Pain management billing encompasses a variety of specialties from different providers. Most medical billing procedures are centered on the procedure and the diagnosis of the patient. The billing differs in the way that several of its Current Procedural Terminology (CPT) codes include both the procedure and the anatomical location of where the procedure will be performed.
Pain management billing requires a level of expertise and sophistication to utilize certain modifiers, and an understanding of how global days affect relative treatment procedures. Proper coding of aspirations, pain pumps, and injections are also expected to satisfy the pain management billing procedures.

Outsource Billing

Enlisting the assistance of professional medical billing companies is the preferred course for several pain management centers in order to assist in turning their revenue cycle management into a success. While the medical staff of a physician practice is skilled at assisting day-to-day activities in the clinic, or medical facility, other responsibilities in the job may hamper productivity when billing tedious pain management claims.

Self-Audits

Pain management practices can be adversely affected by a streak of erroneous billing claims from most pain management practices. Experts always advise medical practices to perform self-audits, and ensure that all data submitted to the payer, or insurer is one hundred percent accurate. Most pain management practices assess their own practice in reviewing their office’s conformity with CMS guidelines for rendering pain management services.

Erroneous Billing

According to the Office of the Inspector General (OIG), pain management billing is one of the most erroneous billing in the medical industry. This may be attributed to an inconsistency in documentation.

Pain management billing is always reviewed with a higher level of scrutiny to make sure that reimbursements are fair to both the pain management practice, and the insurer.

Pain management centers are not the only medical practices that experience scrutiny from auditors. However, insurance payment auditors cannot discredit the fact that pain management claims have an elevated margin for error. Based on several sources, the technicalities of pain management billing always gets the best of clinicians.

CPT codes provide accurate descriptions of the procedure. Performing an internal audit will expose areas for improvement to enhance accuracy in billing and preventing adverse auditing.

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