Pain Management Coding Updates and New Guidelines for 2022
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Managing pain can sometimes be difficult for pain specialists, especially satisfying patients with unique needs. They use several approaches, including interventions, noninvasive techniques, and counseling to help patients manage their pain effectively to improve their quality of life.
Therefore, providers should assign valid codes on claims to describe the patient’s condition in multimodal pain management programs. However, the constant changes in billing rules and codes make this a tedious task.
Check out these pain management coding updates and new guidelines for 2022 as well as other codes currently in use.
CPT Code Changes 2022
Below are the nine new CPT codes for 2022 for anesthesia and pain medicine. The new CPT codes 01937-01942 show the type of surgeries for which anesthesia is provided and whether the surgery is performed on the cervical, thoracic, or lumbar spines.
01937 — | Anesthesia for percutaneous image-guided injection, drainage, or aspiration procedures on the spine or spinal cord; cervical or thoracic |
01938 — | Anesthesia for percutaneous image-guided injection, drainage, or aspiration procedures on the spine or spinal cord; lumbar or sacral |
01939 — | Anesthesia for percutaneous image-guided destruction procedures by a neurolytic agent on the spine or spinal cord; cervical or thoracic |
01940 — | Anesthesia for percutaneous image-guided destruction procedures by a neurolytic agent on the spine or spinal cord; lumbar or sacral |
01941 — | Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic |
01942 — | Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral |
64628 — | Thermal destruction of the intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral |
64629 — | Thermal destruction of the intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (List separately in addition to code for primary procedure) |
93319 — | 3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular septum) and function, when performed (List separately in addition to code for echocardiographic imaging) |
These CPT codes and other information you need to know for coding/billing in 2022 are copyrighted by American Medical Association.
CPT Codes for Other Pain Management Conditions
Acupuncture
The process of acupuncture involves the insertion of thin needles at strategic points on the body. According to the National Center for Complementary and Integrative Health Trusted Source, acupuncture can relieve neck and lower back pain, osteoarthritis, and knee pain.
Acupuncture practices use codes that refer to their specific services. Since services are often coded in 15-minute increments, you will use one code for the initial 15 minutes of service and another code for any additional time. CPT code variations only apply if your acupuncture treatment includes electronic stimulation.
Here Are the 4 CPT Codes for Acupuncture:
97810 — | Acupuncture, one or more needles, without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient |
97811 — | Each additional 15 minutes of personal one-on-one contact with the patient, with re-insertion of needles |
97813 — | Acupuncture, one or more needles, with electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient |
97814 — | Each additional 15 minutes of personal one-on-one contact with the patient, with re-insertion of needles |
In the context of acupuncture, 15-minute increments of personal (face-to-face) contact with the patient are reported and not the duration of the insertion of the acupuncture needle(s).
If an electrical stimulation was not used during a 15-minute increment, report CPT code 97810 or 97811.
If there’s electrical stimulation of any needle during a 15-minute increment, report CPT code 97813 or 97814.
For every 15-minute increment, report only one CPT code.
If you want to set the initial increment of 15 minutes, use CPT code 97810 or 97813.
Report only one initial code each day
Dry Needling
Dry needling, also known as trigger point acupuncture, is reported to the system under the following CPT codes:
CPT code 20560 (Needle insertion(s) without injection(s); 1 or 2 muscle(s)
CPT code 20561 (Needle insertion(s) without injection(s); 3 or more muscles)
Use CPT code 20551 when injecting the origin or insertion of a tendon. Report injections into the tendon sheath using the CPT code 20550.
CPT instructs that CPT codes 20552 or 20553 (trigger point injections) are not reportable with CPT codes 20560 or 20561 when performed for the same muscles.
CPT advises that when performing trigger point injections (specifically, CPT codes 20552 and 20553) are not reportable for the same muscle group along with CPT codes 20560 and 20561.
Radiofrequency Ablation
A minimally invasive method for stopping nerve pain signals is radiofrequency ablation (RFA). This therapy can provide lasting relief for conditions like chronic pain, especially in the lower back, neck, and joints with arthritis. The RFA CPT codes 2022 are as follows:
64625 — | Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) |
64999 — | Unlisted procedure, nervous system |
If radiofrequency ablation is used with traditional or cooled radiofrequency (80 degrees Celsius), report it with CPT code 64625.
Report pulsed radiofrequency ablation by using CPT code 64999.
ICD-10 codes supporting medical necessity should accompany CPT codes. In addition to meeting the criteria specified in the attached determination, services provided must also be reasonable and necessary.
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