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GoHealthcare Pain Management Specialty Hub

Pain Management Procedure Library

Organized index of pain management procedure resources covering epidural, facet, sacroiliac, peripheral nerve, neuromodulation, minimally invasive spine, and injection services.

EpiduralFacetNeuromodulationMinimally Invasive Spine
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Important notice. This page is an educational and operational reference. It is not a physician training manual, procedural technique guide, coding authority, or legal advice. Coverage determinations, utilization-management criteria, code sets, and payment policies change frequently. Verify every code, coverage position, effective date, and payer requirement against the current primary source before operational reliance.

Verified page address: https://www.gohealthcarellc.com/pain-management-procedure-library.html

On This Page

  1. Purpose of the Procedure Library
  2. Epidural Steroid Injection Family
  3. Facet, Medial Branch and Radiofrequency Family
  4. Sacroiliac, Peripheral Nerve and Joint Procedures
  5. Neuromodulation and Targeted Drug Delivery
  6. Minimally Invasive Spine and Vertebral Procedures
  7. Procedure-Guide Quality Standard
  8. How to Use a Procedure Guide
  9. Related Pain Management Pages
  10. Authoritative References
01

Purpose of the Procedure Library

This page organizes the procedure families that interact with pain management operations. It is an index and workflow guide, not a procedural technique manual or a substitute for the current procedure-specific source documents.

Because page inventories evolve, the authoritative live index is the GoHealthcare MSK Procedure Library. Use the verified links below rather than constructing page addresses from procedure names.

Verified Library Index

https://www.gohealthcarellc.com/procedure-library.html

https://www.gohealthcarellc.com/pain-management-procedure-library.html

02

Epidural Steroid Injection Family

Procedure groupOperational focus
Cervical and thoracic interlaminarImaging and symptom correlation, region-specific safety and coverage requirements, conservative care, frequency, and guidance documentation
Lumbar interlaminarRadicular or qualifying indication, level selection, imaging correlation, prior response, frequency, and code alignment
Cervical, thoracic, lumbar and sacral transforaminalLevel and laterality, imaging correlation, injectate and guidance documentation, frequency, and bilateral or multi-level policy restrictions
Caudal epiduralIndication, anatomic rationale, prior treatment, imaging, frequency, and distinction from other epidural approaches
03

Facet, Medial Branch and Radiofrequency Family

Procedure groupOperational focus
Intra-articular facet injectionIndication, level and laterality, diagnostic versus therapeutic intent, frequency, and imaging guidance
Cervical, thoracic and lumbar medial branch blockDiagnostic sequence, percentage and duration of relief, level count, laterality, sedation restrictions, and functional response
Cervical, thoracic and lumbar radiofrequency ablationRequired diagnostic blocks, congruent levels and side, response thresholds, repeat interval, and documentation of prior benefit
Facet cyst proceduresDistinct indication, imaging, anatomic target, and payer-specific coverage
04

Sacroiliac, Peripheral Nerve and Joint Procedures

Procedure groupOperational focus
Sacroiliac joint injection and related proceduresProvocative maneuvers, imaging, diagnostic response, frequency, and payer-recognized pathway
Genicular and other peripheral nerve blocksAnatomic target, indication, diagnostic response, bilateral or multi-region limitations, and sequence to ablation where applicable
Sympathetic blocksIndication, objective findings, physiologic response, series rules, and function
Trigger point injectionsDistinct muscles and regions, conservative care, frequency, response, and same-session services
Large and small joint, tendon and bursa injectionsSite, laterality, diagnosis, guidance, drug and dose, frequency, and distinct-service documentation
05

Neuromodulation and Targeted Drug Delivery

Procedure groupOperational focus
Spinal cord stimulationPatient selection, conservative alternatives, behavioral evaluation where required, trial, quantified success, implant, revision, and replacement
Dorsal root ganglion stimulationIndication, payer position, trial and permanent criteria, device and site coordination
Peripheral nerve stimulationTarget nerve, indication, temporary versus permanent system, evidence, trial or response, and payer-specific status
Intrathecal drug deliverySystemic treatment history, indication, medication plan, trial where required, implant, refill, monitoring, revision, and replacement
Device removal or revisionReason, complication or end-of-service status, prior system details, imaging or evaluation, and authorization of all components
06

Minimally Invasive Spine and Vertebral Procedures

Procedure groupOperational focus
Basivertebral nerve ablationChronic axial pain phenotype, Modic changes, imaging, conservative care, exclusions, and payer policy
Percutaneous image-guided lumbar decompressionNeurogenic claudication, ligamentum flavum findings, conservative care, imaging, coverage program status, and site
Interspinous spacerSymptoms, imaging, stenosis, flexion relief, surgical risk, levels, device and facility
Vertebroplasty and kyphoplastyFracture age, acuity, imaging, pain correlation, conservative care, malignancy or osteoporosis context, and coverage
Other minimally invasive stabilization or fusionExact device and procedure, policy status, imaging, instability, conservative care, alternatives, and facility episode
07

