CPT 64447 Denying for unit or basis of measure

[wonder1963]

Medicare is denying 64447 for unit of measure . I billed per unit with a 59 modifier . can someone tell me how I should bill this?

 

[CodingKing]

Medicare is denying 64447 for unit of measure . I billed per unit with a 59 modifier . can someone tell me how I should bill this?

MUE is 1 per day. If its bilateral use mod 50 w/ 1 unit

 

[albeard99]

Agree with CodingKing.

 

[wonder1963]

Denial

MUE is 1 per day. If its bilateral use mod 50 w/ 1 unit

I did bill for one unit and it is not bilateral this is the rejection i get from medicare



Line: 1 64447 $337.00
Service line rejected
Service line Status: A7 - Acknowledgement/Rejected for Invalid Information - The claim/encounter has invalid information as specified in the Status details and has been rejected.
Service line Detail: 732 - Information submitted inconsistent with billing guidelines. Note: At least one other status code is required to identify the inconsistent information.
Action Taken: Action Code: U - Rejected
Additional Status -----
Service line rejected
Service line Status: A7 - Acknowledgement/Rejected for Invalid Information - The claim/encounter has invalid information as specified in the Status details and has been rejected.
Service line Detail: 659 - Unit or Basis for Measurement Code

 

[mhstrauss]

Why was mod 59 needed?...what else was billed for the same DOS?

 

[LisaAlonso23]

If the block was NOT the primary anesthesia method, we bill 64447 with a 59 at one unit with the dollar amount equal to 7 units. Per the Relative Value Guide, 64447 is 7 units. If the MD used US, we also bill out 76942 with a 26 with dollar amount equal to 2 units.

We found that insurance companies are paying when we bill it out this way.

 

[k8mbee]

Medicare is denying 64447 for unit of measure . I billed per unit with a 59 modifier . can someone tell me how I should bill this?

I understand this is a very old thread however, I am finding the same issue. Primary anesthesia code is 01992-QZ-QS-P2 (moderate sedation, CRNA) billed as Minutes, post-op pain block 64447-59 billed as 1 Unit denying by Medicare via clearinghouse for same reason as above (Acknowledgement/Rejected for Invalid Information-The claim/encounter has invalid information as specified in the Status details and has been rejected : Information submitted inconsistent with billing guidelines... Acknowledgement/Rejected for Invalid Information-The claim/encounter has invalid information as specified in the Status details and has been rejected : Unit or Basis for Measurement Code)."

Does anyone have any suggestions? Does this need to be billed as Minutes for some reason? I have researched everywhere I know and can still not figure out what the issue is however, I am new to anesthesia billing. Thank you.

 

[LisaAlonso23]

I understand this is a very old thread however, I am finding the same issue. Primary anesthesia code is 01992-QZ-QS-P2 (moderate sedation, CRNA) billed as Minutes, post-op pain block 64447-59 billed as 1 Unit denying by Medicare via clearinghouse for same reason as above (Acknowledgement/Rejected for Invalid Information-The claim/encounter has invalid information as specified in the Status details and has been rejected : Information submitted inconsistent with billing guidelines... Acknowledgement/Rejected for Invalid Information-The claim/encounter has invalid information as specified in the Status details and has been rejected : Unit or Basis for Measurement Code)."

Does anyone have any suggestions? Does this need to be billed as Minutes for some reason? I have researched everywhere I know and can still not figure out what the issue is however, I am new to anesthesia billing. Thank you

If moderate sedation or MAC are the anesthesia method, the anesthesia method on the claim should be Regional. Blocks may not be billed separately for these anesthesia methods.

You may only bill blocks separately when the Spinal or General are the anesthesia methods.