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Understanding medical terminology has always been an important requirement for medical coders. They should review anatomy and physiology terms to better understand the language of the new codes.

Another important recommendation for ICD-10-compatible software and computer formats is troubleshooting. This knowledge will aid healthcare providers in quickly resolving any technical issues. As a result, healthcare providers must be aware of the potential impact of changes to the coding system on existing and new insurance programs.

New Pain Management Coding Updates and Guidelines 2022

In this article, we’ll learn about the new pain management coding updates and guidelines for 2022.

New pain management coding updates 2022

In 2022, two CPT codes have been deleted and replaced with new codes that provide more granularity about procedures performed.

Deleted codes:

01935 (Anesthesia for percutaneous image-guided procedures on the spine and spinal cord; diagnostic)

01936 (Anesthesia for percutaneous image-guided procedures on the spine and spinal cord; therapeutic) are deleted in CPT®2022 and replaced with new codes that provide more granularity.

Additionally, new codes 01937-01942 identify the type of surgical procedure for which anesthesia is being performed and whether the procedure is performed on the cervical or thoracic spine or the lumbar or sacral spine.

New CPT codes for 2022

For anesthesia and pain medicine, there are nine new CPT codes for 2022. The new codes 01937-01942 classify the type of surgical procedure for which anesthesia is provided, as well as whether the procedure is performed on the cervical, thoracic, lumbar, or sacral spine.

  • 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 the neurolytic agent on the spine or spinal cord; cervical or thoracic
  • 01940 Anesthesia for percutaneous image-guided destruction procedures by the 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 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)

Acupuncture

According to NCD 30.3.3, Medicare now covers all types of acupuncture for lower back pain. Acupuncture treatment for chronic lower back pain is covered by Medicare for up to 12 sessions over 90 days.

Acupuncture uses tiny needles inserted through the skin to relieve pain and restore energy flow. Acupuncture effectively treats back pain, osteoarthritis, and knee pain, according to the National Center for Complementary and Integrative Health Trusted Source. Furthermore, it promotes health and happiness by stimulating the body’s natural healing processes.

Other Frequently Used Pain Management CPT Codes

Acupuncture CPT Codes

  • 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

Acupuncture data is reported in 15-minute increments of face-to-face contact with the patient, not on the intensity or duration of the acupuncture treatment.

  • Each day you should only report one initial code
  • For each 15-minute increment, you should report only one code
  • Use CPT code 97810 or 97813 for the initial 15-minute increment
  • When electrical stimulation is not used during a 15-minute increment, report CPT codes 97810 or 97811.

Electrical stimulation of any needle during a 15-minute increment is reported by using CPT codes 97813 or 97814.

Dry Needling

Dry needling, also called “trigger point acupuncture” is reported using the following CPT code:

  • 20560  (Needle insertion(s) without injection(s); 1 or 2 muscle(s)
  • 20561  (Needle insertion(s) without injection(s); 3 or more muscles)
  • 20551  Origin or insertion of a tendon is injected
  • 20550  Injection of the tendon sheath

The Current Procedural Terminology specifies that CPT codes 20552 or 20553 (trigger point injections) must not be reported with CPT codes 20560 or 20561 for the same muscle group.

Radiofrequency Ablation

The radiofrequency ablation (RFA) procedure involves passing an electric current through a small nerve tissue area to prevent pain signals from passing through that area. It can relieve chronic pain, particularly in the lower back, neck, and arthritic joints.

RFA CPT codes 2022 are:

  • 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.

CPT Code Changes for Important Diagnoses

  • C56.3 Malignant neoplasm of bilateral ovaries (previously only left, right, unspecified existed)
  • C79.63 Secondary malignant neoplasm of bilateral ovaries (previously only left, right, unspecified existed)
  • G44.86 Cervicogenic headache
  • K22.81 Esophageal polyp
  • K22.82 Esophagogastric junction polyp
  • K22.89 Other specified diseases of esophagus (previously codes as K22.8, 5th character added)
  • K31.A—Gastric intestinal metaplasia (code to appropriate 6th character)
  • L24.A– Irritant contact dermatitis due to friction or contact with body fluids (code to appropriate 5th character)
  • L24.B- Irritant contact dermatitis related to stoma or fistula (code to appropriate 5th character)
  • M54.A- Non-radiographic axial spondyloarthritis (code to appropriate 5th character)
  • M54.50 Low back pain, unspecified
  • M54.51 Vertebrogenic low back pain
  • M54.59 Other low back pain

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