Wiki EPIDURAL STEROID INJECTION 64483

keti

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Hello, our doctor start doing steroid injections in different location.
Does anyone have idea, how it should be billed?
Facility is going to bill their own part, we are going to bill our own part, but as I see this code does not have professional component.
Also I am a bit confused, under which location we should bill this procedure. Per doctor this procedure can't be performed in office and if we bill it under different location, who is going to pay it if the doctor is not in network with that location?
Please help?
 
If the facility that the injection is performed at is not in network then their claim would be processed out of network. The professional claim will be processed according to the participation status of your physician. If he/she is not in network with the patient's insurance then they will process it out of network. However, they will only do that if the patient has out of network benefits. If it is a straight HMO (for either site or physician) and if you do not have a contract with them, neither facility or physician will be paid.
 
64483 is for Transforaminal - Epidural Steroid Injections the code to use is determined on location and if guidance was used or not - 62321 for cervical 62323 for lumbar with guidance, 62320 cervical or thoracic- 62322 lumbar without image guidance
 
My question is not about cpt or ICD codes. My question is about billing. Facility will bill their own UB 04 claim under facility we will bill cms 1500 for doctor. My question is about location and place of service. Does anyone here bill such a claims. Thank you
 
My question is not about cpt or ICD codes. My question is about billing. Facility will bill their own UB 04 claim under facility we will bill cms 1500 for doctor. My question is about location and place of service. Does anyone here bill such a claims. Thank you
My providers perform the procedures in the hospital, surgery centers and office. For the hospital/surgery centers place of service is outpatient unless the patient is inpatient in the hospital. 64483 is payable in an office setting as well. Make sure your place of service match the on the cms 1500 with the facility or yes the claim with deny for invalid place of service
 
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