Procedure-Guide Quality Standard

  • Current CPT and HCPCS orientation with official-source verification.
  • ICD-10-CM diagnostic framework without inventing payer-accepted codes.
  • CMS national guidance, applicable NCDs, LCDs, billing articles, and MAC variation.
  • Commercial payer and delegated-review variation clearly separated from Medicare.
  • Medical-necessity criteria, documentation checklist, frequency and sequencing considerations.
  • Prior authorization workflow, denial prevention, peer-to-peer, appeals, and scheduling readiness.
  • Revenue, site-of-service, facility, implant, drug, and claim coordination.
  • Clinical and specialty-society references, operational insights, key takeaways, and professional disclaimer.
  • Verified internal links only; no placeholder or guessed permalink.
98%GoHealthcare-reported authorization approval performance*
50States supported through national workflows
1Integrated authorization-to-revenue workflow
24/7Operational visibility through structured tracking

*Internal operational performance reported by GoHealthcare Practice Solutions. Results vary by payer, plan, procedure, documentation quality, clinical criteria, jurisdiction, and client workflow. Prior authorization does not guarantee coverage or payment.

08

How to Use a Procedure Guide

  1. Verify the patient-specific payer, plan, product, benefit, network, reviewer, and current policy.
  2. Use the procedure guide to identify the evidence domains and operational dependencies.
  3. Compare the live governing criteria to the record using a criterion-by-criterion crosswalk.
  4. Confirm code, diagnosis, region, level, laterality, units, provider, facility, and site of service.
  5. Reconcile authorization, schedule, procedure note, charge, and claim.
  6. Record policy changes, denials, and audit findings in the organization's controlled knowledge system.

Key Takeaways

  • Never infer an individual procedure permalink; use the live library index.
  • Procedure guidance must distinguish Medicare, commercial payer, delegated reviewer, and operational recommendations.
  • The procedure episode is not complete until the professional and facility claims reconcile to the authorized service.
09

Related Pain Management Pages

Pain Management Specialty Hub

Executive hub for pain management operations, prior authorization, documentation, coding, compliance, revenue cycle, KPIs, AI governance, best practices, procedures, and FAQs.

Open page
https://www.gohealthcarellc.com/pain-management-specialty-hub.html

Pain Management Specialty Overview

Executive overview of interventional pain management scope, care settings, payer governance, medical necessity, and operational dependencies.

Open page
https://www.gohealthcarellc.com/pain-management-specialty-overview.html

Pain Management Practice Operations

Operating model for pain management scheduling, intake, staffing, authorization readiness, site of service, procedure coordination, and governance.

Open page
https://www.gohealthcarellc.com/pain-management-practice-operations.html

Pain Management Prior Authorization

End-to-end pain management prior authorization framework covering criteria mapping, clinical documentation, submission, follow-up, denials, appeals, and quality control.

Open page
https://www.gohealthcarellc.com/pain-management-prior-authorization-460003.html

Pain Management Revenue Cycle

Revenue cycle operating model for pain management from eligibility and authorization through coding, claims, payments, denials, A/R, and revenue integrity.

Open page
https://www.gohealthcarellc.com/pain-management-revenue-cycle.html

Pain Management Documentation

Documentation standards for pain management evaluations, conservative care, imaging correlation, procedure notes, response measurement, medical necessity, and audits.

Open page
https://www.gohealthcarellc.com/pain-management-documentation.html

Pain Management Coding

Operational coding guidance for interventional pain management, including CPT, HCPCS, ICD-10-CM, modifiers, place of service, edits, and documentation alignment.

Open page
https://www.gohealthcarellc.com/pain-management-coding.html

Pain Management Compliance

Compliance framework for pain management practices covering medical necessity, billing integrity, controlled substances, ownership, privacy, audits, and corrective action.

Open page
https://www.gohealthcarellc.com/pain-management-compliance.html

Pain Management KPIs and Metrics

Executive KPI framework for pain management authorization, scheduling, documentation, coding, denials, revenue cycle, quality, workforce, and governance.

Open page
https://www.gohealthcarellc.com/pain-management-kpis-metrics.html

Pain Management AI Applications

Governance-first guide to artificial intelligence and automation in pain management operations, prior authorization, documentation, coding, revenue cycle, and analytics.

Open page
https://www.gohealthcarellc.com/pain-management-ai-applications.html

Pain Management Best Practices

Consolidated best-practice operating standard for pain management practices across access, authorization, documentation, coding, revenue, compliance, technology, and leadership.

