Billing companies aren’t just vendors. They are an important partner that can make or break a clinic’s revenue cycle. But why do you need a pain management billing company? It is because the healthcare regulations are constantly changing. Apart from that, the pain management coding process is also highly complex. That’s where the smart companies come in.

These practices look for all the positive indicators that can streamline the clinic’s billing process. So, let’s dive into the complex world of pain management billing. Before that, let’s delve deep into this world of pain management.

Pain Management Market Demand

The global pain management market was $81.2 billion in 2024. It is expected to grow to $110 billion by 2035. It has been observed that around 1.5 billion people globally suffer from chronic pain. However, 25% of adults in the US experienced pain for more than three months in 2023. Apart from that, the non-steroidal drugs have been in the market with a 34% market share.

These statistics show that pain management has an increased demand. It is because new diseases are coming each year. For this, new healthcare regulations are coming. Hence, billing for all these complex processes is a bit tricky. But the issue is that there are very few RCM companies out there that tackle this complex pain management billing process. But before diving into how the best pain management billing company does it, let’s dive into the common types of pain and their billing complexities.

Common Types of Pain and Their Billing Complexities

According to the Centers for Disease Control, there are several types of pain management. These include chronic back pain, migraines, and arthritis. It has been observed that from the CDC report, 24.3% of adults experienced chronic pain in 2023. However, 8.5% of people suffered from high-impact chronic pain.

Billing for all these processes is highly complex. For example, the coders need thorough knowledge of ICD-10 codes. These include M54.5 for low back pain and applying the correct modifiers. Apart from that, M15-M19 are used for osteoarthritis, which very few coders know about. Furthermore, nerve blocks and E/M codes require different specialties. So, check out the pain management billing company that knows all the complex nuances of the coding process.

Most Common Pain Management Codes Used

The common codes used in the world of pain management include:

• Epidural injections: These include codes such as 62321 for cervical or thoracic injection. Apart from that, the 62323 code is also used for lumbar injection.

• Facet joint procedure: Here, the 64490 code is used for cervical facet joint nerve injection. Apart from that, 64491 and 64635 codes are also used for second-level thoracic or cervical radiofrequency ablation.

There are several other procedures, such as 20552, that are used for trigger point injection. 64405 is used for the occipital nerve block, and G3003 is used for the chronic pain management bundle.

What Is Chronic Care Management in Pain Management

Chronic care management covers non-face-to-face conditions of care. It includes assessment, care plan, coordination, education, and 24/7 access. It has been observed that in the year 2023, Medicare included HCPCS codes G3002 and G3003 for chronic pain management services. That’s where you need the help of a reputable pain management billing company.

Commonly Billed Services in Pain Management

• Epidural Steroid Injections: These types of injections include corticosteroids inside the patient’s body. However, these injections have been billed using specific CPT codes. These codes vary according to spinal region and the number of treated levels.

• Nerve Blocks: It involves infusing anti-inflammatory agents near specific nerves. These common nerve blocks are based on specific CPT codes. The billing process varies whether the block is postoperative pain management or other types.

• Facet Joint Interventions: Facet joints are used to perform this intervention. It includes radiofrequency ablation and injection to treat pain. Billing for this process is highly specific as it includes different CPT codes in the spinal region. Here, the specific KX modifier and RFA codes are being used to streamline the billing process. That’s where the expertise of a pain management billing company comes into the picture.

• Chronic Pain Management: It involves providing care to patients with multiple chronic conditions. The billing process is different from other services, and it requires thoroughly documenting each and every process to make sure no claim denial occurs. Always remember that new CPM codes have different billing rules than the standard CCM codes.

• Complex Pain Management: This process is not a single process. It is a multidisciplinary approach involving different interventions. This process includes spinal cord simulators, intravenous infusion, as well as intrathecal pain pumps. However, this billing process incorporates several types of CPT codes. It also includes pre-authorization to streamline the claim submission process.

SunKnowledge: The Reliable Partner to Consider

Before going into how we can help you, let’s explore different pain management options. These options include home remedies, occupational therapy, complementary medicine, as well as psychological support. But if these steps are not enough, then you need a reliable pain management billing company that can help you with this.

Now you may have this question: “Which diseases mostly cause severe pain”? These diseases include arthritis, burns, cancer, autoimmune disease, neuropathic pain, headaches, and many more. So, if someone has these types of problems, they can refer to anesthesiologists, pain management specialists, nurses, and many more. That’s where we can help you.

We help with entering patient demographics, insurance verification, pain management coding services, billing charge entry, claim submission, rejection analysis, and AR follow-up. Apart from that, we also provide affordable pricing, the highest productivity standards, and dedicated assistance. Furthermore, we have excellent testimonials, which is one of the main reasons clinics choose us.

One of the main reasons for choosing us is that we provide service at $7 per hour. Apart from that, we also provide dedicated account managers for free. We have no binding contract with 30-day exit clause. Furthermore, we have an exceptional productivity standard and an 80% reduction in operational costs.

We also have the highest collection rate of 97%. We also provide 100’s of client references. Apart from that, we also have $1 million HISCOX insurance coverage. Apart from that, we also provide administrative and clinical services. We also provide help with analytics and IT services.

We have dedicated employees with US phone numbers. Furthermore, we also provide 10% buffer resources. We also have free account supervisors and free IT infrastructure setup. We also provide robust and customized reporting and top-of-the-line infrastructure setup. Apart from that, we also provide real-time audits. Along with that, we also provide 100% HIPAA-HITECH compliance. Finally, our turnaround time is less than 48 hours, and we have low service fees.

Still don’t believe us? Get a free trial and then see it for yourself.

FAQs

What is pain management in medical billing?

Pain management billing incorporates the financial aspect of pain management. It includes coding, revenue cycle management, as well as claim submission.

What are the three types of pain management?

The three types of pain management include physical methods, pharmaceutical methods, as well as psychological methods.