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Billing and Coding for Procedures in Headache Medicine AHS 60th Scientific Meeting June 2018Jessica Ailani MD FAHSWhat is BillingAsking for payment for services providedWhat is CodingCrossing ICD with complexity of care to explain services you providedComplexity of care is identified by a 5 digit code called CPT codesCPT codes include those for E&M and ProceduresCPT Code Resources good resource to register for in order to look up CPT codes for various procedures and Medicare payment rates in your areaCommon CPT codes for Headache ProceduresPlease check the advised CPT codes with your coder prior to use to ensure it has not been updated Injection Anes Agent Greater Occipital Nrv 64405Injection Anes Agent Trigeminal Nrv Any Div/Branch 64400Injection Anes Agent Other Peripheral Nrv/Branch 64450Injection Anes Agent Sphenopalatine Ganglion 64505Injection Single/Mlt Trigger Point 1/2 Muscles 20552Injection Single/Mlt Trigger Point 3/> Muscles 20553Chemodenervate Facial/Trigem/Cerv Musc Migraine 64615IM/SQ injection 96372Therapeutic, prophylactic, or diagnostic injection IV push, single or initial substance 96374Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure) 96375IV hydration (pre-packaged fluids and electrolytes) 96360 initial 31 min to 1 hour, 96361 each additional hourModifier Codes to add to CPT Procedure codes when indicatedPlease check the advised modifiers with your coder prior to use to ensure it has not been updated 50- Bilateral59- Distinct procedural serviceXU separate procedure after initial procedureXP if a separate specialist in same office did procedure same day of visit (unclear)XS different sites same procedureXE 2 encounters for 2 procedures same day58- Staged or related procedure or service by same physician during the post-operative period- PLANNED REPEAT PROCEDURE79- Unrelated procedure or service by the same physician during the post-operative period25- Separate and distinct E&M evaluation provided ................
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