There's plenty of room to grow in pain management facilities in the present, particularly since there is a report from the American Academy of Pain Medicine estimates that over 100 million Americans suffer from chronic pain. That's much higher than the total number of people affected by diabetes, heart disease, and cancer. There is a lot of the potential for expansion, certain codes and billing for pain management difficulties make it difficult to succeed. Effective billing and coding are only half the battle when trying to increase the revenue of your practice. Avoid the most common mistakes in billing and coding to ensure your pain management practice is set to develop and prosper in the coming year.
Avoid Billing Procedures Based Solely on Summaries
One of the most common mistakes made in the billing and coding of pain management is to bill for a procedure only based on an overview. According to Medicare it is only allowed to bill for procedures that have been recorded within the body of a report. Coders must be aware of the full report that is at the start of the report to determine purposes of coding.
Ensure Errors in Medical Billing Records are Properly Corrected
As ensuring that documentation requirements are met is essential to ensure that payers are actually paying for services, addressing mistakes in medical records is vital. Physicians should not scratch words out or apply correction fluid in the patient's records. If there's an error within the patient's medical records the error should have only a single line traced through it using ink. The term "error" should be written over it, and the corrections should be made. It is also crucial for doctors to sign off on the corrections made to the patient's records.
Look Out for "Canned" Reports
Certain procedures may require doctors would use "canned" reports or report templates rather than producing a report specifically customized to the particular patient and procedure for pain management. However, these templates might not include all the necessary information needed to document the procedure properly. In certain instances, the report might not contain information about the exact procedure followed or provide the specific side the procedure was performed.
Examine and Verify Codes Listed in Reports
Another expensive error in billing and coding is to simply record codes that doctors provide in their reports. Correct coding requires examining these reports to ensure that the codes accurately and effectively represent the services rendered by the doctor. It's also important to confirm that proper documentation has been given for the procedures that are being recorded.
Fluoroscopy in Pain Management Medical Billing Often Results in Errors
One of the most common mistakes in medical billing for pain management and billing is to charge fluoroscopy as a separate procedure. The procedure is included in a variety of codes for pain management including discography, intraarticular joints procedures or facet block medial branch surgeries, transforaminal epidural injections of steroid, as well as radiofrequency ablations. In many cases, billing fluoroscopy independently causes duplicate claims to be that are made for one procedure, which results in expensive denials that can affect the bottom line of your business.
Don't Forget About Modifier -50
When you code bilateral procedures, be sure to add modifier 50. This modifier offers additional details about the procedure to be coded. Modifier -50 is specifically an action or procedure that's executed across both the sides of the body in a single session. However, it's a typical error to not remember modifier -50, or simply code each body part in a separate way.
Continuing Changes Result in More Challenges for Pain Management Medical Billing
The reimbursement for pain management evolves regularly and the procedures for documentation you've employed in the past could soon be leading to denials. The payers are now required to provide more and more precise documents. The codes for pain management keep changing too. Along with coding and policy changes, your practice's code personnel must stay up to date with these changes and adjust your procedures according to the requirements of each payer. However, any modifications could lead to difficulties in keeping the revenue cycle running for the practice.
For many practices for pain management, outsourcing to a professional medical billing and coding service aids in solving this issue. At Medcare MSO we have extensive expertise in the billing for pain and code and we have a relationship with pain management clinics across the United States. In addition to providing, you with the option of billing and coding We also provide contracting services as well. Contact us now to find out how we can assist you in boosting the revenue of your pain management practice. For more details visit here.
