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2nd request-New CCI edits for botox injections w/nerve blocks

  1. #1
    Everett, WA
    Default 2nd request-New CCI edits for botox injections w/nerve blocks
    Medical Coding Books
    Hope it's ok to repost this question and that perseverance will pay. I see where we can no longer use any modifier with the 64405, 64400, and 64450 codes when done in conjunction with the botox injections. 64612-64614 So, the doctor will still be allowed to be paid for trigger point injections, but not the nerve blocks? Just seems so odd. How shall our doctors adjust to these changes? Find something else to do ? ---Suzanne, CPC-A (candidate for "A" removal!)

  2. #2
    Why do you say that you can't use any modifier on those codes?

  3. #3
    Everett, WA
    Unless I'm totally failing to understand, according to the new CCI edits effective this fourth quarter, column 2 components of Column 1 code 64612 has a designator of "0". And again, please correct me if I am wrong, certain 6xxxx series of codes have been added, and "0" = no circumstances under which a modifier would be appropriate." Is my understanding totally off the wall?

  4. #4
    North Carolina
    I looked at, for example, 64612 and 64405 and the edits have a Zero (0) indicator. Your are correct...these two codes can not be unbundled with a modifier. Is this what you are referring to? If so...This particular edit was implemented 10-1-2005 per the CCI table; not a recent edit. Am I understanding your question correctly?

    (64612 64405 20051001 * 0)

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