Category: CC-Physiatry/Pain

Genicular Nerve Destruction
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Genicular Nerve Destruction

October 1, 2020 Question: My doctor did a destruction of the superolateral and superomedial genicular nerve. Is there a CPT code for this procedure and can I report imaging guidance? Answer: You would report 64624-52 (reduced services). The code includes all of the following branches: superolateral, superomedial, and inferomedial. CPT directs that if all 3...

Evaluation and Management Codes 2021 – Do I Have to Use the Revised Guidelines?
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Evaluation and Management Codes 2021 – Do I Have to Use the Revised Guidelines?

September 17, 2020 A previous version of this coding coach was incorrect; to view a correct version of that question, please click here. Question: I work with a pain management physician and we don’t see many Medicare patients. This doctor believes the revised 2021 E/M guidelines will not impact our office practice because of our...

Transforaminal Injection
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Transforaminal Injection

September 3, 2020 Question: I am new to pain management coding and have a question. What is the correct way to bill for a transforaminal injection of L3-L4 and L4-5? He is injecting L3-L4 bilaterally and L3-L4 on one side. Can I report 64483 three times? Answer: No, you would report 64483 (first level) and...

SI Joint Injection Help
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SI Joint Injection Help

August 20, 2020 Question: My physician performed an SI joint injection in the ASC under ultrasound guidance and wants to bill 27096 and 76942. Is this correct? The description of the codes say imaging is included. Answer: If ultrasound is used instead of fluoroscopy, or CT, report a trigger point injection with 76942. Some payor...

Sphenopalatine Ganglion Block
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Sphenopalatine Ganglion Block

August 6, 2020 Question: I cannot find a CPT code to report using a device to deliver medication through the nose when a sphenopalatine ganglion block is performed under fluoroscopic guidance for patients with migraine headaches. Can you provide me with the correct CPT code? Answer: There is no specific CPT code that accurately describes...

Acupuncture Coverage
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Acupuncture Coverage

July 23, 2020 Question: My practice has decided to do acupuncture in our office. Does Medicare pay for acupuncture in 2020? Answer: Acupuncture CPT codes 97810-97814 are selected based on time and whether electrical stimulation is used. The only diagnosis currently that CMS covers is chronic low back pain. Medicare recently released Decision Memo for...

Botox and Image Guidance
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Botox and Image Guidance

July 9, 2020 Question: Code 64615 says bilateral for the injection of Botox for chronic migraine. Does that mean we can also bill 95873 twice? Answer: Although not explicitly stated in the name for 95873, CPT gives guidance in parentheses to only code one unit of any guidance code when billing 64515. So you would...

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