Getting paid: Get specific on diagnostic outcomes to reduce therapeutic pain procedure denials

Article Overview

This article covers documentation expectations for diagnostic pain procedures in the context of payment review by Medicare Administrative Contractors and private payers. It focuses on the kinds of outcome information payers want to see in the record, why those details matter for follow-up care, and how the guidance may affect prior authorization and downstream therapeutic pain services. The piece is aimed at clinicians, coders, and billing staff working with pain management documentation.