The complexity of billing and coding pain management is drastically increasing every year. New pain management medical billing guidelines are attracting medical attention as millions of Americans suffers from severe and chronic pain. Payers and regulators keep a close eye on the methods for treating chronic pain. Therefore, the focus should be placed on carefully handling pain management billing and coding. Medical practices may effectively manage their revenue cycle by partnering with a pain management medical billing company.
Medical coders must have a sound knowledge of medical terminology and the intricacies of the coding processes. They have to review anatomy and physiology concepts so they may understand the language of the new codes better. Additionally, coders must stick with pain management coding webinars conducted by different local and government bodies to tune their knowledge.
For ICD-10-compatible computer formats and software, troubleshooting is yet another essential recommendation. This information helps medical professionals find quick solutions to any technical issues. Therefore, healthcare practitioners must be aware of the possible effects of coding system changes on both current and future insurance programs.
In this article, we’ll find out what to expect from new pain management medical billing guidelines and coding updates for 2022.
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2022 Pain Management Coding Updates
Two CPT codes have been eliminated as of 2022, and new ones that provide more information about procedures have taken their place.
01935— (Anesthesia to percutaneous image-guided procedures on the spine or spinal cord; diagnostic).
01936– (Anesthesia for percutaneous image-guided procedures on spinal cord and spine; therapeutic) has been deleted from CPT(R).2022.
Additionally, the new codes 01937-01942 indicate the type of surgery performed under anesthesia and whether it was a cervical or thoracic procedure.
New 2022 CPT Codes Pain Management Medical Billing Guidelines
You can find the new CPT code changes for anesthesia and pain management for 2022 in the table below:
Anesthesia for cervical or thoracic spine or spinal cord percutaneous image-guided injection, drainage, or aspiration operations
Anesthesia for lumbar or sacral spine or spinal cord percutaneous image-guided injection, drainage, or aspiration procedures
Cervical or thoracic anesthesia for percutaneous image-guided destructive treatments of the spine or spinal cord
Lumbar or sacral anesthesia for percutaneous image-guided destructive treatments of the spine or spinal cord
Cervical or thoracic anesthesia for intravertebral surgeries (such as kyphoplasty or vertebroplasty) or percutaneous image-guided neuromodulation on the spine or spinal cord
Anesthesia for lumbar or sacral intravertebral surgeries (e.g., kyphoplasty, vertebroplasty) or percutaneous image-guided neuromodulation
Thermal destruction of the intraosseous basivertebral nerve; first two vertebral bodies, lumbar or sacral; all imaging guidance
Thermal destruction of the intraosseous basivertebral nerve, including all imaging guidance, Each additional lumbar or sacral vertebral body (List separately in addition to code for primary procedure)
3D echocardiographic imaging and post-processing during transesophageal echocardiography or transthoracic echocardiography for congenital cardiac anomalies for the evaluation of cardiac structure(s), including cardiac chambers and valves, the left atrial appendage, the interatrial septum, and the interventricular septum, when carried out (List separately in addition to code for echocardiographic imaging)
The American Medical Association has copyrighted these codes and other information you’ll need to know for coding and pain management medical billing guidelines in 2022.
We’ll also talk over some other frequently used CPT codes for pain management. These consist of radiofrequency ablation, dry needling, and acupuncture.
Medicare now covers all forms of acupuncture as a therapy for lower back pain in compliance with NCD 30.3.3. For up to 12 sessions over the course of 90 days, Medicare will provide acupuncture for patients with chronic lower back pain.
By putting tiny needles into the skin, acupuncture works to reduce pain and restore energy flow. Acupuncture is a successful treatment for knee pain, osteoarthritis, and back pain, according to the National Center for Complementary and Integrative Health Trusted Source. Additionally, it encourages health and happiness and activates the body’s natural healing mechanisms.
Acupuncture CPT Codes
Acupuncture with one or more needles without electrical stimulation. Initial 15 minutes of one-to-one contact with the patient
Every additional 15 minutes of one-to-one contact with the patient with re-insertions of needles
Acupuncture uses one or more needles and electrical stimulation. Initial 15 minutes of one-to-one contact with the patient
Every additional 15 minutes of one-on-one patient contact, including re-insertions of needles.
Data on acupuncture is based on 15-minute intervals of face-to-face contact with patients and not on the intensity of treatment. New 2022 Pain management medical billing guidelines thoroughly provide details for the 15 minutes and above electrical needle stimulation.
When electrical stimulation is not used during a 15-minute increment, report CPT codes 97810 or 97811.
Electrical stimulation of any needle during a 15-minute increment is reported using CPT codes 97813 or 97814.
For each 15-minute increment, you should report only one code
Use CPT code 97810 or 97813 for the initial 15-minute increment
Each day, you should only report one initial code
2. Dry Needling
A trigger point acupuncture session uses the following CPT codes, sometimes called dry needling.
