Neurology & Pain Management Coding Alert

On Jan. 17, 2001, in a letter to the Washington office of the Association of Neurological Surgeons/Congress of Neurological Surgeons (AANS/CNS), HCFA has agreed to reverse the edits that now exist for nerve block procedures 64405 (greater occipital nerve) and 64450 (other peripheral nerve or branch) when billed in conjunction with another injection code, t (tendon sheath, ligament, trigger points or ganglion cyst). Cherie L. McNett, a representative from the Washington office of the AANS/CNS, reports that now only the CPT 20550 injection is allowed if they occur on the same day modifier -59 (distinct procedural service) is used. Effective in version 7.1 of the CCI edit software (April 1, 2001), the higher paying nerve block codes will be paid by using the same -59 modifier with it instead of the lesser reimbursed 20550. Codes 64405 or 64450 and 20550 must be two separate injections, performed at different sites in order to get paid.