Pain Management Coding

lcole7465

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Toledo, OH
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I'm new to pain management coding for pain clinics. This is a general question, when coding procedure codes such as 64635 with +64636. I get an edit that a -51 or -59 modifier maybe needed. Since the 64636 is a true add on code for additional joint levels, would a modifier be required?? Or is determined by payor?? I was always told in school that with an add on code, modifiers are not required.

Thanks
 
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Albany
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I never had to use -51 or -59 on these codes. Are you billing with the side? RT or LT? Maybe that is the problem. If not I would contact the carrier to see what their rules are.

Melissa Harris, CPC
The Albany and Saratoga Centers for Pain Management
 
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