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...
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...
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...
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...
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...
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...
June 25, 2020 Question: My anesthesiologist had to perform a blood patch on a patient who received an epidural the day before. Can we bill for this? Answer: It depends. If the patch was performed through the same catheter for the epidural, then this would not be separately billable. However, if the blood patch was...
June 11, 2020 Question: I saw an established patient for her last lumbar epidural in the series and she now complains of right upper extremity radiculopathy. I spent over 30 minutes with her discussing this with her before the performing the epidural injection. I can bill for a visit, right? Answer: Yes, as long as...
May 29, 2020 Question: I’m new to coding. What code would I use for radiofrequency ablation of the genicular nerve? Answer: You’re in luck! There is a new code in 2020: 64624 Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed. The code includes destruction (e.g., chemical means, radiofrequency ablation) of all...
May 14, 2020 Question: What documentation is needed to bill for a phone only visit besides time? Answer: There aren’t any specific rules about documenting telephone calls for covered telephone call services during the current public health emergency, but the general principles of documentation should be your guide. Remember that medical necessity should be documented,...
