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Old 09-15-2009, 12:24 PM
sneekersia sneekersia is offline
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Default Botox billing 64612 - 64616

We are having some difficulties biling for botox injections having to do with the interpretation of the code. Medicare seems to interpret it differently than BC/BS.
Medicare allows these codes to be billed bilaterally with a -50 modifier and multiple -51, which seems to interpret the code as being allowed for each extremity done. BC/BS does not allow the code billed more than one time each session, which seems to interpret the code as all extremities included.
Is anyone else having this problem?
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Old 09-21-2009, 01:01 PM
CRC CPC CRC CPC is offline
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Default botox

We only bill one time per visit unless bilaterally. They wont reimburse for more. Crazy I know but we had a Botox Rep come to our office and told us (Dr. included) how to bill. I have a sheet they prepared for us, if you are interested, send me an e-mail colleenrcoxmso@hotmail.com with your fax # and I will forward it to you.
Colleen CPC
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Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

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