Category: CC-Physiatry/Pain

Trigger Finger Injection
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Trigger Finger Injection

June 10, 2021 Question: Which CPT code is used 20550 or 20551 for a trigger finger /A1 pulley injection? Answer: CPT code 20550 defines an injection to a single tendon sheath, or ligament, aponeurosis (eg, plantar “fascia”). CPT code 20551 defines an injection to single tendon at the origin/insertion site. Trigger finger injections are most...

Telehealth Coding Using Audio Only
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Telehealth Coding Using Audio Only

May 27, 2021 Question: My doctors are providing telehealth office visits using audio only. They have told me it is okay to use E/M codes 99202-99215 for telephone visits. I was reading the temporary guidelines for Telehealth during the PHE and cannot verify these are the right codes. Can you help? Answer: When the telehealth...

MDM Credit for 2021
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MDM Credit for 2021

April 29, 2021 Question:  I am a pain management specialist. I have a patient who was referred to my office who has dementia and was unable to provide her medical history. The patient’s granddaughter was able to provide the patient’s medical history to me as the patient was confused and unable to provide this information....

Modifier 52 vs. 53
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Modifier 52 vs. 53

April 15, 2021 Question: We are confused about the difference between modifier 52 and 53. What is the difference? Answer: Modifier 52 Reduced Services is used when the procedure or surgery is partially reduced or eliminated by the physician. This is used when a procedure has an existing CPT code, but not all of the...

Incident to Services
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Incident to Services

April 1, 2021 Question: One of our physician assistants’ saw one of our established Medicare in the emergency room for increasing pain in the area being treated by the physician. The physician assistant made no changes to the plan of care established by the physician. Our physician assistant submitted this as an incident to service...

E/M Guidelines for 2021
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E/M Guidelines for 2021

March 18, 2021 Question: My physicians have decided they would prefer to continue to use the E/M 1995/1997 guidelines for office visits instead of the new 2021 guidelines. Do we have a choice? Can we continue to use these guidelines? Answer: The new guidelines apply to office or other outpatient services 99202-99215 and are based...

New 2021 E/M Coding Guidelines
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New 2021 E/M Coding Guidelines

March 4, 2021 Question: In the new guidelines, how does Time affect billing for a teaching physician’s E/M service when the resident spends a great deal of time with the patient? Answer: Good question! Only the time of teaching physician would “count” in the scenario you describe. The new guidelines say that the time of...

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