Wiki Medicare and CPT 64561

[Robbin109]

Medicare is denying the 2nd 64561 when billed like this?

64561-LT
64561-RT

Do I need to add a modifier XS to the 2nd line item? Send reports?

The MUE is 1 for this CPT.

Any feedback would be appreciated.

Thank you!

 

[dalanicks@aol.com]

64561

if its denying for frequency I believe co-151, you need to bill it on one line with modifier 50 leave the units as 1 and change the fee

 

[Robbin109]

I didn't think Medicare "liked" modifier 50?

 

[dalanicks@aol.com]

64561

no certain cpt codes medicare will pay more with a 50 - if its frequency they want it on one line without even looking at the eob I bet its co-151, send it back on the portal on one line or call reopening and have them do it

 

[Robbin109]

When billed this way, one line item with a 50, do I need to increase the billed amount?

 

[dalanicks@aol.com]

64561

yes I said that in the first reply leave the units as 1 and double the fee