Wiki Pain Management

[thomson_theresa@yahoo.com]

I have been getting denials forever from Medicaid for the code 64405 below is example:

Does anyone know if they even pay the codes together out billing software is not giving me edits??

99203 25
64405 50
64450 59

 

[rkmcoder]

What has Medicaid told you?

 

[thomson_theresa@yahoo.com]

That it doesnt like the Modifier but even if i take it off and change still nothing

 

[sbicknell]

Have you already tried separating the 64405 and using -RT and -LT?

 

[dmrussell]

I know that KY MCD will pay like this:
99203 25
64405 2 units
64450 59

 

[nan.coder]

Good Tuesday afternoon,

WPS Medicare J5 considers 64450 to be not medically necessary. See their LCD L35222.

Nancy Boyle, CPC
AAPC St Louis West Chaper