Pain Management Billing That Captures Every Dollar You've Earned

Interventional pain is one of the most coverage-restricted specialties in medicine. Epidural steroid injections (62321–62327), facet joint injections and medial branch blocks (64490–64495), and radiofrequency ablation (64633–64636) are governed by Local Coverage Determinations that cap the number of levels and sessions per year and require documented conservative-therapy failure. Bill a fourth level when the LCD covers three, or exceed the annual frequency, and the claim denies regardless of medical necessity.

Modifier accuracy is critical: bilateral procedures take modifier 50, distinct levels or sites take 59/XS, and incorrect level sequencing collapses multiple paid services into one. Spinal cord stimulator trials and implants (63650, 63685, 63688) and intrathecal pumps require prior authorization with specific psychological-evaluation and trial documentation — missing any element voids a five-figure claim.

REL1EF codes interventional pain to the governing LCD, tracks per-level and annual frequency limits, applies modifier 50/59/XS correctly, and manages SCS and pump prior authorization end to end. Because pain practices carry significant out-of-network volume, we benchmark injections and procedures against UCR and Fair Health data and negotiate underpaid claims — while killing the root-cause denials: LCD frequency edits, conservative-care documentation gaps, and modifier errors.