DETERMINATION LETTER: How can I get a copy of the determination (approval/denial) letter for a submitted application?

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Are the radiofrequency ablations allowed now until 3/20/2023, or are already noncovered?

Are there more studies going on to get sacroiliac joint radiofrequencies to be a covered benefit?

CPT code 27096 includes “Image guidance,” what’s the necessary required documentation? Does the physician still need permanently recorded images? Because the fluoroscopy/CT is bundled into the procedure and therefore the fluoroscopy/CT will not be separately reported, would the image guidance in the Radiology section regarding guidance procedures still apply?

Can CRNAs perform these procedures?

Can SIJ ligaments be included in a therapeutic injection?

Can sacroiliac joint injections be performed bilaterally?

Can the patient can have two diagnostic SIJI and then four therapeutic SIJI within a 12-month rolling period for a total of six per year?

Do hospitals bill a different CPT to receive compensation? Usually, the doctor’s office will bill 27096 on 1500 and we bill G0260 for facility claim (UB-04). Will PA need to have both CPTs? 27096 on Medicare fee schedule receives no compensation?

Do we use the KX modifier on facility charges for the ASC?

Do we use the same billing guideline for 64550 and 20551?

Does anti-inflammatory steroid as named in the diagnostic injection mean an injected NSAID or corticosteroid?

Don't use G0260 only applies to POS 49? So, regardless of facility type, G0260 no longer needs to be used? And Is G0260 still fine to bill for an ASC or will they now just have 27096 for facility & should be billed with POS 24 and bill G0260 for our SIJI on the facility side?

For patients who are already receiving treatment do they need to repeat diagnostic procedures under the new policy?

How can provider access post injection pain after the injection?

How do we report unilateral vs. bilateral injections?

How many injections per calendar year?

If SIJ is injected on right and then determined to inject the left side in another session does that count as bilateral?

If a SIJI is performed and a biological agent is added to the injected will the injection still be covered?

If a patient fails an initial diagnostic or therapeutic injection is there a certain criteria that must be fulfilled prior to considering it again, such as duration since the last injection (like over a year ago) or change in symptom character or location?

If using steroid during diagnostic is that when the 12-month clock start?

It does not make sense to use steroids during a diagnostic injection. Please explain.

Many patients have degeneration throughout the spine does that justify need for multiple procedures in same session?

There is a contrast shortage. Use may not be an option.

We are in a group of eight physicians. What if the patient saw a different physician in clinic and a different physician is doing injection. Is that okay?

We receive referrals for an injection with detailed chart notes, does our provider need to see and examine the patient again?

What is the expected duration of steroid effect for diagnostic injection?

What is the purpose of a diagnostic injection, to select patients for fusion surgery only? Also, with diagnostic injections using anesthetic and steroid, what is the duration of effect expected for the steroid?

Take Advantage of Tobacco Counseling When Performing Medicare Wellness Visits 

Take Advantage of Tobacco Counseling When Performing Medicare Wellness Visits Medicare providers can optimize revenue and improve patient outcomes with Medicare's Annual Wellness Visits. These visits help identify gaps in healthcare, increase [...]