decisionhealth Newsletters, Coder Pink Sheets - 2009 Issue 10 (October)
Noridian plans to eliminate payment for facet joint injections
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Article Overview
This article covers a Medicare contractor draft local coverage policy affecting facet joint injection procedures, the surrounding concerns about medical necessity and reimbursement, and the responses from specialty stakeholders. It is relevant to pain management coders, physicians, and billing staff who need to monitor contractor policy changes and supporting documentation requirements.
Why This Topic Matters
Coverage policy changes can affect whether commonly used interventional pain procedures are payable under Medicare and can increase the importance of documentation, medical necessity support, and payer-specific billing review.
What You Will Learn
- What the article says about a pending Medicare contractor coverage policy
- How the policy relates to medical necessity and documentation concerns
- What stakeholders are doing in response to the draft policy
- What types of supporting materials may be relevant in a reconsideration request
Who Should Read This
- Medical coders
- Billing staff
- Pain management practices
- Physicians
- Compliance staff
Codes Discussed
Modifiers Discussed
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