Wiki Botox billing 64612 - 64616

sneekersia

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Erie, PA
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We are having some difficulties biling for botox injections having to do with the interpretation of the code. Medicare seems to interpret it differently than BC/BS.
Medicare allows these codes to be billed bilaterally with a -50 modifier and multiple -51, which seems to interpret the code as being allowed for each extremity done. BC/BS does not allow the code billed more than one time each session, which seems to interpret the code as all extremities included.
Is anyone else having this problem?
 
botox

We only bill one time per visit unless bilaterally. They wont reimburse for more. Crazy I know but we had a Botox Rep come to our office and told us (Dr. included) how to bill. I have a sheet they prepared for us, if you are interested, send me an e-mail colleenrcoxmso@hotmail.com with your fax # and I will forward it to you.
Colleen CPC:)
 
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