The impact of national correct coding policy on interventional pain management.

Abstract

Health Care Financing Administration ("HCFA") created the National Correct Coding Council ("NCCC") to help ensure that providers across various jurisdictions received like payment for the same services and use the same codes and provide similar documentation for services performed. As a direct out growth of NCCC's work, HCFA established the National Correct Coding Policy in 1996 and eventually implemented the Medicare "Correct Coding Initiative" to identify and isolate inappropriate coding, unbundling, and other irregularities in coding. To appropriately implement National Correct Coding Policy in interventional pain management an interventional pain management specialist and their staff must be familiar with correct coding policies as well as understand the physicians current procedural terminology (CPT, medical surgical practice and packages, modifiers, separate procedures, comprehensive and component services, incorrect coding/unbundling and various specific issues relevant to practice of interventional pain management) Comprehensive codes include certain defined services that are separately identifiable by other codes known as component codes. Because component codes are captured by comprehensive codes they man not be listed separately when the complete procedure is done. For example, in interventional pain management, 62279, which is continuous lumbar epidural, is considered a comprehensive code. Various component codes include 62270, 62272 - 62274, 62276 - 62278, 62288 and 62289, among others. This review describes National Correct Coding Policy, correct procedural terminology, medical and surgical practice and packages, evaluation and management services along with description of most codes used in interventional pain management with correcting coding edits for comprehensive codes and for mutually exclusive codes.