Wiki Coding denervation

Amber123

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Need help with CPT and modifiers for the following scenario:

Denervation of branches using transection from:
1. Superficial radial nerve
2. Lateral antebrachial cutaneous nerve
3. Palmar cutaneous branch of median nerve

As far as I understand these should be coded using CPT Code 64772. Now, lat. antebrachial cut. nerve originates from C5-C7 while both radial and median nerves originate from C5-T1.

I've narrowed it down to following possibilities:

1. 64772 X 3 (Shows an MUE edit because CPT Code 64772 has an MUE value of 2 and is also a date of service edit)

2. 64772, 64772-XS, 64772-XS (It doesn't show an edit but per CMS FAQ we need to appeal for date of service edit to claim in excess of MUE. Can't we use modifiers at all for these services to show medical necessity?)

Any help would be greatly appreciated.

Thanks!
 
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Need help with CPT and modifiers for the following scenario:

Denervation of branches using transection from:
1. Superficial radial nerve
2. Lateral antebrachial cutaneous nerve
3. Palmar cutaneous branch of median nerve

As far as I understand these should be coded using CPT Code 64772. Now, lat. antebrachial cut. nerve originates from C5-C7 while both radial and median nerves originate from C5-T1.

I've narrowed it down to following possibilities:

1. 64772 X 3 (Shows an MUE edit because CPT Code 64772 has an MUE value of 2 and is also a date of service edit)

2. 64772, 64772-XS, 64772-XS (It doesn't show an edit but per CMS FAQ we need to appeal for date of service edit to claim in excess of MUE. Can't we use modifiers at all for these services to show medical necessity?)

Any help would be greatly appreciated.

Thanks!
I have a similar situation, just wondering if you ever got an answer to this.
Thanks!
 
Anyone have any insight?
I was never able to find formal info on this but I have been billing the procedure below as 64772 x2 units w/64772-XU x2 units to all payers. On the original submission insurances are either paying only the first 2 units or denying all units but all 4 units are being paid on appeal by all payers I've billed so far including BCBSM/BCN/Priority Health/Priority Health Medicare/Medicare.

PROCEDURE PERFORMED
1. Complete wrist denervation through a dorsal approach including neurectomy of the posterior
interosseous nerve.
2. Neurectomy of the anterior interosseus nerve.
3. Neurectomy of the dorsal radial sensory nerve articular branches.
4. Neurectomy of the dorsal ulnar sensory nerve articular branches.
 
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