Best Practices for Pain Management Billing Services

Every year, billing and coding for pain management billing services become more difficult. Payers and regulators are closely scrutinizing approaches used to treat chronic pain as public and medical interest in alternative pain control methods, pain management protocols, and new treatments grow.

Not only is it critical to carefully treat pain management billing and coding to avoid denials and investigations, but consistency in billing and coding is also critical to the practice’s financial well-being. Here’s a look at some of the best pain management billing and coding practices to help you keep your practice financially secure.

  • Knowing the Codes and Modifiers

Firstly, to begin, it’s critical to understand the most popular pain-management codes and modifiers, and it’s also critical to keep up with coding and modifier updates, which occur every year.

CMS makes improvements every year that practices around the country must become familiar with or face denials and revenue loss the following year. Getting up to speed on new policies and codes as soon as possible will help the practice succeed.

  • Make Detailed Diagnosis Descriptions

Another important aspect of pain management billing services is to be as specific as possible when describing diagnoses. It’s critical to include not only the ailment, but also the origin, the location, and the degree of laterality.

A qualifier and any special information, such as without/with bleeding/obstruction, hemorrhage, as appropriate for the services performed, should also be included in the definition. With ICD-10, descriptive diagnosis explanations are more relevant than ever, and they can help you avoid denials.

  • Tips for Properly Documenting Injections

Injections for:

  • Facet joint
  • trigger point
  • nerve blocks

Necessitate a lot of paperwork, particularly when multiple levels are involved. When preparing these statements, it’s important to have the correct details on hand. The following are some of the details you’ll need to provide to prevent costly delays and claim full reimbursement for injections:

  • Injections at various stages of the spine
  • The needle’s path and final location in the process,
  • Whether or not fluoroscopic guidance was used.
  • Diagnoses that back up the treatment
  • The name of the Specific drug that was injected
  • Both muscles injected, as well as laterality, must be registered for trigger point injections (coding depends on the number of muscles injected)
  • The Effect of the Fee Schedule on Pain Management Billing

The Centers for Medicare and Medicaid Services (CMS) recently announced their proposed physician fee schedule for the coming year. It also includes guidelines for the Quality Payment Program, in addition to the physician fee schedule. The following are some of the improvements in the proposed physician fee plan that affect pain management billing services:

  • Some codes for occipital nerve blocks, electronic analysis of programmable pumps, and suprascapular nerve blocks have been reduced.
  • Increases in the number of neuro-electrodes implanted in the spinal cord
  • Hip joint injection increases
  • Outsourcing Pain Management Billing and Coding Has Its Advantages

Many practices find that outsourcing their Pain Management billing services saves time and resources because pain management billing and coding is so complicated and constantly evolving.

Practices also see sales growth and higher net collections when they hire a good billing and coding business.

  • Increased collections
  • more complete and correct coding
  • fewer days in accounts receivable
  • lower denial rates
  • lower fixed costs

Are only a few of the advantages that outsourcing may have for your pain management billing services.

Hence to conclude, while searching for Pain Management billing services, always remember that it should have:

  • well-trained
  • professional staff

This simplifies the otherwise complicated billing process.

This streamlines the intricate billing process for practices around the country, and we collaborate with you to make sure that it can fulfill your specific pain management billing and coding requirements.