Pain Management Billing

Pain Management Billing & RCM Experts

Revenue cycle solutions for interventional pain practices, opioid compliance, and chronic pain billing challenges.

We help pain specialists navigate complex coding, documentation, and payer guidelines — covering procedures like epidural injections, RFAs, and medication monitoring. Reduce denials and increase reimbursements with our expert billing team.

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Interventional Pain Procedure Coding

We code and bill for spinal injections, nerve blocks, radiofrequency ablation (RFA), and other pain procedures using the latest CPT/ICD-10 guidelines. Our coders ensure documentation supports medical necessity.

Epidural Injection (62321-62323) Facet Joint Injection (64490-64495) RFA (64633-64636) SI Joint Injection (27096)

Medication & Opioid Compliance

We ensure pain practices meet strict regulatory standards when prescribing opioids and managing long-term medications. Our billing specialists help maintain proper documentation and frequency limits.

Urine Drug Testing (80305-80307) Medication Monitoring (G0480-G0483) Tapering Documentation Support

Pre-Authorizations & Coverage Checks

Our team secures prior authorizations for interventional pain procedures and validates payer coverage rules — helping prevent denials and delays.

  • Real-time eligibility and benefit verification
  • Payer-specific documentation requirements
  • Tracking pre-auth approval status
  • Re-authentication for ongoing treatments

Appeals & Denial Management

Pain management claims often face rejections due to lack of documentation, bundling edits, or incorrect modifiers. Our denial team ensures fast appeal submission with strong clinical backup.

Common Denial Reasons:

  • Bundling of fluoroscopy with injection
  • Missing procedure notes or time logs
  • Invalid modifier combinations
  • Frequency limitations on RFA

Our Denial Recovery Steps:

  • Appeal letter generation with medical support
  • Timely filing within payer windows
  • Denial code tracking and trend analysis
  • Provider documentation education

Pain Management-Specific Modifiers

Modifier misuse causes frequent denials in interventional pain billing. We apply correct modifier usage for bilateral procedures, distinct services, and separate anatomical sites.

Modifier Usage Example
-50 Bilateral procedure Bilateral facet injection
-59 Distinct procedural service Injection + separate nerve block
-LT / -RT Left/right side designation SI joint injection (unilateral)

What Pain Specialists Say

Dr. Melissa Ray

Precision Spine & Pain

"They completely restructured our billing process and helped us recover thousands in denied RFA claims. Excellent with compliance, too."

John T., Practice Manager

Regional Pain Consultants

"Their knowledge of pre-auth rules and pain-specific codes makes a huge difference. We now have cleaner claims and fewer write-offs."

Pain Management Billing FAQs

Do you handle fluoroscopy billing separately?

We ensure that fluoroscopy billing is only applied when appropriate and not bundled with injections as per payer guidelines. We use codes like 77003 when applicable.

How do you manage opioid documentation?

We help practices meet documentation requirements for long-term opioid therapy including monitoring, taper plans, and UDT results. This helps reduce audit risk and claim denials.

Do you support implantable pain device billing?

Yes, we handle coding and billing for spinal cord stimulators (63650–63688), trial phases, and permanent implants with correct modifier usage and device-specific documentation.

Want to improve your pain management practice’s billing accuracy?

Schedule a Free Consultation