Injections-What is the

relyard

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What is the correct way to bill for occipital nerve block and to get paid for the medications as well-J3301 and J3490? I can get the nerve block paid but they will not pay for the medications and this is very expensive.
 

ollielooya

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I take it you're billing 64405 with or without a modifier, and as far as the J3490, this is an unlisted code, and you'll have to make sure you place the details along with the NDC number in box 19, manner in which administrated, dosage, etc. Insurance companies can be very picky about this. We don't always succeed with this approach but it's worth a try. Who is your carrier? Can you provide further details about the denial?

---Suzanne E. Byrum CPC
Noridian MCR-WA State
 

relyard

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The claim is sent to North Carolina Palmetto. I am going to try and send it thru using the 50 modifier for bilateral and see what the come back with. With my software the NDC is put on the service line with the medication listed as well. Now they want me to send the notes so I will try all this first. Thank you very much for the input-Medicare so much fun!!!
 

ollielooya

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I forgot to mention that sending in the notes might be a good idea, as usually when I billed for Palmetto they would ask for them after the fact. So doctor wanted us to send the claims via paper with chart notes attached. It might help. Just make sure you make special notations in box 19 regarding the medication that was billed. This might help too. ---Suzanne
 
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