Chronic Pain

Rx Drug Management for 99214

Listing the Patient’s Medications. Many physicians think that if they document in their progress notes a list of the medications the...

Recent Chronic Pain Audits

There have been several recent chronic pain audits our clients are undergoing. 1. Kyphoplasty and Vertebroplasty. Performant...

DHHS Enforcement Actions Involving Anesthesia and Chronic Pain

DHHS just released its Annual Report for the Health Care Fraud & Abuse Control Program, wherein it detailed the Government’s latest...

Rx Drugs Not Enough for 99214

Most pain physicians try to achieve billing 99214 (moderate medical decision making) by relying on the fact that they have prescribed...

UDT Cannot be Billed as Incident to

In a recent TPE (Targeted Probe and Educate) audit that we are defending, Palmetto GBA (one of the Medicare carriers) is taking the...

Medicare Temporary Bundling of UDT Codes

1. Medicare Bundling of Screens and Definitive Tests. Effective July 1, 2023, CMS implemented NCCI edits between Column One codes...

New SIJ Injection LCDs

Five of the seven Medicare Carriers around the country have adopted a multijurisdictional new LCD for SI Joint Injections (“SIJIs”). The...

STIMWAVE Former CEO Indicted

Many of you have inquired about using STIMWAVE (“SW”) stimulator products and whether Medicare would pay for them. The DOJ just issued a...

Prescribing Excessive Opioids

Over the past several years, multiple pain physicians have been found guilty of illegally prescribing opioids in violation of the...

AMA Issues New Coding Guidance on Planar Blocks

1. Types of Blocks Addressed. The AMA has issued new guidance regarding the billing of plane (a/k/a"planar") blocks, including PECS I,...

Search Warrant Regarding Urine Drug Screens

The FBI has alleged, in an affidavit filed in support of a Search Warrant of Carolina Liquid Chemistries, that it is a crime to knowingly...