Power Up Your Interventional Pain Coding


*agenda subject to change

7:15AM — 8:00AM

Check-in and Breakfast (provided)

8:00AM – 8:45AM

Overview of Pain Coding and Reimbursement

  • A message from the OIG
    • Current OIG Enforcement Actions
    • Who is looking at your Coding and Documentation
    • Medical Necessity
    • Risks of Using an Electronic Health Record (EHR)
  • Coding vs. Reimbursement: How do they differ and how does this impact coding?
  • Medicare Update: 2019 and Beyond
  • RVU calculation and Medicare Fee Schedule: Deconstructing your payment.
  • Bundling and CCI Edits: What they are how they impact multiple procedures in pain coding, and how you can correctly override a CCI Edit.

8:45AM – 9:30AM

The Global Period and Use of Modifiers

  • The Global Period
    • Reporting post-op visits to Medicare
  • Modifiers:
    • Avoiding Overuse and Misuse of Modifier 25: Can an E/M be billed on the same day as an injection? An EMG?
      What documentation is needed?
    • Modifier 50 (bilateral procedure)
    • Modifier 51 (multiple procedure)
    • Modifier 59 and Medicare changes to the
      59 modifier deciding which one to use.
  • Using the X modifiers.

9:30AM – 10:00AM

Coverage Policies and the Interventional Pain Physician

  • Medicare Policies: NCDs and LCDs in Pain Care: What you need to know, where to find the policies and how they impact reimbursement.
  • Private payer coverage policies in pain care.

10:00AM – 10:15AM


10:15AM — 11:30AM

Pain Management Procedures

  • Carpal tunnel injections
  • Tendon injections
  • Trigger point injections
  • SI joint injections
  • Case Scenarios

11:30AM — 12:30PM

Lunch (provided)

12:30PM — 2:00PM

Procedure Coding (continued)

  • Joint and bursa injections
  • Nerve injections
  • Chemodenervation: Non-spine
  • Spine Procedures
    • Epidural injections: Intralaminar and transforaminal
    • Medical branch blocks
    • Neurolysis, spine
    • Hardware blocks
  • Neurostimulators: Spinal and peripheral
    • Trial placement
    • Ongoing programming
  • Spinal pumps: Placement, reprogramming, refilling
  • Baclofen pain trials
  • Pump maintenance for the pain physician.
  • Case Scenarios

2:00PM — 2:15PM


2:15PM — 3:15PM

Evaluation and Management Overview

  • Levels of E/M Codes
    • Documentation Dos and Don’ts for History
    • History
    • Documentation Dos and Don’ts for Exam
    • Examination
    • Documentation Dos and Don’ts for Medical Decision Making
    • Medical Decision Making
  • E/M Modifiers
    • Modifiers: 24, 25 and 57
  • CMS Guidelines: Advanced Practitioner Billing
    • Incident to
    • Direct billing
    • Split/Shared
  • Hand-on Case Studies

3:15PM — 3:45PM

Diagnosis ICD-10-CM Coding for Pain NEW!

  • Coding Guidelines for Pain
    • Acute vs. chronic
    • Codes for common pain conditions
    • Case Scenarios

3:45PM — 4:00PM

Be Audit Ready

  • Steps to be Audit Ready
  • Tips to survive an Audit
  • Minimizing your Risk

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