Tendon sheath injection
Injecting the tendon’s insertion or origin
(Needle insertion(s); three or more muscles; without injection(s))
(Needle insertion(s), but no injection(s); one or two muscles (s)
The Current Procedural Terminology prohibits the recording of trigger point injections (CPT codes 20552 or 20553) along with procedures for the same muscle group using CPT codes 20560 or 2056.
3. Radiofrequency Ablation (RFA)
In order to prevent pain signals from traveling through a tiny region of nerve tissue, the radiofrequency ablation (RFA) method delivers an electric current to that area. It can ease chronic discomfort, particularly in the neck, lower back, and arthritic joints.
The RFA pain management medical billing guidelines CPT codes 2022 are as follows:
64625: Radiofrequency nerve ablation using image guidance for the sacroiliac joint (i.e., fluoroscopy or computed tomography)
64999: Unlisted nervous system procedure
Use CPT code 64625 to record radiofrequency ablation when using conventional or cooled radiofrequency (80 degrees Celsius).
Use CPT code 64999 to report pulsed radiofrequency ablation.
Usage of Modifiers (Pain Management Medical Billing Guidelines)
Applying the wrong modifiers may lead to claim denials, whereas using the correct modifiers clarifies the procedure thoroughly. Pain management billing guidelines typically use the following modifiers:
Anatomically speaking, -LT stands for left and -RT for right.
Signifies the originality and distinction of a service or activity from other services offered on the same day.
Incomplete process; postponing a part of the procedure for reasons unrelated to the patient’s wellbeing.
Unfinished procedure; for the patient’s safety, the doctor decides to stop the surgery.
Bilateral operations need the use of the modifier -50, which designates a surgery carried out simultaneously on both sides of the patient’s body. A common issue is forgetting the modifier -50 or inaccurately coding each body side.
Important Factors to Take into Account When Evaluating Pain Management Billing Services
Numerous medical billing revenue cycle management companies are providing pain management services across the US. All are calling for 100% complaints to the CMS pain management medical billing guidelines. Only a few of them are targeting the goals.
Your claims should be handled by trained processing personnel who are familiar with the worker’s compensation requirements for pain management.
The majority of delayed or rejected claims are the result of coding errors. A pain management billing professional should be familiar with these codes and comprehend their use.
Pre-authorizations from payers should be obtained and stored until a new authorization is required for each treatment.
One of the primary benefits of working with a reliable medical billing service provider is that they are aware of the specific needs of various payers, have a thorough understanding of them and work closely with them.
Outsource Your Pain Management Billing Services to The NEO MD?
It is imperative to recognize all the resources that are mandatory for applying pain management medical billing guidelines. A good understanding of guidelines will significantly lessen the chances of coding errors while billing the patient’s treatment. Our team will thus assist you in boosting profitability by monitoring, measuring, and managing every component of your revenue cycle.
The NEO MD team offers top-notch pain management coding resources and medical billing knowledge. Moreover, we have created adaptable revenue cycle management services that truly meet provider needs in order to collect timely payments from clients. Getting funds from all these sources can help assure your clinic’s capacity to make medical payments while also improving its profitability.
The medical billing companies directly impact the Revenue Cycle Management of your medical practice. Medical practices need long-term revenue cycle management in order to compete in the market for more extended periods. Hire a Medical billing company with competent and trained coding staff to ensure your updated CMS Pain Management Medical Billing Guidelines. In terms of offering medical billing services to healthcare professionals, NEO MD has made considerable strides. Moreover, among its competitors Revenue Cycle Management Companies, NEO has reckoned the top for unique medical billing services.
What Makes NEO MD the Best Pain Management Services Company?
NEO MD stood best among competitors due to ensuring the latest CMS Pian Management medical billing guidelines in coding services;
Our experts work hard to reduce your front-end denials by 20%.
Improve RCM system efficiency with a robust credentialing team.
Provide fortnightly financial and practice overviews
Refunds adjustment and Payment posting to improve the cash flow.
Identify potential under, over, and incorrect coding scenarios
Provide Pain Management Medical Billing Guidelines and collection services that are of high quality and error-free.
What are the latest CPT codes for 2022?
What are Brand-New CPT® Codes Available for 2022? To report remote therapeutic monitoring, there are now five new CPT codes: 98975, 98976, 98977, 98980, and 98981. According to the American Medical Association, these new CPT codes “build on remote physiologic monitoring codes developed in 2020 (99453, 99454, 99457, and 99458).”
How do you code pain management?
Use of Pain Codes and Category 338 Codes If the visit is for pain management or control, assign the category 338 code and the precise location of the pain. For instance, a pain management encounter for trauma-related acute neck pain might be recorded with 338.11 and 723.1.
What is the ICD-10 code for chronic pain?
Use ICD-10 code G89 or the diagnosis “chronic pain syndrome” to refer to this condition. Other symptom diagnostic codes could be used if they are not documented. Note: ICD-10 code Z45.
Can you bill an office visit with a trigger point injection?
The decision to deliver the injections was made after the examination; thus, the office visit is acceptable and should be charged with the modifier -25.