Medical Billing Forum

Starting a Medical Billing Business => Starting Your Own Medical Billing Business => Topic started by: sagemb on July 16, 2011, 01:03:58 AM

Title: Anesthesiologist & Pain Management
Post by: sagemb on July 16, 2011, 01:03:58 AM
Hi There Everyone,

Been a while since I posted here. However, I'm going to be meeting potential client day after and wanted see if you folks have any tips for me. This guy is very revered in his profession. He's got a small clinic across town but has a very healthy (no pun intended) business going for himself.

My big concern is that I don't want to sound like an idiot while talking to him. What should I know about his specialty? What kinds of codes to these folks use most often? What's the big challenge in their specialty? I know that Anesthesiologists have a tough time with the quantity (as in ml of anesthesia used) of the codes.

What else can I look into? What can you folks tell me, those who are already dealing with Anesthesiologist & Pain Management Specialist? Please help!
Title: Re: Anesthesiologist & Pain Management
Post by: Michele on July 16, 2011, 11:33:58 AM
Haven't done pain management but I have done anesthesia.  The important thing with anesthesia is getting the units correct.  There are units for time, physical status, and other factors.  You need to know if they will be expecting you to calculate the units or if it will come over with units indicated.  You may want to look up what factors into the units.

Title: Re: Anesthesiologist & Pain Management
Post by: sagemb on July 16, 2011, 01:05:53 PM
Thanks Michele...this is good stuff. is there Anything else in particular that gives a hard time to these spealists to get paid? A typical CPT, icd, or something that takes longer To get paid?
Title: Re: Anesthesiologist & Pain Management
Post by: Billergirlnyc on July 25, 2011, 12:32:21 AM

I'm a newbie here, but my one of my specialties is Pain Management. I'm sure you've already gone to your meeting, but pain management doctors do a lot of injections, tendon sheath, joint injections, trigger points, carpel tunnel, nerve blocks. Then you have Interventional Pain Management docs who do a lot of facet joint injections some with fluro guidance. The main concern is the units too, and ensuring their services aren't bundled, and actually billing based on RVU's. A lot of ins carriers will cite Medicare's guidelines when paying for these services, so it's good to be familiar w/how MC pays for these services. I had a doctor whose biller was billing the TP w/4 units, and he wondered why he wasn't getting paid, and why all of sudden he had refund requests. I had to explain to him that for trigger point (20052/20553) is only 1 unit despite how many muscle sites he injected, the corticosteroid is inclusive in the charge, can't bill it separately. Aetna has stopped paying for TP being done in isolation aka patient needs to have comprehensive pain management care, and TP's can't be done indefinitely. Lots of changes to pain management recently, and again many ins carriers are following MC's guidelines. Good thing to do is grab MC's LCD's and NCD's based on these codes.


Title: Re: Anesthesiologist & Pain Management
Post by: sagemb on July 31, 2011, 07:15:45 AM
Thanks a bunch Dee. The dr bailed out hour before the meeting and never spoke since. However you, along with others freely give away pearls of wisdom. As far as I know, what you're telling me cant be read in a book. These are realy your experience based and I'm grateful to you for it.