Eli's Rehab Report
Destruction Not Based on Time
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Question: How should I bill for my physiatrist's time? She spent more than an hour blocking a patient for a Phenol injection. Is there anything we can bill for her time?
Tennessee Subscriber
Answer: The Destruction by Neurolytic Agent codes (646XX) are not based on time. You may consider using a modifier 22 (Unusual procedural service) with the procedure code (such as 64612, Chemodenervation of muscle[s]; muscle[s] innervated by facial nerve [eg, for blepharospasm, hemifacial spasm]).
If you apply the modifier 22, make sure that the documentation clearly supports that the services your physiatrist 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 physiatrist 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 physiatrist performed.
Eli's Rehab Report
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