MBB's with Aetna

ksellman

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Wasilla, AK
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Had anyone has any guidance on how to bill for medial branch blocks on different levels in the cervical region that you have performed on the 1st and & 2nd MBB?

Ex:
We performed c2-c3 mbb 1 & 2 - not effective, but patient still experiencing neck pain
We performed c5-c7 mbb 1 & 2 - patient had relief from this one, but insurance wont pay as they already paid for c2-c3

Their medical policy only states 3 levels unilateral or bilateral only, doesnt state if/when there could be an additional mbb performed on either same or other levels.

We appealed this and it was denied stating the above, but I wanted to see if anyone else had any luck with appealing this matter.
 

Katie22c

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I am alittle confused by the wording of your question oh how these injections were performed and over what timeframe. But most insurances will only pay for the first two levels on the same day, uni or bi. Our Medicare contractor denys any third facet level and we need to send medical records to support necessity and don't always win.
 
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