Wiki Penile block-64450

[hopeu6]

In previous conferences we received information to code for the penile block using cpt 64450 with modifier 59. This is usually performed with a meatoplasty, circumcision etc. Recently we have been getting edits on this combination. Is anyone aware of the guidelines changing for this?

Thanks

 

[OCD_coder]

64450 is considered inclusive when the RVU values are determined. It it bundled into the primary CPT code because the physician has to do a block and is considered "typical" work for a meatoplasty or circumcision.

So billing with a 59 modifier and unbundling is not appropriate.

Compare it to a laceration repair, the physician has to numb the area in order to suture a wound.

 

[sbicknell]

I agree with the above. The block became inclusive it seems at least 4-5 years ago. Mod -59 to try and bypass payer or CCI edits is not appropriate