Our pain management medical billing services streamline revenue cycle operations for interventional pain practices nationwide. We manage complex procedures such as nerve blocks, epidurals, and spinal injections with accuracy and compliance, helping you achieve timely and reliable reimbursements. With over 51.6 million Americans managing chronic pain annually, dependable billing is essential. Let Nexus io handle your revenue cycle while you focus on improving patient outcomes.
Billing for interventional pain procedures requires documentation precision across multiple payer protocols. Nerve blocks, epidurals, and spinal injections use CPT codes such as 62321 (cervical epidural with imaging), 62323 (lumbar epidural with imaging), and 64483 (lumbar transforaminal injection), with modifiers LT, RT, AA, 50, and 59 applied based on procedure laterality and bundling rules.
Medicare, Medicaid, and commercial insurers each maintain distinct medical necessity criteria and prior authorization requirements for pain management services.
Nexus io manages eligibility checks, claim submission, payment tracking, and denial resolution:
Collection Ratio
Revenue Growth
States Served
First Pass Claim Ratio
High patient volumes create documentation backlogs that delay claim submissions. Trigger point injections and radiofrequency ablations require detailed procedure notes that match payer medical necessity standards.
Insurance companies deny claims when clinical documentation lacks specificity about pain location, intensity measurements, or failed conservative treatments. Modifier errors trigger automatic rejections. Applying modifier 59 incorrectly results in bundling denials that require manual appeals.
Common billing obstacles include:
Clean Claims Rate
Reduction in A/R
Coding Accuracy Rate
In-house billing drains resources through staff hiring, software licensing, and infrastructure costs. Nexus io eliminates these expenses with dedicated pain management billing specialists who handle eligibility verification, prior authorizations, coding, and claim submission. Our pain management medical billing services combine certified coding expertise with advanced technology to prevent denials before submission.
Automated denial alerts trigger immediate appeals. Payment posting captures underpayments and contractual adjustments. Your practice avoids staffing turnover and training gaps while maintaining steady reimbursement timelines.
Industry data shows pain management claim denials average 15%, which translates into a significant amount. Nexus io prevents these losses through AI-driven claim scrubbing that catches errors before submission. Pain management medical coders conduct targeted audits on fluoroscopy bundling and modifier application.
Claims for nerve blocks avoid separate billing errors when fluoroscopy is included in codes 62321 and 62323. Practices reduce reversal costs and accelerate reimbursements through proactive error prevention and systematic denial resolution.
AAPC-certified pain management medical coders apply CPT code 62321 for cervical epidural injections with imaging, 62323 for lumbar injections, 64479 for cervical transforaminal procedures, and 64483 for lumbar transforaminal injections. Radiofrequency ablations use codes 64633 for cervical procedures and 64635 for lumbar treatments.
ICD-10 diagnosis codes align with medical necessity documentation. HCPCS codes cover supplies and equipment. Modifiers LT, RT, AA, 50, and 59 prevent bundling denials. EHR integration captures complete procedural details. Pain management billing services from Nexus io maintain accuracy across complex coding requirements.
Pain management practices often schedule procedures across extended hours to accommodate patient treatment protocols. Comprehensive pain management medical billing services require round-the-clock availability to address urgent credentialing issues and time-sensitive appeals.
Nexus io’s pain management billing team provides 24/7 support to resolve Medicare, Medicaid, and commercial payer credentialing issues, medical necessity appeals, and claim follow-up—ensuring accounts are collected as quickly as possible.
Each payer maintains distinct coverage policies for pain procedures. Medicare demands specific LCD compliance for epidural injections. Commercial insurers have set different frequency limits for radiofrequency ablation procedures. Your team should not spend hours decoding authorization requirements that vary by procedure type.
Workers’ compensation claims require causation documentation, which standard medical billing never addresses. Patients who switch from Medicare Advantage to traditional Medicare create eligibility gaps, causing payments to be delayed for weeks. Specialized pain management medical billing services navigate these complexities through dedicated teams trained in payer-specific authorization protocols and benefit coordination.
Our pain management billing specialists deal with payer complications every day. Authorization protocols are confirmed before your patients arrive. Claims are processed without delays in reimbursement or surprise denials due to benefit coordination errors.
Fluoroscopy bundled into CPT code 62321 is still billed separately by practices that do not catch the error. Claims are denied. Bilateral procedures that do not include modifier 50 are automatically rejected. Revenue is in limbo while your team reworks submissions that should have cleared the first time.
Money remains uncollected due to incorrectly coded multi-level injections. Nerve blocks have been downgraded to trigger point injections, which cost your practice hundreds per procedure. These are not random errors. They are patterns that repeat throughout your revenue cycle until the underlying cause is identified and addressed.
Nexus io’s pain management billing specialists conduct coding audits to identify these issues before claims are issued. Scrubbing protocols detect bundling errors. Clean claim rates improve without adding to your staff’s workload.
Pain management medical billing services from Nexus io improve collections through expertise in interventional procedures, workers’ compensation coordination, and multi-level injection documentation. Nexus io manages multi-location pain management practice support, handles post-surgical pain management billing when patients transition from acute to chronic care, and processes emergency consultation claims for breakthrough pain episodes.
What Makes Nexus io the best pain management billing company?
Nexus io employs AAPC-certified coders trained specifically in pain management procedures, including epidurals, nerve blocks, and radiofrequency ablations. Our team understands fluoroscopy bundling rules, modifier requirements for bilateral procedures, and payer-specific utilization limits that general medical billers typically miss.
Why should I outsource pain management billing services to Nexus io?
Outsourcing to Nexus io gives your practice immediate access to pain management billing specialists who handle complex prior authorizations, workers’ compensation coordination, and Medicare LCD compliance. You eliminate the cost of hiring, training, and retaining specialized billing staff while improving clean claim rates and reducing accounts receivable days.
What is the HCPCS code for pain management?
HCPCS codes in pain management typically cover medications, supplies, and equipment rather than procedures. Common examples include J3301 for Kenalog injections and J2001 for lidocaine, while procedural codes use the CPT system (62321, 64483, 64633).
How do you code a pain management diagnosis?
Pain management diagnosis coding uses ICD-10 codes that specify pain location and type, such as M54.16 for lumbar radiculopathy or M54.5 for low back pain. Documentation must support medical necessity and link the diagnosis to the procedure performed for payer approval.
How long does it take to transition to your pain management billing service?
Transitioning to Nexus io typically takes 60-90 days for complete onboarding, including credentialing verification, EHR integration, staff training, and patient account transfer. We begin processing new claims immediately while working through any outstanding accounts receivable from your previous billing system.
Are you ready to partner with Nexus io? Get in touch with our pain management billing specialists today and let our experts streamline your workflow.
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