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What to Expect from New Pain Management Coding Updates and Guidelines 2022

pain management cpt code May 3, 2022

The ability to understand medical terminology has always been an essential requirement for medical coders. To better understand the language of the new codes, they should review anatomy and physiology terms.

Troubleshooting is another important recommendation for ICD-10-compatible software and computer formats. This knowledge will assist healthcare providers in resolving any technical problems in time. Thus, healthcare providers must be aware of the potential impact of coding system changes on existing and new insurance programs.

In this article, we’ll find out what to expect from new pain management coding updates and guidelines 2022.

Pain Management Coding Updates 2022

As of 2022, two CPT codes have been deleted and replaced with new ones that provide more detail about procedures.

01935— (Anesthesia for percutaneous image guided procedures on the spine and spinal cord; diagnostic)
01936—(Anesthesia for percutaneous image guided procedures on the spine and spinal cord; therapeutic) are deleted in CPT®2022.

Moreover, the new codes 01937-01942 identify the type of surgical procedure performed under anesthesia and whether it’s done on the cervical, thoracic or lumbar spines.

New CPT codes for 2022

In the table below, you can refer to the  new CPT code changes for 2022 applicable to anesthesia and pain medicine:

01937Anesthesia for percutaneous image-guided injection, drainage, or aspiration procedures on the spine or spinal cord; cervical or thoracic
01938Anesthesia for percutaneous image-guided injection, drainage, or aspiration procedures on the spine or spinal cord; lumbar or sacral
01939Anesthesia for percutaneous image-guided destruction procedures by a neurolytic agent on the spine or spinal cord; cervical or thoracic
01940Anesthesia for percutaneous image-guided destruction procedures by a neurolytic agent on the spine or spinal cord; lumbar or sacral
01941Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic
01942Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral
64628Thermal destruction of the intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral
64629Thermal destruction of the intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (List separately in addition to code for primary procedure)
933193D echocardiographic imaging and postprocessing during transesophageal echocardiography, or transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular septum) and function, when performed (List separately in addition to code for echocardiographic imaging)
These codes and other information you need to know for coding/billing in 2022 are copyrighted by American Medical Association.

Likewise, we’ll discuss some other commonly used pain management CPT codes. These include acupuncture, dry needling,  and radiofrequency ablation.

Acupuncture

In accordance with NCD 30.3.3, Medicare now covers all types of acupuncture as a treatment for lower back pain. Patients with chronic lower back pain can receive acupuncture treatment for up to 12 sessions within a 90-day period through Medicare.

The purpose of acupuncture is to relieve pain and restore energy flow by inserting tiny needles through the skin. According to the National Center for Complementary and Integrative Health Trusted Source, acupuncture effectively treats back pain, osteoarthritis, and knee pain. Furthermore, it stimulates the body’s natural healing processes and promotes health and happiness.

Acupuncture CPT Codes

97810— Acupuncture, one or more needles, without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient
97811—Each additional 15 minutes of personal one-on-one contact with the patient, with re-insertion of needles
97813—Acupuncture, one or more needles, with electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient
97814—Each additional 15 minutes of personal one-on-one contact with the patient, with re-insertion of needles

Acupuncture data is reported based on 15-minute increments of personal contact (face-to-face) with the patient, not on the intensity or duration of the acupuncture treatment.

  • When electrical stimulation is not used during a 15-minute increment, report CPT codes 97810 or 97811.
  • Electrical stimulation of any needle during a 15-minute increment are reported by using CPT codes 97813 or 97814.
  • For each 15-minute increment, you should report only one code
  • Use CPT code 97810 or 97813 for the initial 15-minute increment
  • Each day you should only report one initial code

Dry Needling

The following CPT codes are used for dry needling, which is also known as trigger point acupuncture.

20560—(Needle insertion(s) without injection(s); 1 or 2 muscle(s)
20561—(Needle insertion(s) without injection(s); 3 or more muscles)
20551—Origin or insertion of a tendon is injected
20550—Injection of the tendon sheath

The Current Procedural Terminology specifies that CPT codes 20552 or 20553 (trigger point injections) must not be reported with CPT codes 20560 or 20561 for the same muscle group.

Radiofrequency Ablation

The radiofrequency ablation (RFA) procedure involves delivering an electric current to a small nerve tissue area to prevent pain signals from being transmitted through that area. It can relieve chronic pain, specifically in the lower back, neck, and arthritic joints. 

These are the RFA CPT codes 2022:

64625— Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography)
64999—Unlisted procedure, nervous system
  • If radiofrequency ablation is used with traditional or cooled radiofrequency (80 degrees Celsius), report it with CPT code 64625.
  • Report pulsed radiofrequency ablation by using CPT code 64999.

CPT Code Changes for Important Diagnoses

  • C56.3 Malignant neoplasm of bilateral ovaries (previously only left, right, unspecified existed)
  • C79.63 Secondary malignant neoplasm of bilateral ovaries (previously only left, right, unspecified existed)
  • G44.86 Cervicogenic headache
  • K22.81 Esophageal polyp
  • K22.82 Esophagogastric junction polyp
  • K22.89 Other specified diseases of esophagus (previously codes as K22.8, 5th character added)
  • K31.A—Gastric intestinal metaplasia (code to appropriate 6th character)
  • L24.A- Irritant contact dermatitis due to friction or contact with body fluids (code to appropriate 5th character)
  • L24.B- Irritant contact dermatitis related to stoma or fistula (code to appropriate 5th character)
  • M54.A- Non-radiographic axial spondyloarthritis (code to appropriate 5th character)
  • M54.50 Low back pain, unspecified
  • M54.51 Vertebrogenic low back pain
  • M54.59 Other low back pain

Any ambulatory surgical centers performing pain management procedures need to be aware of these low back pain diagnosis changes. In order to avoid an unspecified diagnosis, surgeons must understand how the revisions affect their documentation. They must be as specific as possible about the type of low back pain treated.

Tap Into Our Expertise

Medical coders might face some new challenges in light of the new pain management billing codes and guidelines. As a result, healthcare providers should evaluate how medical coding changes will affect their programs and take steps to ensure a smooth transition.

At 5 Star Billing Billing Services Inc, we offer the highest level of performance for high-quality medical billing and coding. Save your money by outsourcing to a professional billing service.

Schedule a call with our experts today!


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