Medical necessity on procedures
Injections and ablations denied for missing prerequisites. Requirements checked before scheduling.
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Pain Management medical billing services
Pain management bills interventional procedures — epidurals, facet injections, radiofrequency ablation, spinal cord stimulators — under strict medical-necessity policies, prior authorization and frequency limits, plus E/M and medication management with their own documentation demands.
What makes pain management billing different
General billers treat every specialty the same. These are the rules, code families and payer habits that decide whether pain management claims pay the first time.
- Epidural (62320–62327) and facet (64490–64495) codes are level- and side-specific, with bilateral and multi-level rules that differ between Medicare and commercial payers.
- Radiofrequency ablation requires documented diagnostic blocks with defined relief percentages before payers cover it.
- Imaging guidance is bundled into many injection codes and separately billable with others; billing it wrong is a common denial.
- Spinal cord stimulator trials and implants require authorization, psychological evaluation documentation and specific trial-to-implant timelines.
Denials we see most in pain management
Every denial gets a root cause, a fix and a feedback loop, so the same denial stops coming back.
Guidance bundling errors
Fluoroscopy billed with codes that include it. NCCI edits applied.
Frequency limits
Repeat injections denied as too frequent. Tracked per patient and policy.
How Core MB bills for pain management
A dedicated team that already knows your payers' rules, plus the reporting to prove it is working. Credentialing for new pain management providers runs in the same system, tracked live in your client portal.
- Pre-procedure requirement checks for every interventional service.
- Level, side and guidance coding under payer-specific rules.
- Authorization and frequency tracking per patient.
Everything in the service
The full revenue cycle as standard for pain management practices, priced on what we collect for you. Take all of it, or start with one piece such as AR recovery or credentialing.
- Insurance verification and eligibility checks
- Charge entry and specialty-specific coding review
- Claim scrubbing and electronic submission
- Payer follow-up on every open claim
- Denial management and appeals
- Payment posting and reconciliation
- Accounts receivable recovery
- Patient statements and balance support
- Monthly reporting you can read in five minutes
- Provider credentialing and payer enrollment
Pain Management billing questions
Why are pain procedures denied?
Most denials are prerequisite failures: diagnostic blocks not documented, conservative therapy not tried, frequency exceeded. We check the policy requirements before the procedure is scheduled.
Is imaging guidance billable separately?
It depends on the code. Many injection codes include guidance; billing it separately is denied. We apply the right pairing.
Do you handle spinal cord stimulator authorizations?
Yes, including the trial and implant stages and the documentation payers require for each.
How do we get started with Core MB for pain management billing?
Send us your specialty, provider count and monthly claim volume through the quote form and we will come back with a written proposal. Transitions run alongside your current billing so nothing is dropped, and credentialing for new pain management providers can start at the same time.
More in therapy, rehabilitation and musculoskeletal
Find out what your pain management billing is leaving on the table
Send us a snapshot of your current billing and we will come back with a quote and a realistic view of recoverable revenue.