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KX modifier

S

suec

Guru
Messages
120
Location
Clifton Park, NY
Can someone explain the KX modifier for injections? Seems Medicare wants a KX modifier appended for all diagnostic injections (CPT 64633-64636 & 64490-64495) How does a hospital coder know if it is a diagnostic or therapeutic injection.
 
Sue C:
64633-64636 codes would not be a diagnostic procedure, the definition of the procedure states using ultrasound guidance the paravertebral facet joint nerve is destroyed using a neurolytic agent, therefore; this is a therapeutic injection.

64490-64495 The physician first performs the diagnostic facet joint injection using a local anesthetic to identify the specific area generating the pain. If the patient experiences pain relief for a significant period of time following a diagnostic injection, the physician will perform a therapeutic injection on a subsequent date of service using a long-acting local anesthetic in conjunction with a steroid.

I hope this clarifies when the code is diagnostic verses therapeutic for you Sue. Good Luck.
Rhonda
 
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