Wiki 64612

[anggand@aol.com]

Does anybody know if we can still bill cpt code 64612 with a modifer 50 to medicare and blue cross?

 

[raghu.kurna]

YES....you can give

 

[ollielooya]

Yes, our Palmetto MCR accepts 64612-50 if documentation substantiates. Anthem Federal does not accept modifier 50 anymore we have found (an ongoing issue). They want units instead, but that doesn't seem correct per the research I've been archiving, but again, an ongoing issue and very time-consuming. Our local Anthem follows MCR guidelines utilizing modifier 50 on one line. If you have this month's Coding Edge there is a very good article by Marvel Hammer concerning modifiers per the 64612-64614 codes. Basically, you've got to work with each of your carriers to see how their systems "want" the bilateral services to be noted. ---Suzanne E. Byrum CPC

 

[anggand@aol.com]

thank you

I will call blue cross and have them reprocess claim. They denied for improper modifier.