Epidurals, facet and transforaminal injections, RFA and fluoroscopy are denial magnets — prior auth, level/laterality units and guidance bundling all have to be right. Helix gets them right before the claim goes out.
Clean-claim rate
Avg. collections lift
Days in A/R
Denials overturned
Few specialties draw payer scrutiny like interventional pain. Prior-auth requirements, strict medical-necessity policies, level/laterality unit rules and guidance bundling mean a single oversight can sink an expensive procedure claim.
Helix assigns pain-management coders, runs auth before the procedure, and scrubs level, laterality and guidance on every injection and ablation — so high-value services actually get paid.
Authorization secured and documented before each procedure.
Base + add-on levels with bilateral/laterality modifiers.
Fluoroscopy/ultrasound billed only where separately payable.
LCD/NCD-aligned diagnoses and frequency limits tracked.
Level, laterality and guidance decide what these high-value procedures actually collect. We capture every supportable unit.
| 64483 | Transforaminal epidural, lumbar, single | +64484 |
| 64635 | RFA, lumbar/sacral facet, single | +64636 |
| 64490 | Facet joint injection, cervical, single | +64491 |
| 62323 | Interlaminar epidural, lumbar, w/ imaging | guidance incl. |
| 20552 | Trigger point injection, 1–2 muscles | units |
| 77003 | Fluoroscopic guidance, spine injection | -26 / -TC |
Injections and RFA performed without the payer's required prior auth — the top denial in pain management.
Helix fix: procedure-scheduling auth queue blocks billing until auth is on file.
Injection series billed beyond the payer's allowed frequency per region per year.
Helix fix: frequency tracker flags claims approaching policy limits before submission.
Fluoroscopy billed alongside a code that already includes imaging guidance, triggering a bundling denial.
Helix fix: guidance-inclusion rules prevent unbundling on imaging-included codes.
Multi-level or bilateral injections billed with wrong add-on units or missing -50.
Helix fix: level/laterality logic sets add-on units and the bilateral modifier.
Authorization secured and documented ahead of each injection or RFA.
Level, laterality, guidance and J-code units coded precisely.
LCD/NCD diagnoses and frequency limits validated.
Pain-specific appeals and aged-A/R workdown.
"Auth denials were killing us — expensive procedures performed and never paid. Helix put auth in front of every case and the write-offs stopped."
An interventional pain group with a 16% denial rate driven by missing prior auth, frequency-limit rejections, and incorrect level/laterality units on multi-level injections.
Helix built a procedure-scheduling auth queue, a payer frequency tracker, level/laterality unit logic, and guidance-inclusion scrubbing, plus a focused aged-A/R recovery project.
Clean-claim rate reached 98.3%, A/R days fell to 23, the group recovered $318K in aged claims, and collections rose 26%.
Representative composite based on Helix engagement outcomes. Individual results vary.
"We finally stopped performing procedures we couldn't collect on. Auth-first changed everything."
Result: $122K recovered in year one.
"Multi-level injection units were always wrong. Helix's scrubbing fixed our reimbursement."
Result: +$17K average monthly net collections.
Representative composites based on Helix engagement outcomes. Individual results vary.
Get a free audit of your auth process, injection coding and denial patterns, and a clear picture of the revenue you could be recovering.