My billing office has recently started billing for a physiatry practice..We have some old paperwork for code 64614 stating that this code should be billed with modifier 51. This paper is several years old and came from a company that makes botox. I don't see any reason to bill with a 51 modifier unless this code is part of multilpe procedures? Does anyone have idea about this or any idea where I could find more information about this issue? Any help would be greatly appreciated!