# RFA 64635 and 64636



## rmness (Jul 11, 2017)

Hoping someone can help or has experienced a similar problem.  We keep getting denials from MNBCBS for 64635 and 64636.  These are done bilaterally and we have tried billing 64635-50, 64636-50 x 3.  64635-50 and then the 64636-50 billed with 1 unit per line x 3 and the denial we have been getting is CO 16 remark code N657 this should be billed with the appropriate code for these services........ these are the correct CPT codes and it seems no matter how we submit them they deny them.  Anyone else have a problem with these or any suggestions?  I have called the insurance company and all they will tell me is they can't tell me how to code.  They are not following CPT guidelines, so I'm not sure what it is they are looking for. Appreciate any help!


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## kjohnson79 (Jul 11, 2017)

*Rfa coding*

I currently bill for pain management and these codes I constantly use in billing.  I haven't had a problem with BCBS with that denial, we sometimes may get a "Not Med Necc" denial, however when I bill these charges I bill as follows
64635-50 1unit
64636-50 1unit
64636- 50,59 1unit

Have you tried using LT/RT Modifiers?
64635 LT
64635 RT.....


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## jflorezc (Jul 16, 2017)

*Fra 64635/64636*

Hi,

I have a lot of this cases in the pass.
I know for experience that BCBS does not pay Mod-50
I tried, successfully, Mod -RT in one line for one level; then Mod -LT for the same level an additional line
for the 3rd level (64636) I added mod -59 in addition to RT and LT to report that is a different level that has been treated

In other words, try this:
64635 -RT
64635 -LT
64636 -RT
64636 -LT
64636 -RT -59
64636 -LT -59

Hope this help.





rmness said:


> Hoping someone can help or has experienced a similar problem.  We keep getting denials from MNBCBS for 64635 and 64636.  These are done bilaterally and we have tried billing 64635-50, 64636-50 x 3.  64635-50 and then the 64636-50 billed with 1 unit per line x 3 and the denial we have been getting is CO 16 remark code N657 this should be billed with the appropriate code for these services........ these are the correct CPT codes and it seems no matter how we submit them they deny them.  Anyone else have a problem with these or any suggestions?  I have called the insurance company and all they will tell me is they can't tell me how to code.  They are not following CPT guidelines, so I'm not sure what it is they are looking for. Appreciate any help!


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## rmness (Aug 10, 2017)

Thank you both so much for your responses.  I have not tried the RT and LT modifiers, but I will give that a shot.


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