Be on a look out for Scans, TPIs, and more

Though coding for whiplash diagnosis and treatment is pretty straightforward, you should still watch out situations when the patient’s symptoms persist despite conservative therapy and warrant more extensive treatment. You will miss your pay if you miss these diagnoses.

When a patient presents with whiplash symptoms, your pain management specialist will conduct a thorough exam and will often order neck x-rays to rule out fractures. On diagnoses of whiplash (847.0, Sprains and strains of other and unspecified parts of back; neck sprain), he typically will prescribe conservative treatment. Common options include physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), and muscle relaxants. Some patients may also benefit from wearing a soft cervical collar or by using a portable traction device.

If conservative treatment fails, the physician might order additional diagnostic imaging tests. These could include:

• CT scans – 70490 (Computed tomography, soft tissue neck; without contrast material), 70491 (… with contrast material[s]) and 70492 (… without contrast material followed by contrast material[s] and further sections)
• MRIs – 70540 (Magnetic resonance [e.g., proton] imaging, orbit, face and/or neck; without contrast material[s]), 70542 (… with contrast material[s]) and 70543 (… without contrast material[s], followed by contrast material[s] and further sequences)
• Bone scans – CT, MRI, and x-ray tests include basic bone scans. If your physician orders more extensive bone scans for the patient, you might to get authorization for 78300 (Bone and/or joint imaging; limited area) or 78305 (… multiple areas) instead.

Correctly Count Trigger Point Injections

Your physician might also administer trigger point injections to relieve the patient’s pain and muscle tenderness. Code these procedures with 20552 (Injection[s]; single or multiple trigger point[s], one or two muscle[s]) or 20553 (…three or more muscles).

Because of the “one or two muscles” and “three or...