Interventional pain and spine practices are often paid less than their contracts allow, and the claims look paid so nobody checks. We find the underpayments in injections, ablations and spine surgery, recover them and fix the billing that caused them.
Free analysis. Written findings. No obligation to switch.
No new software for your physicians, schedulers or billing staff.
The biggest losses here are not denials. They are claims that were paid, just not paid enough, and closed as finished.
Payers apply the multiple procedure reduction to add-on codes such as 64484, even though add-ons are exempt from it.
Bilateral procedures go out without modifier 50 or RT and LT, and the payer pays a single side.
Distinct procedures in the same session miss modifier 59 or XU, so payers bundle and reduce them.
Multi-level fusion, instrumentation and revision claims receive partial payments that look reasonable and are never checked.
Facet, ablation and spinal cord stimulator coverage requires prior conservative care, diagnostic blocks or level limits that were not documented.
Without an expected-payment comparison, underpayments repeat every month across every payer.
Injection and ablation codes carry their own rules for levels, sides and imaging. Pick a scenario to see how it should be reported.
Check my injection billingGeneral CPT guidance. Payer coverage policies, level limits and frequency rules vary.
A billing team that works interventional pain and spine surgery claims every day.
Epidurals, facet injections, nerve blocks, ablations and stimulator trials coded by level and side.
62321, 62323, 64483, 64484, 64490–64495, 64633–64636
Fusion, decompression, instrumentation and revision procedures coded from the operative note.
22630, 22633, 22614, 22842–22847, 22853, 63047, 63048
Every payment compared with your contracted rate, with underpaid claims appealed and recovered.
Payer coverage criteria checked and authorizations obtained before injections, ablations and surgery.
Bundling, frequency and medical necessity denials worked to resolution inside the appeal window.
Claim numbers, adjuster details and state fee schedules handled for spine injury cases.
Not sure how much your contracts are under-paying? The free analysis measures it.
Find my underpaid claimsA written comparison of what your claims were paid against what your contracts allow, with every gap sized in dollars.
Two practices that were already billing cleanly, and still being paid less than their contracts allowed.
recovered within 180 days
Fusion, decompression, instrumentation and revision claims were paid below negotiated rates and closed as paid. We compared every payment with the contract and sent the underpaid claims back to the payers.
recovered from underpaid injection claims
Add-on levels were reduced by an incorrect multiple procedure reduction, bilateral injections lacked modifier 50 or RT and LT, and NCCI edits cut payments. Nobody was comparing payments with the contract, so it repeated every month.
Find out how much your contracts are under-paying.
Review my pain and spine billingPractices stay because the work is accurate, communication is steady and the results grow over time.
“MBW is very prompt and sets very high standards in quality and quantity.”
“We have regular meetings and communications with MBW.”
“MBW has allowed us to grow in the past several years.”
Want to see what we would find in your practice?
Underpayments hide in paid claims, and catching them takes a system that checks every payment against the contract.
| Area | Typical in-house billing | MBW RCM |
|---|---|---|
| Payment checks | Claims closed once a payment posts | Every payment compared with the contracted rate |
| Injection coding | Levels, sides and add-ons coded by habit | Levels, laterality and add-on rules applied on every claim |
| Coverage rules | Checked after the payer denies | Checked before the procedure is scheduled |
| Spine surgery | Partial payments accepted as final | Underpaid fusion and instrumentation claims appealed |
| Data security | Depends on the controls your office has | SOC 2 Type II and ISO/IEC 27001, independently audited |
| Cost | Coders, appeals staff and contract analysts to hire | Custom pricing based on your volume and payer mix |
Pain and spine practices handle protected health information on every procedure note and image. Our controls are audited by independent third parties.
Security, availability and confidentiality controls audited over time.
Certified information security management system.
Certified quality management for consistent, accurate billing.
PHI handled under HIPAA privacy and security rules at every step.
Certified India, April 2026 to April 2027. Stable teams mean consistent work on your account.
Share your provider count, procedure mix and payers, and we will send a custom quote with no obligation.
Yes. We compare each payment with the contracted rate for that code and payer, then appeal the claims that were paid short.
Yes. We code epidurals, facet injections, nerve blocks, ablations and stimulator trials, as well as fusion, decompression and instrumentation.
We check each payer’s coverage criteria, such as prior conservative care, diagnostic blocks and level or frequency limits, before the procedure and obtain authorization where required.
It depends on your provider count, claim volume, payer mix and the services you need. Outsourced billing is commonly priced as a percentage of collections or per claim. Request custom pricing for a quote with no obligation.
Yes. We manage claim numbers, adjuster communication and state fee schedules for spine injury claims.
Recent remittance and A/R aging reports, or read-only access to your billing system. A specialist tells you exactly what to send, and nothing changes in your workflow while we review it.
If your payments match your contracts, you get that in writing. If they do not, you get a list of underpaid claims and what they are worth.
One short form. A pain and spine billing specialist follows up with next steps.
