decisionhealth Newsletters, Coder Pink Sheets - 2014 Issue 12 (December)
Fee schedule 2015: Switch to fluoroscopy not the solution for ultrasound bundled with injections
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Article Overview
This article explains how 2015 payment changes affect joint injection services performed with image guidance and why a simple switch to another imaging modality may not be straightforward. It is aimed at coding, billing, and clinical staff who follow CPT and Medicare fee schedule updates, CCI edits, and guidance related to image-guided injections.
Why This Topic Matters
Payment changes and imaging-guidance bundling can alter reimbursement and documentation expectations for common joint injection services. Understanding the article helps readers anticipate how the 2015 fee schedule and related edits may affect workflow, coverage support, and choice of imaging service.
Article Sections
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Payment comparison for joint injections with and without ultrasound guidance
This section presents a side-by-side comparison of payment changes for common joint injection services across 2014 and 2015. It focuses on the overall reimbursement impact of bundled imaging guidance.
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CPT manual guidance and alternative needle guidance services
This section discusses how CPT guidance relates certain injection services to other needle guidance options. It also notes additional imaging guidance categories referenced in the discussion.
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Considerations before changing imaging approach
This section outlines broader operational and documentation considerations related to imaging choice for injections. It includes provider experience, medical necessity concerns, and the potential effect of edits and manual updates.
What You Will Learn
- How the article frames 2015 payment changes for joint injection services
- What broader coding and reimbursement issues are associated with image-guided injections
- Why medical necessity and documentation concerns matter when imaging modalities change
- How Medicare edit updates and CPT guidance are relevant to this topic
Who Should Read This
- Medical coders
- Billing staff
- Physician practices
- Orthopedic and pain management clinics
- Compliance staff
- Revenue cycle professionals
Codes Discussed
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