Author Topic: pain managment billing  (Read 922 times)

ddcool

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pain managment billing
« on: August 20, 2020, 01:35:06 PM »
Hi guys,

I am new here. I have been billing various provider out of network for years. I just got a new client . They will be billing R.O.M, muscle testing, trigger point injections, tendon injections, Arthrocentesis Aspiri injection, Cortisone injections to name a few!!! My Question is I can look up the codes, but I need to know how exactly to bill it ,, units, areas etc. Also I am having difficulty coming up with out of net pricing.

I would appreciate any help anyone can give me.

Thanks All. Stay safe and well.

Michele

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Re: pain managment billing
« Reply #1 on: August 24, 2020, 10:48:14 AM »
Are you a biller or a coder?  The reason I ask is because the questions you are asking are coding questions but you are stating you are a biller.  Not trying to split hairs here, but if the billing is being sent over to you as the biller, it should be coded.  We don't usually have access to all we need in the billing dept to be able to make the decisions on units, areas, etc.  You would have to have access to the patient's chart. 

As for the pricing, the provider should be giving you their fee schedule for all services.  If they don't have a fee schedule, then you can help them set one.  Most people use the Medicare fee schedule as a baseline and go from there.  Average pricing is 140% - 200% of Medicare allowed amounts.  Some providers, especially out of network providers will go even higher, like 300%.  So you can look up the codes on your local MAC website, and then set a fee schedule from there.

Sorry, I don't know if this was that much help, but the question is too vague to give specific coding advice. 
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Re: pain managment billing
« Reply #1 on: August 24, 2020, 10:48:14 AM »