July 11, 2019 Question: Our physicians have instructed us to bill under a physician’s NPI number for all Advanced Practitioners (PA’s 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. ...
June 20, 2019 Question: Can you provide the CPT code for this procedure? Also can I report an E/M service for this patient encounter? Patient is a pleasant 60 year-old gentleman who presents in our office for a follow-up visit for left knee pain. He continues to have some left sided knee pain. We drained...
June 6, 2019 Question: A patient comes to our office for a sacroiliac joint injection and is also requesting a cervical trigger point injections as he woke with a stiff neck. The physician evaluated the patient and performed a right SI joint injection and also injected 4 spots along the left trapezius. Fluoroscopy is used...
May 23, 2019 Question: I know that CPT code 64910 is the code I report for a nerve repair of the spine. My question is when performing this procedure on three levels how to I report this. Answer: You would report CPT code 64910 for each level. Since the second and third levels are bundled...
May 9, 2019 Question: I am new to pain management and am trying to find the correct CPT code for a lumbar sympathetic plexus block. Can you help? Answer: The correct CPT code is 64520 (Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic). *This response is based on the best information available as of 5/9/19.
April 25, 2019 Question: In our office we have LPN’s working in our office who are giving trigger point injections under a physician order. I don’t think this is correct. Can an MA, LPN or RN give a trigger point injection? Answer: A trigger point injection is a procedure that can be administered by a...
April 11, 2019 Question: What does “separate procedure” mean when it follows a CPT code description? Answer: Per CPT : Some of the procedures or services listed in the CPT codebook that are commonly carried out as an integral component of a total service or procedure have been identified by the inclusion of the term...
March 28, 2019 Question: If I perform a transforaminal epidural injection of L4-L5 on both sides can I report CPT 64483 twice? Also, when I use fluoroscopic guidance can I report that separately? Answer: If you perform a bilateral transforaminal epidural injection (64483) you can report CPT 64483 with Modifier 50 (bilateral procedure). Some payors...
March 14, 2019 Question: I am trying to find a CPT code for a Botox injection in the right hand, and found CPT code 64653. Is this the code I should report? Answer: There is not a specific CPT code for a Botox injection (chemodenervation) of the hands. You should report the unlisted code CPT...
February 28, 2019 Question: What CPT code do I use to report a spinal accessory nerve injection? Answer: CPT code 64999 (unlisted) is reported for the injection of a spinal accessory nerve. The CPT code previously used was CPT 64412 which was deleted in 2016. *This response is based on the best information available as...
