coccydynia

[axm397]

So now, they won't cover impar blocks or sacrococcygeal ligament injections. What is left? How do you guys manage coccydynia and what procedure codes do you use?

Per humana:
"
Humana’s medical policy effective 01/01/16 state the following are all considered E&I. I would anticipate other carriers publishing similar policies if they have not already.


· Cluneal nerve block

· Ganglion Impar block

· Genicular nerve block

· Iliotibial band injection

· Obturator nerve block

· Pedicle screw block/hardwareblock of instrumentation used in spinal fusions

· Repetitive peripheral nerve blocks for chronic nonmalignant pain

· Sacrococcygeal junction/Sacrococcygeal ligament injection (for any indications, including coccydynia)

· Transversus abdominis plan (TA) block


These technologies are considered experimental/investigational as they are not identified as widely used and generally accepted for the proposed uses are reported in Nationally recognized peer-reviewed medical literature published in the English language."

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[101N]

#1 Sitting doughnut: A bunch available on Amazon.

#2 Pelvic floor PT if available in your area.

#3 Behavioral therapies.

 

[lobelsteve]

Chronic intractable pain of the trunk and/or limb.

63650 x2

 

[olafa]

isn't billing impar as LS sympathetic block more descriptive?

 

[nvrsumr]

Wow. Our field becomes less intersting to practice all the time. It is amazing the number of treatments i no longer offer patients.

Probably only get 5 coccydinia patients a year. They are absolutely miserable and do great with a block. I generally do not offer cash pay but will for them.

 

[hyperalgesia]

I don't get the logic that if a procedure is not widely used, it should not be covered. Even from a financial perspective. Maybe it's more like the procedure not being covered won't piss off enough people.

 

[bedrock]

I don't get the logic that if a procedure is not widely used, it should not be covered. Even from a financial perspective. Maybe it's more like the procedure not being covered won't piss off enough people.

That's it right there. Not enough of a critical mass of coccydynia pts to force change.

I just offer these things cash pay. If it hurts enough they will pay for it. With current deductibles that's not very different anyway.