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Medial Branch Blocks 64493

J

Jocopoco53

Networker
Messages
47
Location
Smithtown, NY
Hello
We are getting denials for Medial Branch Blocks CPT code 64493. We only use Lidocaine we never billed for lidocaine . We are now getting denials to bill for lidocaine.
Is this a new policy has anyone encountered these issues
 
Who is the health plan? What is the reason code?
Is it stopping at the clearinghouse or making it all the way to the payer?
This is an automated flag because you are missing an associated J code with an injection CPT. This isn't new.
Some plans have guidance to use an unlisted J code with a penny charge. You would have to talk to someone to set this up in your EMR/EHR and see what the clearinghouse allows/does not allow as far as penny charges or zero dollar. The NDC and the narrative fields need to be filled for the Lidocaine. Depends on the practice's EHR/EMR, clearinghouse, and who you are sending the claim to.
Sadly, you might have to appeal it if there is no workaround.
 
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