Specialized billing and coding for pain management services. From interventional procedures to chronic pain management, we handle the complexities of pain management revenue cycle management.
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Epidural injections, facet blocks, and radiofrequency procedures require precise anatomical coding and modifier usage.
Complex authorization requirements for advanced pain procedures and expensive medications affecting reimbursement.
Where clinics get stuck: MBB/RFA, TFESI/ESI, SI‑joint injections, SCS trials/implants, and UDS frequency rules. Payers deny for missing proof of conservative therapy, lack of specific ICD‑10, insufficient relief from diagnostic blocks, or missing imaging guidance.
Result: Higher medical‑necessity pass rate and fewer CO‑50/PR‑49/CO‑16 denials.
Where clinics get stuck: CO‑97/B7 bundling denials, MUE/unit edits, E/M‑with‑procedure (-25) issues, bilateral/level add‑ons, J‑code units and wastage (JW) documentation.
Result: Cleaner first‑pass claims, fewer reworks, and recovered underpayments.
Expert coding for epidural injections, nerve blocks, and ablation procedures.
Specialized billing for ongoing pain management and medication monitoring.
Comprehensive billing for spinal cord stimulators and pain pumps.
Billing support for workers' compensation pain management claims, with applicable state requirements.
Proactive management of complex authorization requirements.
Yes. We bill procedures such as epidural steroid injections, nerve blocks, and radiofrequency ablation. Our coders review documentation, imaging guidance, laterality, and modifiers on each claim.
Yes. Presumptive and definitive drug tests are coded differently, and many payers have specific medical-necessity rules. We follow each payer's policies and review documentation to support every test billed.
Yes. These cases follow different rules than standard insurance, including state fee schedules, adjuster communication, and attorney or lien arrangements. We track them separately so they get the follow-up they need.
Yes. We can manage prior authorizations and eligibility checks for your practice, or support your staff if you prefer to keep that work in house.
Request a free consultation. We'll review how your billing works today and explain how we would support your practice.
Most practices pay between 4% and 7% of net collections, depending on specialty, monthly volume, and the services included. Flat monthly and per-claim options are also available. Visit our pricing page or request a consultation for an exact quote.