Wiki Pain Managment

[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

 

[csampson3379]

Procedure code 64450 has been billed on the same DOS as another procedure without an appropriate modifier. Typically, procedures or services with the lower relative value should be reported with modifier 51.

Per LCD guidelines, as stated by policy(es) 64400, diagnosis code(s) do not support medical necessity for procedure code 64405.

They do not bundle per ingenix software