Question: We are hiring a scribe for the doctor because it will help improve his documentation. Is there anything we need to know about how to document this? Answer: Yes, absolutely. This situation should be clearly delineated so a third party reviewer can identify the provider who performed the service, and the...
September 5, 2019 Question: Can we bill implantation of a trial neurostimulator (63650) with CPT code 95970 for the electronic analysis at the same time? Answer: Per CPT guidelines in 2019, Electronic analysis (95970) at the time of implantation is not separately reported. In addition, test stimulation to confirm correct target site placement of the...
August 22, 2019 Question: One of our pain management doctors saw a patient in the hospital at the request of the orthopedic surgeon. The patient was discharged and is coming to our office for the first time to see the same physician. Can we bill a new patient visit? Answer: You cannot bill a new...
