Category: Physiatry

New Patient Visit
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New Patient Visit

August 22, 2019 Question: One of our pain management doctor saw a patient in the hospital at the request of the orthopedic surgeon. The patient was discharged and is coming to our office for the first time to see the same physician. Can we bill a new patient visit? Answer: You cannot bill a new...

PA Performing Joint Injections
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PA Performing Joint Injections

August 8, 2019 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...

Incident-To Billing
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Incident-To Billing

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. ...

E/M with Procedure
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E/M with Procedure

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...

SI and Trigger Point Injections
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SI and Trigger Point Injections

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...

Nerve Repair
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Nerve Repair

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...

Lumbar Sympathetic Plexus Block
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Lumbar Sympathetic Plexus Block

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.

Separate Procedure Definition
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Separate Procedure Definition

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...

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