Category: CC-Physiatry/Pain

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...

Blood Patch with Epidural
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Blood Patch with Epidural

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...

Established Patient New Problem
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Established Patient New Problem

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...

Genicular Nerve RFA
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Genicular Nerve RFA

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...

Phone Call Documentation
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Phone Call Documentation

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,...

Billing Multiple Phone Calls
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Billing Multiple Phone Calls

April 30, 2020 Question: Can we bill telephone only (99441-99443) calls subsequently during the week (or the same day) for the same patient by the same provider or another provider of the same specialty within the practice if each call is documented properly? Answer: The following information is only for guidance during the current COVID-19...

G2012 Telephone or Portal
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G2012 Telephone or Portal

April 16, 2020 Question: Is G2012 for telephone calls or just for the patient portal? Answer: Keep in mind that G2012 is not a telehealth visit but rather a “virtual check-in” service. If you are indeed performing a “virtual check-in” visit rather than a telehealth visit, then G2012 would be appropriate. G2012 can be used...

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...

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