Wiki 64450 not a benefit any longer

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shegge

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Am I correct in understanding that Medicare is no longer allowing payment for 64450? I am in Colorado, we use Novitas. In a 'proposed draft' DL35033 it indicates the 64450 is not reasonable and necessary and specifically states 64450 is non-covered as of 10/01/2015. It appears the Medicare Managed care programs are following suit as I just received denials.

Question: The CPT book does not have a complete list of body regions, so is there a "go to" code that will maybe take it's place?

Thanks.
 
If it is a proposed Draft then it is not active yet and the reason that you are getting denials is not from it not being covered. How are you billing the service? I am in South Carolina and 64550 is still covered and on the 10/01/15 MUE table.
 
Here's what our LCD for WPS says:

The use of nerve blocks or injections for the treatment of multiple neuropathies or peripheral neuropathies caused by underlying systemic diseases is not considered medically necessary. Medical management using systemic medications is clinically indicated for the treatment of these conditions.

I have not had any luck getting it paid even when the patient has NO underlying systemic disease.
Seems to me they are not going to pay it for any kind of nerve pain.

Also, if you are using it as anethesia for other treatment it is usually included.
 
Thank you very much. I will continue to watch Medicare's decision.

I appreciate your help.


Shelly
 
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