Wiki 64505 and 64400

[kr2011]

We are performing a bilateral procedure for patients with migraines. The physician injects both the sphenopalatine gaglion and trigeminal nerve. We are receiving denials stating that only 1 unit of service per day is payable. Modifier 50 is appended to show distinction between the RT and LT sides as this can be a bilateral procedure. Does anyone have any information about these injections and how to get both sides paid as each were injected? Thank you.

 

[lace659]

Try billing separate units with LT on one and RT on the other unit. You may even need to add XS modifier on the second unit (replaces 59 modifier for different site). Some payers are picky and won't pay with modifier 50 because they look for LT, RT instead.

 

[calexander1265]

We are performing a bilateral procedure for patients with migraines. The physician injects both the sphenopalatine gaglion and trigeminal nerve. We are receiving denials stating that only 1 unit of service per day is payable. Modifier 50 is appended to show distinction between the RT and LT sides as this can be a bilateral procedure. Does anyone have any information about these injections and how to get both sides paid as each were injected? Thank you.

We have started billing for the the 64505-50 and 64400-50 for the Sphenocath. I am finding there are some insurances which will not pay for the 64400 for the diagnosis headache. One of our doctors was at a meeting this weekend and she said she was told it would be considered double billing to bill both of these codes on the same day.

Any insight your can provide would be appreciated.