Need help with CPT code 64493

JWEILER

Contributor
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I have a provider that does CPT code 64493 but does not use image guidance. Would it be appropriate to use -26 modifier even though guidance is not being used? I am open to working experience of other coders. Thank you for your help!
 

conniff

Networker
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64493

Hi
since 64493 is a surgical code, you would not use a 26mod.
..you can confirm that with the cms physician fee schedule which indicates codes that can be billed globally, with 26, and/or with tc
..you should query the md, maybe forgot to mention in report.
..otherwise if truly done without any guidance, you could go with 64493-52. reduced service indicating not all aspects of 64493 were performed without changing the description of 64493.
 

CodingKing

True Blue
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Modifier 52 would not be appropriate. CPT Guidelines state [FONT=&quot]fluoroscopy or CT must be used to report codes in the range of [/FONT]64490-64495. If no imaging is performed to report 20552-20553, If ultrasound guidance use 0213T-0218T.
 
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