E/M Coding Alert - 2015 Issue 3
Reader Question: Change Your Epidural Injection Guidance Rules
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Article Overview
This reader Q&A reviews a Medicare policy update tied to the 2015 physician fee schedule and the impact on reporting image guidance with select epidural injection procedures. It is aimed at coding and billing professionals who need to understand the scope of the Medicare change, the related federal guidance, and how payer policies may vary. The article discusses the broader reimbursement and compliance context without serving as a substitute for the underlying premium guidance.
Why This Topic Matters
Billing rules for epidural injection services changed in 2015, and the article helps readers identify when Medicare no longer permits separate reporting of imaging guidance. It also matters because practices may need to verify whether commercial payers adopt the same policy, which affects compliance and claim submission workflow.
Article Sections
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Question
A reader asks about Medicare’s 2015 fee schedule update, local coverage guidance, and whether image guidance may still be reported separately with certain epidural injection services.
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Answer
The response summarizes Medicare’s 2015 policy position, cites the federal rulemaking discussion, and notes that practices should compare commercial payer policies with Medicare’s approach.
What You Will Learn
- How Medicare’s 2015 physician fee schedule update affected reporting of image guidance with epidural injection services
- How federal rulemaking language can support payer policy interpretation
- Why commercial payer policies may need to be checked separately from Medicare guidance
- How the article frames the compliance impact for practices billing epidural procedures
Who Should Read This
- Medical coders
- Coding auditors
- Billing staff
- Revenue cycle professionals
- Physician practices
- Compliance teams
Codes Discussed
Code Ranges Discussed
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