Stay on the Top of the CPT Pain Management Medical Coding Updates

2010 introduced a  series of updated pain management codes  We have a total throughout the whole CPT book of 195 new, 53 deleted, not any deleted that really come in to play for us in pain management and 155 revised.

Let's start with  the E/M medical coding and billing sections.  AMA really tried to identify the definition of a consultation and the change verbiage is that it's either to recommend care for a specific condition or problem. That's a key phrase there - either to recommend care for a specific condition or problem or to determine whether to accept responsibility for ongoing management of the patient's entire care or the care of a specific condition or problem.

Continuing on with those medical coding guidelines, the written or verbal request of a consult maybe made by a physician or other appropriate source. Documented in the patient's medical record by either of a consulting or requesting physician or appropriate source. So the AMA is taking the stands that either the requesting source or the consulting physician or appropriate source needs to document that in the patient's medical record.

The specific medical coding and billing coding options for the office consultations, office or other outpatient are 99241 through 99244. That key is that bottom sentence where services that constitute transfer of care.

We do want to point out that the AMA did include a definition of transfer of care. It is in the evaluation and management services guidelines at the very first of the section.

You must use subsequent hospital care codes or subsequent nursing facility care codes to report transfer of care services. So the AMA is trying to direct providers that if they are having a transfer of care for the patient or a portion of the patient's care, directing providers to correctly report those with a correct E/M categories.

If you do an out-patient consult and then the patient is admitted and you see them on the same date of service, report these codes. If you do an out-patient consult code and they're admitted and you see them on that date, then report these codes for accurate medical coding and billing.

To keep yourself updated with the medical coding guidelines, visit our medical coding training online page.