tci Outpatient Facility Coding Alert - 2013 Issue 8

Pain Management: Don't Let Vertebroplasty Policy Differences Sideline Your Coding

Your first move is to identify vertebral locations. The AMA and Medicare’s recent differing guidance on vertebroplasty coding feels like clash of the titans, leaving coders wondering how to navigate two different sets of directions.  Strengthen your claims by knowing Medicare’s special guidelines for deciding which add-on codes apply. Go Straight Down the List for AMA If you’re following AMA rules, your code choices are easy: simply report the parent code and each add-on in the code family as they’re listed. Example: The pain management physician completes vertebroplasty at spinal levels T12, L1, L2...

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