# Procedure 64640 and medicare



## LaVoncye (Dec 12, 2013)

Good morning, I am in need of some advice

My Dr. Performed a Bilateral lateral branch dorsai rami denervation at the S!, S2, and S3  under Fluoroscopy aslo with IV sedation on a patient with medicare as the primary. I coded the procedure as follows.

64640 50
64640 50, 76 with 2 units 
99144 59

Medicare denied the 2nd level with the B15 stating the service/procedure requires that a qualifying service/procedure be received and covered.

It is also directing me to 835 healthcare policy identification segment. I'm confused if someone can help me it would be greatly appreciated.


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## dwaldman (Dec 16, 2013)

Modifier 50 with quantity 2 could be difficult to process. Need to confirm they accept  76 modifier on surgical procedures  and typically 76 is reported per line with one unit of service, If they don't accept 76 you could report as:

64640 50
64640 50 51
64640 50 51

With an additional note on the claim stating 

3 separate levels performed bilaterally


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