• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki 62311

Create Wiki
M

Marcey28

Guest
Messages
1
Best answers
0
Medicare is not paying for CPT 62311 when it is billed with 64493, 64494, 64495 also for the past couple of months they are not covering our drug screens can some one please help
 
how are you billing for the drug screens? Where are you located? Is the provider supplying appropriate indications for each of the injections? There are no CCI edits stating those codes can't be billed together, but you should check the LCD.
 
You might want to look at the local coverage determination policy for both paravertebral facet injections and urine drug screens to determine specifics in their policy for coverage versus limitations.

For example, in the below LCD from WPS Medicare J5, they do not endorse the performance of a combination of epidurals and facet blocks.

__________________________________________________________


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
 
You must log in or register to reply here.
Top