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Thread: cpt 64520 & 64640

  1. #1
    Join Date
    Apr 2007

    Question cpt 64520 & 64640

    AAPC: Back to School
    Is it correct to code cpt 64520 or 64640 twice on the same date of service for Medicare pts and for third party payors (mainly workers comp)? I have a doctor who says yes if he injected twice, it needs to be coded and billed twice. I recently went to a company sponsored seminar that said no, you can only code it once per encounter regardless of the number of injections. I have researched on the internet until I have a migraine trying to find something in writing that states either way to show the doctor and my supervisor. Any well help would be appreciated.


  2. #2


    Hi Diann,
    I say yes you can bill these more than once per day!

  3. #3
    Join Date
    Apr 2007


    Thank you for your quick response. It just gets frustrating when one entity says yes and another says no and face it CMS website is not that user-friendly (sorry to say!).

  4. #4
    Join Date
    Apr 2007
    Athens, Ga.


    We use 64640 all the time and bill it per injection.
    Walker Bachman, CPC, CPPM

  5. #5
    Join Date
    Apr 2007
    St. Joseph County, Indiana


    I'm suspicous of the 64520 x 2. 64520 are lumbar sympathetic blocks which can be done bilaterally (50 modifier). If not done bilaterally, I'm not sure why he would be doing them 2 x.

    64640 can be per injection. Its not that common. What nerves is he injecting?

    Brock Berta
    Billing Czar & Arm-chair Pain Doctor

  6. #6

    Default 64520

    64520 lumbar (paravertebral sympathetic) L2 and L3, can you code 64520 twice as he wants to co.

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