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

Posted on 29. Oct, 2009 by .

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 innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level

• 64491 — … second level

• 64492 — … third and any additional level(s)

• 64493 — Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level

• 64494 — … second level

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CCI 15.1: Adhere to These Osteotomy, Laminectomy Edits

Posted on 08. Apr, 2009 by .

You’ll need a modifier on this code pair to bust bundle.

Be cautious about reporting a same-session spinal osteotomy with a laminectomy due to the new edits the Correct Coding Initiative (CCI) version 15.1 unloads.

First, Take a Large Picture View

Version 15.1, effective April 1, contains 304,038 additions. “The file is one of the largest I’ve seen,” says Barbara Cobuzzi, MBA, CPC, CENTC, CPC-H, CPC-P, CIMC, CHCC, president of CRN Healthcare Solutions in Tinton Falls, N.J.

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The official reason CMS has given for the size is a need to control anesthesia bundles.

Spot Where Most New Edits Pop Up

Despite the numerous edits, CCI aims its fire at a select few codes this round, with only 524 unique codes listed in column 2 of the new column 1/column 2 edit list, and “only 48 codes make up the top 80 percent” of those listed, said Frank Cohen, MPA, senior analyst with MIT Solutions, Inc. in Clearwater, Fla., in a March 12 news release.

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News Flash: Over 300,000 New Code Pair Edits from CCI

Posted on 25. Mar, 2009 by .

Extra! CCI also creates a few welcome deletions.

If you thought CCI versions after January were pretty tame, get ready for a big surprise.

The Correct Coding Initative’s (CCI’s) version 15.1, which goes into effect on April 1, adds over 304,000 new edit pairs to its already massive list.

On the radar: CCI aims its fire at a select few codes this round, with only 524 unique codes listed in column 2 of the new column 1/column 2 edit list, and “only 48 codes make up the top 80 percent” of those listed, said Frank Cohen, MPA, senior analyst with MIT Solutions, Inc. in Clearwater, Fla., in a March 12 news release.

Extra, Extra! CCI Meets UHC. Get your tools for survival here.

The top most commonly-occurring codes in column 2 of the new non-mutually exclusive edits are 94250 (Expired gas collection, quantitative), 94680-94690 (Oxygen uptake, expired gas analysis), 95812-95819 (Electroencephalogram), and 96376 (Therapeutic, prophylactic, or diagnostic injection; each additional sequential IV push), all with 1.67 percent of the total (5,065 occurrences each), Cohen says.

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Save Time Coding Facet Injections With This Coding Tool

Posted on 19. Mar, 2009 by .

Hint: Location, number and substance are key.

Several factors come into play when you’re successfully coding facet joint injections – spinal level, the number of injections, unilateral versus bilateral, and even the type of substance injected.

Use this handy chart to help pinpoint the correct codes for each case.

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Audit Hot Spot: Facet Joint Injection Claims

Posted on 12. Feb, 2009 by .

Here’s why the OIG wants to stick it to facet joint injection claims: Auditors found errors in 71 percent of physician office claims submitted to Medicare in 2006, resulting in $96 million in improper payments, according to a report released last year.

Get your injection coding right on target with Marvel Hammer.

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