Wiki BILLING 36471 WITH J3490

[mwells2020]

Does anyone know how to get reimbursement from BCBS when billing 36471 & J3490? I keep getting denials that this is not medically necessary. I also read that you can't bill the med with the procedure code. I have 2 of these that I can't get paid. Any insight would be greatly appreciated!

 

[SharonCollachi]

According to an old Medicare national policy that I found:

When reporting sclerotherapy procedures performed on opposite legs, report CPT code 36470 one vein) or 36471 (multiple veins) on separate lines using the RT and LT modifiers. Only one service should be reported for each leg regardless of how many veins are treated. When the procedure is performed for cosmetic purpose, use code V50.1. Please be advised that the practice expense for CPT codes 36470 and 36471 already contain the reimbursement for the sclerosing solution. Providers should not bill separately for the sclerosing solution.

Here is a link to all of the current LCD's on the subject: https://www.google.com/url?sa=t&rct...ocedures.pdf&usg=AOvVaw01LNLxvpSAwfWMiUTvaYJT