decisionhealth Newsletters, Coder Pink Sheets - 2014 Issue 12 (December)
Switch to fluoroscopy not the solution for ultrasound bundled with injections
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Article Overview
This premium article is for coders, billers, and clinic staff who handle joint injection claims and related imaging guidance. It reviews payment changes between 2014 and 2015, discusses the relationship between ultrasound and fluoroscopic guidance, and summarizes general concerns about medical necessity and bundling edits that may affect claim submission and reimbursement.
Why This Topic Matters
Understanding these changes helps practices anticipate reimbursement differences, recognize when imaging guidance may be bundled or separately reportable, and identify claim scenarios that could draw payer scrutiny.
Article Sections
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Getting paid
Introduces the payment impact of imaging guidance with joint injection services and discusses the broader reimbursement context for 2015.
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Before you fire up the C-Arm for your joint injection patients, here are four things you should consider:
Reviews general considerations related to imaging choice, documentation, and payer review when imaging guidance is used with injections.
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Joint injection coding & payment - 2014
Presents a payment comparison for selected joint injection services and associated imaging guidance under 2014 coding and reimbursement.
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Joint injection coding & payment - 2015
Presents the updated coding and payment comparison for selected joint injection services under 2015 rules.
What You Will Learn
- How payment changes can affect imaging guidance used with joint injection services
- Which general coding and reimbursement topics are tied to joint injection claims
- What kinds of documentation and medical necessity issues may arise with imaging guidance
- How annual coding updates can change claim structure and payment patterns
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle professionals
- Pain management practices
- Orthopedic practices
- Outpatient clinic administrators
Codes Discussed
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