Role of correct coding for interventional techniques

Abstract

There has been enormous emphasis on the description and definition of what the physician does for and to the patient, with fraud and abuse evolving as an important aspect of interventional pain medicine. Compliance with the laws and regulations encompassing documentation with coding, billing, and collections, and medical records, is crucial in today's interventional pain medicine practices. The Health Insurance Portability and Accountability Act of 1996, provided the Office of Inspector General and the Federal Bureau of Investigations with broad powers and directed them to identify and prosecute health-care fraud and abuse. The National Correct Coding Council was created by Centers for Medicare and Medicaid Services to help ensure that providers across various jurisdictions receive like payments for the same services, use the same codes and provide similar documentation for services performed. As a direct outgrowth of the National Correct Coding Council's work, the Centers for Medicare and Medicaid Services established the National Correct Coding Policy in 1996 and eventually implemented the Correct Coding Initiative (CCI) to identify and isolate inappropriate coding, unbundling, and other irregularities in coding. Multiple versions of National Correct Coding Policies have been released in the form of National Correct Coding manuals ranging from version 5.0 to 7.2. This review discusses various aspects of correct coding in interventional pain medicine.