Wiki 64483 - 64484 Payer Denial

[JulieDcpc]

Working in pain management. We bill the following combination often with no issue. However, an Arizona Medicaid plan is denying the 64483 and 64484 with "Procedure code inconsistent with modifier or required modifier is misssing". Upon query at the payer, they verified the modifiers submitted were valid for the code, but provided no further explanation. I have been searching policies, LCDs, NCDs, etc with no luck. Does anyone have an idea what the issue might be?

64483-RT
64484-RT
Q9966
J3301


Thanks.

 

[SALLYCPR]

No Modifier on 64483 except 50

We are a pain specialist office we do not use LT or RT on that code. According to AAPC it is not recommended nor required to use any modifier on that code. You CAN bill with a 50 for bilateral but doesn't mean they will allow any additional amount. Try removing the LT and RT and send it back to them

 

[JulieDcpc]

Thanks!

We are a pain specialist office we do not use LT or RT on that code. According to AAPC it is not recommended nor required to use any modifier on that code. You CAN bill with a 50 for bilateral but doesn't mean they will allow any additional amount. Try removing the LT and RT and send it back to them

Thank you! I looked back through CPT Assistant and can see that the LT/RT is payer specific and will continue accordingly.