Open page
https://www.gohealthcarellc.com/pain-management-best-practices.html

Pain Management Frequently Asked Questions

Executive answers to frequently escalated pain management questions involving prior authorization, documentation, coding, operations, compliance, revenue cycle, and AI.

Open page
https://www.gohealthcarellc.com/pain-management-frequently-asked-questions.html
10

Authoritative References

Use current primary sources and the version in effect for the patient, plan, jurisdiction, procedure, and date of service.

  • Centers for Medicare & Medicaid Services - Medicare Coverage Database: https://www.cms.gov/medicare-coverage-database/search.aspx
  • Centers for Medicare & Medicaid Services - National Correct Coding Initiative: https://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits
  • Centers for Medicare & Medicaid Services - Medicare Physician Fee Schedule: https://www.cms.gov/medicare/payment/fee-schedules/physician
  • Centers for Medicare & Medicaid Services - Ambulatory Surgical Center Payment: https://www.cms.gov/medicare/payment/prospective-payment-systems/ambulatory-surgical-center-asc
  • Centers for Medicare & Medicaid Services - WISeR Model: https://www.cms.gov/priorities/innovation/innovation-models/wiser
  • U.S. Department of Health and Human Services, Office of Inspector General: https://oig.hhs.gov
  • U.S. Department of Health and Human Services - HIPAA for Professionals: https://www.hhs.gov/hipaa/for-professionals/index.html
  • U.S. Drug Enforcement Administration, Diversion Control Division: https://www.deadiversion.usdoj.gov
  • American Medical Association - CPT Resources: https://www.ama-assn.org/practice-management/cpt
  • eviCore by Evernorth - Clinical Guidelines: https://www.evicore.com/provider/clinical-guidelines
  • Carelon Medical Benefits Management - Current Musculoskeletal Guidelines: https://guidelines.carelonmedicalbenefitsmanagement.com/current-musculoskeletal-guidelines/
  • American Society of Interventional Pain Physicians: https://www.asipp.org
  • North American Spine Society: https://www.spine.org
  • GoHealthcare Practice Solutions - Case Studies: https://www.gohealthcarellc.com/case-studies.html

Strengthen Pain Management Operations Across the Entire Episode

GoHealthcare Practice Solutions supports pain management practices, ASCs, hospitals, and MSK organizations across patient access, prior authorization, clinical documentation, coding alignment, denial prevention, revenue cycle management, compliance, performance analytics, and healthcare AI governance.

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Developed by Pinky Maniri

Pinky Maniri, MSc, BSc, CRCR, CSAPM, CSPPM, CSBI, CSPR, CSAF
Founder and Chief Executive Officer, GoHealthcare Practice Solutions
Certified in Healthcare A.I. Governance

This resource reflects more than three decades of healthcare operations experience across pain management, spine, orthopedics, patient access, prior authorization, revenue cycle management, compliance, workforce operations, and healthcare technology.

Professional Disclaimer

This material is intended for professional education and operational guidance. It does not replace clinical judgment, official coding publications, payer policies, benefit-plan documents, legal advice, compliance review, or current CMS guidance. Coverage, authorization, coding, modifiers, units, payment, frequency limitations, and site-of-service rules vary by payer, plan, Medicare Administrative Contractor, delegated utilization-management entity, jurisdiction, contract, and effective date.

Nothing in this resource guarantees authorization, coverage, reimbursement, or a specific claim determination. Verify the live governing policy, current code set, current NCCI edits, and patient-specific benefits before treatment, authorization submission, scheduling, or claim filing. CPT is a registered trademark of the American Medical Association.

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  • Who we are
  • What We Do
  • Leadership
  • Case Studies
  • Knowledge Center
    • 8 Excellence Frameworks™
    • CMS Ambulatory Specialty Model (ASM)
    • Procedure Library
  • Specialty Guides
    • Spine Specialty Hub
    • Pain Management Specialty Hub
    • Neurosurgery Specialty Hub
    • Physical Medicine & Rehabilitation (PM&R) Specialty Hub
    • Orthopedic Surgery Specialty Guide
    • Ambulatory Surgery Center Specialty Hub
  • Prior Authorization Resource Center
    • Overview
    • Our Prior Authorization Process
  • Revenue Cycle Management Resource Center
    • Overview
    • RCM Process
    • Revenue Integrity
  • CLIENT PORTAL
  • READ OUR BLOG
  • GoHealthcare Pain and MSK Value-Based Reimbursement Centerâ„¢
  • Frequently Asked Questions and Answers - GoHealthcare Practice Solutions
  • Remote Therapeutic Monitoring, Remote Physiologic Monitoring, and Chronic Care Management