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64493 and 77003

  1. Default 64493 and 77003
    Medical Coding Books
    Hi
    My doc performed an 64493, injection paravertebral facet with fluoroscopic guidance, 77003, Medicare is denying stating inclusive, can I add a 59 modifier for this?

    Thanks

  2. Red face
    as per CPT book it states 64493 is with image guidance (fluoroscopy or CT) so it is not separately reported like the old facet codes were for 2009.

    Sorry, Medicare is correct!

    Susan

  3. #3
    Location
    North Carolina
    Posts
    3,126
    Default
    Quote Originally Posted by richelle25 View Post
    Hi
    My doc performed an 64493, injection paravertebral facet with fluoroscopic guidance, 77003, Medicare is denying stating inclusive, can I add a 59 modifier for this?

    Thanks
    The description for facet injections changed in 2010; now including fluoro. Adding modifier 59 would indicate that separate encounters took place or two separate anatomic locations were involved and this would be inappropriate for the scenario you presented.

  4. Default
    Thank you!!

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