Imaging Services for Pain Management and/or Neurology

by  Find-A-Code™
Jan 1st, 2019 - Reviewed/Updated May 4th

Imaging services in pain management and neurology may be either diagnostic (e.g., diagnosing structural issues, nerve damage, and soft tissue injuries) or utilized to guide certain therapeutic procedures (e.g., injections). Common services include MRI for soft tissues, CT scans for bone, ultrasound for injection guidance, and specialized studies like PET scans, myelograms, and EMG to detect nerve or musculoskeletal disorders.

When ordering imaging services, be aware of individual payer policies regarding pre-authorization and written orders. Services ordered for Medicare beneficiaries are checked against the exclusions list to verify that the ordering provider is authorized to request the service. ICD-10-CM codes either identifying the condition, illness, injury, or an appropriate symptom to be investigated should be included on the order and coded to the highest specificity, based on documentation provided. Check your Medicare Administrative Contractor (MAC) for local coverage determinations (LCDs) or articles which identify any specific criteria that must be documented or appropriate ICD-10-CM codes required to meet medical necessity for the service being ordered.

The following is a list of some common imaging services for these specialties:

CT scan to evaluate bone/structural issues:

70450 Computed tomography, head or brain; without contrast material

MRI to evaluate soft tissues:

Magnetic resonance (eg, proton) imaging;

70551 brain (including brain stem); without contrast material

70553 brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences

72141 spinal canal and contents, cervical; without contrast material

72148 spinal canal and contents, lumbar; without contrast material

Guidance:

76942 Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation

Tip: When billing radiology or ultrasound codes, remember to report the referring/ordering physician’s NPI number in Item Number 17A of the 1500 Claim Form (where applicable).