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Thread: Add On Codes In Pain Management

  1. #1
    Join Date
    Apr 2007
    Hamden, Ct

    Default Add On Codes In Pain Management

    AAPC: Back to School
    I have been asked this question- When an ASC is used for CPT Codes 64475-rt/lt, 64476-rt/lt the carriers are paying 100%, 50%, 50%, 50%. The coder is stating multiple rules do not apply to add on codes. She feels the claim should be paid as follows:
    64475 rt 100%
    64475 lt 50%
    64476 rt 100%
    64476 lt 50%
    We do not do these injections where I work. Please advise.

    Donna SanGiovanni CPC
    President/Founder Hamden CT. Local Chapter

  2. #2
    Join Date
    Apr 2007

    Exclamation Add-on codes

    I have billed with those cpt's and they pay as follows: 100%, 50%, 50%, 50%. The multiple procedures rules does apply.

  3. #3
    Join Date
    Apr 2007
    Palm Beach


    I agree, the multiple procedure rule does apply. I have worked with multiple facilities doing those procedures and they always pay 100%, 50%, 50%, 50%

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