- April 29, 2021
- Posted by: Thomas Anderson
- Category: Pain Management Billing
As we find millions of people around the United States already suffering from ongoing and severe pain, chronic pain management has come up to play a significant role. According to a recent report shared by the CDC, Centers for Disease Control, it is estimated that almost 50 million people currently suffer with some chronic pain that equals to 1 in every 5 adults!
The rise of the aging population and frequent incidents of pain rising from arthritis and other related diseases with age, there is no denying that pain medicine specialty will continue to evolve and expand. Likewise, the demand for cannabis products, that can help relieve pain, also seems to be on the rise. Products similar to edibles, gummies and oils have gained popularity over the last couple of years. What needs to be understood though is that proper research and knowledge in this domain is of utmost importance as it is still seen as an alternative form of medication.
Similarly, the cannabis industry might have a huge growth opportunity as the demand in countries where it has been legalized has grown rapidly. This can be assumed by looking at online cannabis stores and others like them who have been providing people with their needs efficiently, both for medical as well as recreational purposes.
Nonetheless, we find that a lot of providers are already under the crossfire of expanding requirements with prior authorization. Also, there are a lot of issues with fee schedules and their downward adjustments as well as shifting patient financial responsibility.
The top 5 issues with Pain Management Billing and Coding
To be precise, a lot of processes with revenue cycle management must include solid practices with pain management billing. Making sure everything is managed timely as well as in an efficient manner is what that sets the benchmark to maximize reimbursement flow.
A competent pool of medical billers and coders offers the needed support which will elevate your practice management efforts. Let us now review some of the best practices that will optimize your reimbursement in the near future!
Documentation has to be appropriately done before visit: Accurate documentation is critical in pain management billing more than ever! There are a number of areas where you may miss information and on a number of issues.
The providers have to include accurate procedural information as well as the correct operative note and addendum. Once it is sent to the correct department in coding, they have to clarify information in accordance with the latest guidelines in coding.
Up to date with insurance guidelines and policies: Your team of medical billers and coders have to stay abreast of the latest regulatory policies which will ensure maximum reimbursement. Collection of information, understanding of the major changes announced with regulations has to be updated.
A great example of the same will be the telehealth changes that impacts patient E/M codes as well as the ICD-10 CM codes that took place during last year with the pandemic.
Understanding how to bill Fluoroscopy separately: A lot of practices offer pain management support bill for fluoroscopy separately. Making sure if there are any bundled charges for the procedure in use for example SI Joint (27096) , medial branch books or the facet injections. Also, you have to recognize separately the fluoro guidance codes for peripheral joints. Having a proper management guideline in the form of a book can be helpful.
Correct use of Modifiers is critical to reimbursement: Modifiers exist for clarifying the service as well as the procedure which can trigger the denials or negative influence the revenue stream to flow. Hence it is doubly important to include the correct modifiers which will optimize the process of pain management billing.
To conclude, what you need is a reliable partner that can deliver you actionable support. Dedicated resources with versatility across practice management systems will provide the much needed impetus to your practice.