This page addresses follow-up questions and additional information pertinent to our webinar Acute and Chronic Pain Procedure Coding.
** The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic as they can change rapidly.
Q: The carpometacarpal joint always throws me off a little bit because of its location at the thumb and wrist. What size joint would this be? A small joint or an intermediate joint?
A: This question comes up commonly in reference to the 1st CMC, which is situated at the base of the thumb on palm side of the wrist. Per a CPT assistant, this joint is considered a small joint.
Q: Trigger point injections are reported per muscle. Should the specific muscles injected be documented or will a simple statement of the number of muscles treated suffice?
A: You will want to check with your Medicare contractor for an LCD or article on code 20552 and 20553. Many will require that trigger point in an individual muscle or muscle group be clearly documented.
Q: A patient with an intrathecal pump has a routine refill done. The note also mentions that the pump was analyzed and reprogrammed, but I don’t see any changes to drug dosage. The pump was programmed to the same dose, and the new alarm was set. How do I decide between 62369 or 95990? What should I be looking for to report “reprogramming”?
A: Make sure to carefully review the documentation before selecting a code that includes reprogramming. Per a 2022 CPT Assistant Question and Answer article, both code sets 62367-62370 and 95990-95991 reference an electronic analysis. An electronic analysis will include a review of the reservoir amount, alarm and drug prescription status. So, if all of these are fine, the pump is refilled and parameters are left the same with no reprogramming to drug rate or dose, report with 95990 of 95991. If any of the parameters are changed during the refill, report 62369.
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Meet the Presenter: Emily Lomaquahu, CPC, CPMA, CEDC
Emily is a Senior Coding Quality Auditor for Haugen Consulting Group and brings over a decade of experience to the profee team! She began her career as an auditor and with her keen eye for detail, she quickly found it was a perfect fit. Emily thrives in a collaborative environment and enjoys creating high-quality trainings to help providers and coders navigate charts and improve their accuracy. She earned a bachelor’s degree from the University of Colorado, in Denver. Emily specializes in Evaluation and Management (E/M), Primary Care, Anesthesia, Emergency Department, and Neurology, though she says Anesthesia and Neurology are her favorites! She is a Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA) and Certified Emergency Department Coder (CEDC).
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