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Billing of procedure codes 64613 & 64640

  1. Question Billing of procedure codes 64613 & 64640
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    Greeting. I need your assistance in processing charges for a doctor's office for reimbursement from Workers Comp. insurance. Would it be correct to bill and receive allowances for procedures 64613 & 64640 on a particular date of service, and then bill and receive allowance again for the same procedures performed a few days later? For example,

    1/05/09 64613 allowance?
    64640 allowance?

    1/07/09 64613 allowance?
    64640 allowance?

    1/09/09 64613 allowance?
    64640 allowance?

    Which one would be receiving allowances and which one should not be billed? Or should I consider comparable procedure codes for maximum allowance?

    I appreciate greatly for any response.

    Matthew
    CPC
    Last edited by brandonvalerie; 04-20-2010 at 12:34 PM.

  2. #2
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    Quote Originally Posted by brandonvalerie View Post
    Greeting. I need your assistance in processing charges for a doctor's office for reimbursement from Workers Comp. insurance. Would it be correct to bill and receive allowances for procedures 64613 & 64640 on a particular date of service, and then bill and receive allowance again for the same procedures performed a few days later? For example,

    1/05/09 64613 allowance?
    64640 allowance?

    1/07/09 64613 allowance?
    64640 allowance?

    1/09/09 64613 allowance?
    64640 allowance?

    Which one would be receiving allowances and which one should not be billed? Or should I consider comparable procedure codes for maximum allowance?

    I appreciate greatly for any response.

    Matthew
    CPC

    I am unsure why a provider would be billing chemodenervation of the same area (64613) every couple of days. If using Botox, this should last for 3 - 4 months. For the neurolytic destruction (64640) of peripheral nerves, those could well be different nerves, done on different days for the patient.

    Since this is work comp, you should check with the work comp carrier - they need to approve treatment before they will pay for it, in most cases.

    I hope this helps.
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

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