Category: CC-Physiatry/Pain

Incident to Services
Post

Incident to Services

June 30, 2022 Question: We just recently began hiring PAs to see patient to assist our pain physicians. Our pain doctors want the PAs to see new patients and bill under their NPI number. We see a large population of Medicare patients and I am worried this could get us into trouble. Answer: For Medicare...

Remote Patient Monitoring
Post

Remote Patient Monitoring

June 2, 2022 Question: We are going to begin using remote therapeutic monitoring in our pain practice to monitor our patients pain functional status and compliance with exercise therapy. For the initial set up and education can our MA perform this service? Answer: Yes, the clinical staff may perform the initial set up, and education...

ER Visit Coding
Post

ER Visit Coding

May 5, 2022 Question: What code do use when our pain doctor sees a patient in the emergency department for a consultation at the request of the ED physician? Our pain doctor treated the patient and discharged the patient from the ED. Answer: Since the patient was not admitted your physician to the hospital you...

Billing for a Neurostimulator Implant
Post

Billing for a Neurostimulator Implant

April 7, 2022 Question: My physician billed implanted a neurostimulator into the sacral nerve for urinary incontinence. We billed CPT codes 64562 and 95972 for a Medicare patient. Medicare denied CPT 95972 for the analysis and programming. My physician says it should be paid and we should appeal. Can you provide advice? Answer: Based on...

Counting Problems Addressed for Medical Decision Making
Post

Counting Problems Addressed for Medical Decision Making

February 24, 2022 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 does not work that way. The problems are no additive or cumulative. One stable chronic illness and one acute uncomplicated...

Inpatient E/M Coding
Post

Inpatient E/M Coding

February 10, 2022 Question: I did an inpatient consultation and coded 99253 (non-Medicare). I did not need to follow the patient, so I signed off. They asked me to re-consult a week later. What is the code for a re-consult? Answer: There are no specific E/M codes for an inpatient re-consultation. You will use the...

Waiving Medicare Cost-share for Telehealth Visits
Post

Waiving Medicare Cost-share for Telehealth Visits

January 27, 2022 Question: I heard that Medicare patients don’t have to pay their deductible or coinsurance if they have a telemedicine visit. Is this true? Answer: Medicare is not waiving deductibles or co-insurance. However, they are allowing providers to do so at their discretion without penalty for telemedicine visits. This means the provider will...

Sign up for KZAlertsSign up for KZAlerts

Coding Coaches