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Pain Management Billing Services

When reporting both an E&M and procedure code, modifier 25 should be appended to the E&M service. Often, both services are reported when the E&M service involved an initial evaluation of a presenting problem and the decision to perform the procedure was based on that evaluation. For example, after an evaluation of a patient presenting with knee pain a decision may be made to proceed with an injection. The same diagnosis would likely apply to the E&M Service and the procedure code. In other situations, the visit might be prompted by a condition unrelated to a planned procedure. Consider a patient who presents for a lumbar epidural steroid injection, but also asks you to evaluate his shoulder pain. In this situation you would report both the E&M service and the epidural injection code but you would have different diagnoses. In this instance, each CPT code is linked to the applicable diagnosis code on the insurance claim form.

Telfonix provides pain management practices medical billing solutions that maximize reimbursement, reduce costs and streamline practice operations. Our team of certified medical coders and billing experts will manage all aspects of your medical billing, including common documentation shortfalls such as time-based visits, which help to ensure your practice receives maximum compensation for services rendered.

Contact Telfonix Medical Consulting today