Medical Coding News: Oig Still Eyes Transforaminal Epidurals

The OIG recently released its findings from its latest review of transforaminal epidural

injections and this is certainly not a good tiding for pain management practitioners. According to the review, 34 percent of transforaminal epidural injection services that Medicare allowed in 2007 did not meet Medicare requirements. The mistakes resulted in approximately $45 million improper payments.

Most mistakes arose from errors in documentation, medical necessity, or coding. CMS plans to educate providers on correct documentation and strengthen safeguards against improper payments.

Understand what you are coding

Often, physicians adminster transforaminal epidurals laterally through the chosen neuroforamen under fluoroscopy. Once there, the doctor carries out an injection at the nerve root area to help relieve the patient's pain. The medication goes into the anterior epidural space, 'bathing' a specific spinal nerve as it exits the spinal cord.

CPT covers four codes to represent transforaminal epidural injections, which you select between based on the injection site and number of injections.

What you should do: You must encourage thorough documentation and know how to code the procedures properly if your providers administer transforaminal epidural injections. For more tips on correctly coding and documenting transforaminal epidural injections and other medical coding news, sign up for a one-stop medical coding website.

When you sign up for one, you'll stay tuned to all details on how to keep your claims clean. Onboard such a website, you'll have access to the latest medical coding articles that will help you code right for your practice. So sign up for one today!

by: James Article

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