Coding Challenge / Pain Management

Pain Management Coding: Endoscopic Lumbar Nerve Decompression

Hint: Think ‘unlisted procedure.’ Question: One of our physicians is looking into “endoscopic lumbar spinal nerve decompression.” One of the medical device representatives indicated he could bill it like the lateral extraforaminal approach for lumbar decompression, but I haven’t found much information. What’s your advice? Answer: Despite what you physician might have heard, your most appropriate choice [...] Related articles:

  1. Spinal Surgery Coding Challenge: Is Hemilaminectomy Bundled With Fusion?Question: Our orthopedic surgeon turned in a note that says,...
  2. Pain Management Coding Update: Facet Joint Injection CPT Changes for 2010Pain management, anesthesia, orthopedic, physiatry & neurology coders get ready...
  3. Anesthesia & Pain Management Denials: Sweep Them Away Now ‘Good Housekeeping’ tips that reduce denials. Tip 1: Beware...

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November 14, 2009
Anesthesia / Hot Coding Topics / ICD-10 / Pain Management

Pain Management Coding Update: Facet Joint Injection CPT Changes for 2010

Pain management, anesthesia, orthopedic, physiatry & neurology coders get ready for a facet joint codes shift that preps for ICD-10. The 2010 version of CPT attempts to organize the facet joint injection codes by deleting 64470-64476 and debuting 64490- 64495 in their place, as follows: • 64490 — Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves [...] Related articles:

  1. MAC Auditors Will Stick It To Facet Joint Injection Claims We hook you up with CMS instructions for when...
  2. Audit Hot Spot: Facet Joint Injection ClaimsHere’s why the OIG wants to stick it to facet...
  3. Save Time Coding Facet Injections With This Coding Tool Hint: Location, number and substance are key. Several factors...

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October 28, 2009
Anesthesia / Coding Challenge / modifier 59

Anesthesia Coding Education: Sciatic Nerve Block & Same-Day General Anesthesia

Question: My anesthesiologist performed a sciatic nerve block for a patient with postoperative pain on the same day he provided general anesthesia for that patient’s knee surgery. How should I code this? Answer: Use modifier 59 (Distinct procedural service) when you need to show that your physician performed two distinct services on the same day. When [...] Related articles:

  1. 64450 or 64421: Which Code to Tap for TAP Block?Question: What exactly is a “tap block,” and what code...
  2. Anesthesia Coding: Unlisted Procedures, E/M and Nerve BlocksThere’s no denying that anesthesia coding is like no other...
  3. Plantar Digital Nerve Coding Education: 64455 & 64632With these 4 tips, you’ll code clean claims every time....

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October 21, 2009