Neurology & Pain Management Coding Alert
Destruction Not Based on Time
Question: How should I bill for my neurologist's time? She spent more than an hour blocking a patient for a phenol injection. Is there anything we can bill for her time? Answer: The codes for destruction by neurolytic agent (64600-64681) are not based on time. You may consider using modifier 22 (Unusual procedural services) with the procedure code (such as 64612, Chemodenervation of muscle[s]; muscle[s] innervated by facial nerve [e.g., for blepharospasm, hemifacial spasm]).
Tennessee Subscriber
If you apply modifier 22, make sure the documentation clearly supports that the services your neurologist provided were greater than usually required.
Remember to provide your payer with an explanation regarding how the service differs from the usual destructive procedure -- that is, how and why the neurologist took more than an hour to block the patient for the phenol injection.
Also, you should request additional compensation equal to the extra work your neurologist performed.
Neurology & Pain Management Coding Alert
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