The Most Pressing Concerns in The Field of Pain Management Billing Services

Posted by Willam Smith on April 29th, 2021

Today, pain management billing services have a lot of room to develop. According to a new study by the Centers for Disease Control and Prevention, some 50 million people suffer from chronic pain (CDC). It accounts for 20.4% of the adult population or one in every five adults. This is much more than the average number of heart disease, diabetes, or cancer patients.

While there is space for development, some of the pain treatment billing and coding issues make it difficult to succeed. We'll go through some of the common blunders and problems in the Pain Management Billing services here.

Avoid relying solely on summaries

One of the major flaws in pain management billing services is to bill a procedure based only upon a summary. According to Medicare, you can only bill for procedures that are recorded in the body of a review. This means that coders must look past the report's initial summary for coding purposes.

Delays in the administrative setup

A time-consuming manual process undertaken by in-house workers is used by many pain management billing practices to treat claim denials. Consequently, the re-submission process takes longer, and labor costs go up. Outsourcing pain management billing services to an experienced team of specialists would:

• improve claim denial settlements
• case mix results
• Claim time in accounts receivable

Inaccurate coding

Simply listing codes given by physicians in reports is another costly billing and coding flaw in pain management billing services. Proper coding involves examining certain documents and ensuring that the codes accurately and consistently reflect the physician's services. It's also important to double-check that the procedures being coded are well-documented.

Billing Fluoroscopy

In pain management billing services, Fluoroscopy is used in many pain management codes, such as:

• Discography
• Medial branch block facet joint operations
• Intra-articular joint
• Steroid epidural injections for transformation
• Ablation with radiofrequency

When fluoroscopy is billed separately, it's common for duplicate claims to be made for the same treatment, resulting, in costly denials that hurt the bottom line.

Modifier-50

While coding bilateral procedures, make sure to add modifier -50. This modifier adds further information to the procedure that is being coded. A procedure or service that is performed on both sides of the patient's body in a single session is designated by the modifier -50. Unfortunately, many people make the mistake of ignoring modifier -50 or coding each side of the body separately.

To summarize, outsourcing to specialist medical billing services aids in the resolution of the pain management billing problem. Make sure the outsourcing partner has a lot of experience in billing and coding for pain management. It should also be current and knowledgeable about recent changes and innovations.