All ASC CPT codes
PM&R Pain Medicine · Pain 62320–64999; 20550–20611

PM&R and Pain Medicine CPT Codes in the ASC and Outpatient Setting

Physical medicine and rehabilitation (PM&R) pain physicians treat chronic spine and joint pain with image-guided injections rather than open surgery, in office-based labs and selected ambulatory surgery centers. The specialty's CPT families are the pain procedure codes in the 62320 to 64999 range and the musculoskeletal injection codes in 20550 to 20611. For example, 64483 describes a transforaminal epidural injection at a lumbar or sacral level, and 20610 describes aspiration or injection of a major joint or bursa.

Whether a code is payable in an ASC depends on its CMS Addendum status. Addendum AA codes are on the ASC Covered Procedures List, meaning Medicare pays them when furnished in an ASC, while Addendum EE lists procedures excluded from ASC payment. DataLily maintains a procedure library that tracks CPT-specific prior authorization and documentation requirements across these families.

PM&R – Pain Medicine codes(1–60 of 329)

Are pain medicine procedures performed in an ASC?

Some are. Many pain injections are routinely done in an office-based lab under place of service 11, while selected procedures are furnished in an ambulatory surgery center. Whether Medicare pays a specific code in an ASC depends on its CMS Addendum status. Codes on Addendum AA are on the ASC Covered Procedures List, and codes on Addendum EE are excluded from ASC payment.

What CPT codes does pain medicine use?

The core families are the pain procedure codes in the 62320 to 64999 range and the musculoskeletal injection codes in 20550 to 20611. Examples include 64483 for a transforaminal epidural injection at a lumbar or sacral level, 64493 for a single-level lumbar or sacral facet joint injection, and 20610 for aspiration or injection of a major joint or bursa. Our dataset maps 329 ASC-relevant codes to this specialty.

Why do pain injection codes have so many billing rules?

Many of these codes specify imaging guidance, laterality, and the number of spinal levels treated, and add-on codes apply for additional levels. Documentation must support the exact level, side, and guidance used, and several codes carry prior authorization requirements. A procedure library that tracks CPT-specific prior authorization and documentation rules helps coders apply the right code and supporting notes for each case.

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