# SI injection with Lumbar TF injection



## jenbet25 (Feb 7, 2012)

Can you bill 27096 on the same day as 64483 and 64484??? Please help 

Thank you


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## jmcpolin (Feb 7, 2012)

Per CCI you can bill both if medically necessary with a 59 modifier on the 64483


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## jenbet25 (Feb 7, 2012)

ok thank you soooo much. I am new to this specialty and couldnt find anything that said otherwise but wanted to make sure.


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## vnsconsultants (Dec 29, 2017)

*NEW EDIT - 64484 inclusive to 27096*



jmcpolin said:


> Per CCI you can bill both if medically necessary with a 59 modifier on the 64483



Any particular reason why the add-on TF ESI 64484 is now inclusive as of April 2017 to 27096 with suprascript of "0" for NCCI Edits; whereas, 64483 (primarily level of same TF ESI) is separately reportable with modifier when billed with 27096?

This just does not make sense to me.

Sounds like an error in the coding edits TBH.


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## vnsconsultants (Dec 20, 2018)

*Commented again on this Coding Scenario in another thread*

"If you're reporting 64484 (only) with 27096 then this is automatically going to get denied because 64484 is an add on code and can only be reported with 64483"

That's not what's going on according to the NCCI edits. 
From AAPC CCI Edit Checker: 
"Code 64484 is a column 2 code for 27096, These codes cannot be billed together in any circumstances.
Code 64484 is bundled into code 27096 Code 64484 cannot be billed with 27096.
CCI edit Rule:
Misuse of column two code with column one code"

The NCCI edits show suprascript "0" for 64484 when reported with 27096. It's saying the codes can't be billed together in ANY circumstances... not even when reported with 64483. I think it's a limitation by the carriers on ESI injections due to medical necessity. I think they're curbing how many levels / types of injections can be done at once. It's in total conflict with the NCCI edits that existed before. I've gotten to the point where if we did enough levels of TF ESI, I don't even report the SI Joint Injection because I just know it will cause exhausting denials that will never be paid because the carriers can simply say "See NCCI Edits" and not pay for all the services. I also told my neurosurgeon to stop performing these this way due to the edits... but y'all know how that goes. lol


ALSO: RELATED QUESTION - - Why does NCCI edits show 64483 is inclusive to 27096 when 64483 is the CPT with the HIGHER RVU? Shouldn't 27096 be inclusive to 64483 since it has the LESSER RVU?


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