Question Throacic RFA

jlp19771

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Hello, new coder for pain management ASC. We billed 64633 RT LT, 64634 RT LT, 64634 59 RT LT. Insurance company is denying both 64634's for missing code or modifier. Any advice on how to bill correctly?

Thanks
 

dwaldman

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If you are talking about a 3 level bilateral procedure.

They might want:
64633-50
64634- x4

or if no 50
64633 RT
64633 LT
64634 x 4
 

dwaldman

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Melissa, I suggested it this way because:
64633 50
64634 50
64634 50

Trying to add modifier 59 or modifier 76 to the third line of 64634 50 I have gotten denials saying modifier 59 or 76 is inaccurate modifier usage, if it was two level I would have only suggested 64633 50 64634 50 since I agree that AMA instructions was not widely adopted from at least a Medicare perspective that I am aware of. Back when WPS Medicare LCD accepted 3 levels of RFAs bilateral, they had told us to add the sides for the add on code instead of using 64634 50 on two lines with 59 or 76
 
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