Ask the Experts: Insurance Approvals and Denials – Podcast Episode 4

Jump right to the topic you want to explore:

• 3.10    Tactics to Navigate Medicare/Medicaid and Avoid Recoupment and Penalties
• 3.16    Strategies to Document and Schedule ESIs (Medicare)
• 5.53    LCD definition
• 9.52    Tips on Avoiding Peer-to-Peer Reviews — Regardless of Region
• 10.59   Strategies to Document and Schedule Facet Interventions
• 13.57    Billing/coding procedures and consults
• 17.31    KX modifier (diagnostic vs. therapeutic procedure)
• 18.20    Time statutes for repeating RFA
• 19.55    Templated notes
• 20.59    RAC audits
• 24.30    Strategies to Document and Schedule SIJ Ablation/regional LCD differences
• 27.46    Methods to Utilize Advance Beneficiary Notices (ABNs) of Non-Coverage to Get Paid for Services Not Usually Covered by Medicare
• 30.29    Functional Measures for Documentation
• 32.27    Miscellaneous procedures: Genicular RFAs, Trigger Point Injections, SIJ injections, Facet joint injections, etc
• 41.26    Lumbar MBB vs. ESI
• 44.46    Multispecialty vs. Single Specialty Practice Coding
• 48.22    Choice and Dosage of Corticosteroids and Alternative Approaches for ESIs
• 52.55    Miscellaneous questions: percutaneous discectomy, mild procedure, etc
• 56.05    IPSIS Source for Local LCD Information (link?)
• 57.14    Diagnostic SIJ Injection with Corticosteroid
• 58.02    Follow Medicare Documentation Rules When in Doubt

Your expert panel for this October 23, 2023 webinar included:

• D. Scott Kreiner, MD, a physiatrist and interventional spine specialist at Barrow Neurological Institute who also serves on the IPSIS Board as a Member-at-Large; and

• Richard W. Rosenquist, MD, Chairman of the Department of Pain Management in the Anesthesiology Institute of the Cleveland Clinic.

The panel was moderated by Michael B. Furman, MD, MS, Fellowship Director at OSS Health and Chair of the IPSIS Membership Committee.

This webinar is also available as a streamable video.

© 2023 International Pain and Spine Intervention Society – All Rights Reserved
Materials presented in this activity have been made available by the International Pain and Spine Intervention Society for educational purposes only.