the paragraph below is in the recent Edge Blast. the last paragraph is what is stumping me. It states to not report the +64476 as multiple charge lines.
This is how I've been billing:
64475-RT L3
64476-RT L4
64476-RT L5
64476-RT S1
77003
When reading the last paragraph do you interpret that we report the +64476 once with 3 units?
Thank You,
Susan G
The National Correct Coding Initiative Policy Manual (NCCI manual) for Medicare Services and the Medicare Claims Processing Manual state that you should use modifiers to indicate when a service differs from CPT® definition. Up to two modifiers are allowed for each CPT® code on a claim. Use modifier 50 bilateral procedures to indicate bilateral facet joint injections performed on both the right and left sides of a level. This increases reimbursement to 150 percent of the base rate. If a physician performs multiple bilateral injections, attach modifier 50 to each facet joint injection code.
Primary codes 64470 Injection; Paravertebral facet joint or facet joint nerve; cervical/thoracic, single level and 64475 Injection; Paravertebral facet joint or facet joint nerve; lumbar/sacral, single level include pre-surgical and post surgical expenses related to the procedure. Use add-on codes to represent additional levels, not sides. Do not bill multiple lines of CPT® add-on codes +64472 Injection; Paravertebral facet joint or facet joint nerve; cervical/thoracic, each additional level and +64476 Injection; Paravertebral facet joint or facet joint nerve; lumbar/sacral, each additional level in addition to the primary code.
This is how I've been billing:
64475-RT L3
64476-RT L4
64476-RT L5
64476-RT S1
77003
When reading the last paragraph do you interpret that we report the +64476 once with 3 units?
Thank You,
Susan G
The National Correct Coding Initiative Policy Manual (NCCI manual) for Medicare Services and the Medicare Claims Processing Manual state that you should use modifiers to indicate when a service differs from CPT® definition. Up to two modifiers are allowed for each CPT® code on a claim. Use modifier 50 bilateral procedures to indicate bilateral facet joint injections performed on both the right and left sides of a level. This increases reimbursement to 150 percent of the base rate. If a physician performs multiple bilateral injections, attach modifier 50 to each facet joint injection code.
Primary codes 64470 Injection; Paravertebral facet joint or facet joint nerve; cervical/thoracic, single level and 64475 Injection; Paravertebral facet joint or facet joint nerve; lumbar/sacral, single level include pre-surgical and post surgical expenses related to the procedure. Use add-on codes to represent additional levels, not sides. Do not bill multiple lines of CPT® add-on codes +64472 Injection; Paravertebral facet joint or facet joint nerve; cervical/thoracic, each additional level and +64476 Injection; Paravertebral facet joint or facet joint nerve; lumbar/sacral, each additional level in addition to the primary code.