64640 billing

akaeb

Networker
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33
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Hello! We have some providers wanting to start doing this procedure we are wondering where most people are doing this in the office or hospital?

thank you!
 

sienamt

New
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We do this procedure in our ASC (outpatient surgery). I think it would be rather difficult to tolerate in the office.
 

jwoods22

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64450 and 23700

The provider would like to start completing 23700 in an outpatient setting using 64450 for anesthesia. I cannot find any information from Medicare if these codes are covered together. I see only general anesthesia as I research this 23700 code. Can someone help?
 
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226
Location
Albany
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Which procedure are your doctors interested in? 64640 is RFA of the peripheral nerves and this can bee occipital, genicular, etc. We do these in the office in our procedure room as well as in our ASC.

Melissa Harris, CPC
The Albany and Saratoga Centers for Pain Management
 

Orthocoderpgu

True Blue
Local Chapter Officer
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919
Location
Salt Lake City, UT
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Your doc can't bill for 64450

If your physician is performing the MUA, 23700 your provider cannot bill 64450 for the anesthesia too. That's part of the GSP per CMS & CPT.

Sounds like your provider is grasping at straws to bump up their income / RVU's.
 
Last edited:

mkency

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Help needed. Billed 64640 with 77003

We billed 64640 with 77003; however, it is asking for a primary code for 77003. I need help - what do we bill with 77003?

The patient was taken to the fluoroscopy suite and supine The patient was them prepped and draped in the usual sterile fashion. Anatomic landmarks were identified fluoroscopically. Local anesthesia was obtained with1_ cc of 1% Lidocaine per level. A 22 g sMK needle was advanced under fluoroscopic visualization to left supraorbital foramen AP and lateral view showed excellent neddle positioning. Sensory stimulation was prositive at 0.3 volt or less .We treated each level for 120 sec at 2 Hz and greater than 50 V followed by continous RF treatment at 60-65 degrees centigrade for 60 seconds. After that, all needles were restyletted and withdrawn
 

Henson65

Networker
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44
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We billed 64640 with 77003; however, it is asking for a primary code for 77003. I need help - what do we bill with 77003?

The patient was taken to the fluoroscopy suite and supine The patient was them prepped and draped in the usual sterile fashion. Anatomic landmarks were identified fluoroscopically. Local anesthesia was obtained with1_ cc of 1% Lidocaine per level. A 22 g sMK needle was advanced under fluoroscopic visualization to left supraorbital foramen AP and lateral view showed excellent neddle positioning. Sensory stimulation was prositive at 0.3 volt or less .We treated each level for 120 sec at 2 Hz and greater than 50 V followed by continous RF treatment at 60-65 degrees centigrade for 60 seconds. After that, all needles were restyletted and withdrawn
Try 77002: Code 77002 describes fluoroscopic guidance during pain management injection procedures when your physician requires guidance for needle placement in areas other than the spine. Code 77003 (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures...…..Submitting 64640 tips off the payer that you're not reporting a spinal injection.
 
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