Radiology Coding Alert

No fooling -- did you catch this important April change?Put a little effort into breaking your somatic nerve injection coding habits, and you're sure to see a payoff. Or if your radiologist is new to pain management, be sure you catch this important reimbursement tip from the start.Check All 2008 Claims for These CodesThe scoop: Medicare changed the bilateral status indicator for many somatic nerve injection codes to "1," meaning Medicare will pay for bilateral injections, says Marvel J. Hammer, RN, CPC, CCS-P, ACS-PM, CHCO, principal of MJH Consulting in Denver.Medicare pays 100 percent of the allowable for the first procedure and 50 percent for the second with modifier 50 (Bilateral procedure).Previously these codes had a "0" status indicator, which meant that if you reported the code with modifier 50 or with RT (Right side) and LT (Left side), Medicare would pay for a single injection only, Hammer says.Watch out: These changes apply to Medicare, but other payers may not update their fee schedules until 2009, Hammer says.Affected codes include those in the somatic nerve range: 64400-64410, 64413-64417 and 64421-64449. All of these codes' descriptors begin with "Injection, anesthetic agent ..."Example: If the interventional radiologist performs bilateral femoral nerve blocks with guidance, you should report 64447 (Injection, anesthetic agent; femoral nerve, single) with the appropriate modifier for the nerve block. Depending on your payer, you may report 64447-50; 64447 and 64447-50; or 64447-LT and 64447-RT. Medicare would pay about $60 for the first injection and $30 for the second.Good news: The change's implementation date was April 7, but it's retroactive to Jan. 1.Resource: You can find the transmittal online, Hammer says, at http://www.cms.hhs.gov/transmittals/downloads/R1482CP.pdf.