Wiki 62311 and 64493 can be charged them together?

[millortsui]

Question is when a physician performed procedure 62311 at the same level and same side as the 64494. Can we bill it or it was considered bundle? Please advice.

 

[MFREUTEL]

They can be coded together but you should be using 64493 for the first level, 64494 is an add on code.

 

[dwaldman]

No bundling issue exists betwen 64493 and 62311

But I would review the local coverage determination policy for you Medicare carrier. If the LCD has a similiar statement, I would print the LCD and share their stance with the physician performing the mentioned procedures.

I am billing WPS Medicare J5 and for Paravertebral Facet Injections LCD it states:

LCD
L30483


Multiple nerve blocks may be necessary for proper evaluation and management of chronic pain in a given patient. It is reasonable to use the modality most likely to establish the diagnosis or treat the presumptive diagnosis. If the first procedure fails to produce the desired effect or rules out the diagnosis, the provider may proceed to the next logical test or treatment if desired.

Accordingly, providing a combination of epidural block, facet joint blocks, bilateral sacroiliac joint injections, lumbar sympathetic blocks or providing more than three levels of facet joint blocks to a patient on the same day is considered not reasonable or necessary. Such therapy can lead to an improper diagnosis or unnecessary treatment.

Indications:
Suspicion of facet joint pain.

Limitations:
Radiculopathy should be ruled out by physical or electrophysiologic examination.

 

[millortsui]

Thanks!