Category: Physiatry

Sphenopalatine Ganglion Block
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Sphenopalatine Ganglion Block

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...

Acupuncture Coverage
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Acupuncture Coverage

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...

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...

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