We Handle the Billing. You Handle the Healing
Pain management medical billing and coding involves high-denial interventional procedures, complex CPT structures, strict frequency limits, and payer-specific documentation rules, making specialized pain management billing expertise essential for accurate reimbursement.
Our billing workflows are explicitly engineered for pain specialists, ensuring accurate coding, compliant documentation, and faster reimbursements.
Our pain management revenue cycle management services cover the full billing lifecycle, from eligibility verification to final reimbursement recovery.
Epidural steroid injections (ESI)
Facet joint injections (cervical, thoracic, lumbar)
Medial branch blocks (MBB)
Radiofrequency ablation (RFA)
Transforaminal injections
SI joint injections
Sympathetic nerve blocks
Caudal injections
Peripheral nerve blocks
EMG/NCV studies
Ultrasound guidance billing
Fluoroscopic guidance
Diagnostic nerve blocks
Pain mapping & localization procedures
Trigger point injections (TPI)
Joint injections (knee, shoulder, hip)
Viscosupplementation
Soft-tissue injections
PRP injections (if covered)
Opioid management documentation billing
Medication management
Chronic condition monitoring
Behavioral/pain psychology integration
Long-term pain follow-ups
Virtual medication management
Follow-up telehealth visits
Remote assessment of chronic pain symptoms
Pain psychology & behavioral health care
Functional restoration program billing
Cognitive behavioral therapy coordination
Multispecialty care documentation alignment
Long-term pain outcome tracking
For each pain management service, we ensure
Complete documentation review for procedures and imaging
Accurate CPT and ICD-10 pairing
NCCI bundling and unbundling checks
MUE and frequency-limit validation
Correct modifier usage (25, 50, 59, XS, XU, LT/RT)
Prior authorization verification when required
Payer-specific pain management rules applied
Medical necessity confirmed per LCD and payer policy
Fix: Automated global-period tracking + coder review.
Diagnosis-to-procedure validation using payer LCD policies.
NCCI edit review with modifier 59, XS, XU application.
Pre-service authorization verification and payer tracking.
Anatomical-level coding with MUE and frequency validation.
CO-50
CO-16
CO-151
CO-97
PR-1
Not medically necessary
Missing info
Frequency limit
Bundled services
Deductible
MBB, RFA, ESI diagnosis mismatch
Missing imaging guidance documentation
Facet/RFA repeated too soon
Multi-level injection billed incorrectly
Medicare chronic pain visits
Correct ICD pairing + attach imaging/notes
Add op-report + imaging rationale
Eligibility check + rescheduling
Apply correct modifiers (59, XS, XU)
Verify Part B benefits upfront
Speak with pain management billing experts experienced in
injections, RF ablation, imaging guidance, and payer edits.
It includes coding, billing, and managing claims for interventional, diagnostic, therapeutic, and chronic pain programs.
It involves multilevel procedures, strict modifier rules, imaging guidance, and payer-specific approval requirements.
ESI, facet, MBB, RFA, TPI, joint injections, nerve blocks, EMG, ultrasound, chronic care, and more.
Yes, trained pain coders ensure CPT, ICD-10, and modifier accuracy.
Yes, with aggressive 30/60/90+ follow-up and payer appeals.
Yes, including interventional groups, chronic pain centers, and hybrid ortho-pain practices.
Yes, we manage prior authorizations and payer approvals for injections, RF ablation, imaging-guided procedures, and chronic pain services.
Modifier 25, 50, 59, XS, XU, and LT/RT are frequently required for multi-procedure and bilateral pain management services.
