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appropriate revenue code/cpt PENS treatment

  1. #1
    Default appropriate revenue code/cpt PENS treatment
    Medical Coding Books
    Hi can anybody please help me,

    In our office we use 64565 in billing for PENS treatment -- every now and then we get a denial that that says part of 90 day global surgery ---

    Is there some other code or modifier that we may use? or is this treatment not really payable?

    Does anyone knows the CMS stand on Percutaneous Electrical Nerve Stimulation (PENS)?


    Thanks

  2. Default
    Quote Originally Posted by primpa View Post
    Hi can anybody please help me,

    In our office we use 64565 in billing for PENS treatment -- every now and then we get a denial that that says part of 90 day global surgery ---

    Is there some other code or modifier that we may use? or is this treatment not really payable?

    Does anyone knows the CMS stand on Percutaneous Electrical Nerve Stimulation (PENS)?


    Thanks
    Hello,

    CPT 64565:

    Global Information

    Global-Split

    Preoperative %: 10
    Intraoperative %: 80
    Postoperative %: 10

    Global Period (days): 010

    Regards,
    LMohan

  3. Default PENS Treatment Coding
    Good afternoon,

    Refer to the insurance carrier's policy on PENS treatment. Aetna's policy is to report 64565. Some of the Blues recommend 64999 and some indicate 64555. These procedures do have a global period of 10 day. If the treatment is stages, then utilizing modifier 58 would be appropriate.

  4. #4
    Location
    York, PA
    Posts
    61
    Default question on revenue code 274, you may be able to help?
    Hello. Are you able to tell me what HCPCS codes qualify for revenue code 274 (orthotic and prosthetics)? Can anyone give me a listing of possible HCPCS codes that might fall under revenue code 274 in an ASC setting? We want to be sure to not overlook any possible HCPCS codes that we might use at our ASC as a possible orthotic/prosthetic falling under category 274.

    Thank you for any help.
    ms123
    Last edited by ms123; 08-15-2017 at 07:09 AM.

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