4 Changes to Pain Management Coding in 2011

CPT copyright 2010 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.


Editor’s Note: This article by Paul Cadorette, director of education for mdStrategies, originally appeared in The Coding Advocate, mdStrategies free monthly newsletter. Sign-up to receive this newsletter by clicking here.
 
1. The transforaminal injection codes have been revised and now take on the same look as the facet injection codes. Image guidance (fluoroscopy or CT) is required when performing the injection procedure, but the CPT code definitions for 64479-64484 now include fluoroscopic or CT imaging as an inclusive component of the procedure, so 77003 is no longer reported for fluoroscopy in addition to the transforaminal CPT code.

Advertisement

 

2. Category III codes should be reported when transforaminal or facet injections are performed using ultrasound guidance.

 

3. Epidural, transforaminal or facet injection(s) performed at theT12-L1 interspace/facet would be reported with the appropriate CPT code for the cervical or thoracic level and not a code from the lumbar or sacral level series of codes.

 

4. There are three new codes for both the hip arthroscopy (femoroplasty, acetabuloplasty, labral repair) and endoscopic balloon dilation of the sinuses (maxillary, frontal, sphenoid).  For those ASC’s performing spinal arthrodesis procedures, you should note that a threaded bone dowel (previously reported as a biomechanical device) is now considered a structural bone allograft and a discectomy for decompression of the spinal cord and/or nerve roots is included in an anterior interbody technique (CPT code 22551) so code 63075 will no longer be additionally reported.

 

The information provided should be utilized for educational purposes only. Please consult with your billing and coding expert. Facilities are ultimately responsible for verifying the reporting policies of individual commercial and MAC/FI carriers prior to claim submissions.

At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.

Register to Attend Webinar

Is ambulatory care healthcare’s big margin engine? 4 leaders weigh in

Wednesday, July 29
1:00 PM - 2:00 PM CDT

Presenters: Joe Ganley, athenahealthJeffrey Flynn, CASC, Gramercy Surgery CenterBryan Tsao, Access Center, Loma Linda University HealthJason Zepeda, Northridge Hospital Medical Center, CommonSpirit HealthGreg DeConciliis, PA-C, CASC, Boston Out­Patient Surgical Suites

Advertisement

Next Up in ASC Coding, Billing & Collections

Advertisement

Comments are closed.