dsisk
Guest
I have been told that the only modifiers we can use when billing anesthesia is modifier 59 or the new Medicare XP, XU, ect. where are the guidelines or rules for this?
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Wiki modifier 50 for anesthesia
- Thread starter dsisk
- Start date
dwaldman
True Blue
Do you have scenario where they performed a bilateral nerve block for postoperative pain?
dsisk
Guest
Yes, the surgeon did a bilateral knee replacement. We billed 01402. Then the surgeon asked us to do bilateral continuous femoral blocks. I coded as 64448-50. This was denied. Should I have coded 64448-50 twice? or 64448 and 64448-50? 
dwaldman
True Blue
1 - 150% payment adjustment for bilateral procedures applies.
CPT 64448 has a bilateral payment indicator of 1 which means Medicare will allow modifier 50 and process it at 150%.
What carrier is it?
Possibly they need 64448 RT 64448 LT or they just want to see the documentation.
But another thing to consider is you stated you billed 64448-50, do you also have modifier 59 in addition if the criteria was met. If not it is denying for NCCI edit or similar edits from a private payer.
CPT 64448 has a bilateral payment indicator of 1 which means Medicare will allow modifier 50 and process it at 150%.
What carrier is it?
Possibly they need 64448 RT 64448 LT or they just want to see the documentation.
But another thing to consider is you stated you billed 64448-50, do you also have modifier 59 in addition if the criteria was met. If not it is denying for NCCI edit or similar edits from a private payer.
LisaAlonso23
True Blue
You need to add both 59 and 50 modifiers to the nerve block.