Wiki ASC Medicare Reimbursement on Facet Injections

DCOMPauditor

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Please someone help!!:confused: My ASCs reimbursement on facet injections are getting reduced by Medicare and I am not sure why. CPT clearly states that Add-On codes are excepts from multiple procedure modifier -51, so why is Medicare adding this mod and cutting our additional levels in half.

This is how MCR is processing our claims:
64490 RT 100%
64490 LT 50%
64491 RT 50% (MCR automatically adds -51 mod)
64491 LT 50% (MCR automatically adds -51 mod)
64492 RT 50% (MCR automatically adds -51 mod)
64492 LT 50% (MCR automatically adds -51 mod)

I hope someone can clarify this for me. Thanks
Jaimy
 
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