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Thread: Pain Management

  1. #1

    Default Pain Management

    AAPC: Back to School
    I have been getting denials forever from Medicaid for the code 64405 below is example:

    Does anyone know if they even pay the codes together out billing software is not giving me edits??

    99203 25
    64405 50
    64450 59

  2. #2


    What has Medicaid told you?

  3. #3


    That it doesnt like the Modifier but even if i take it off and change still nothing

  4. #4


    Have you already tried separating the 64405 and using -RT and -LT?

  5. #5


    I know that KY MCD will pay like this:
    99203 25
    64405 2 units
    64450 59

  6. #6
    Join Date
    Apr 2007
    St Louis West MO Chapter

    Default Pain Management

    Good Tuesday afternoon,

    WPS Medicare J5 considers 64450 to be not medically necessary. See their LCD L35222.

    Nancy Boyle, CPC
    AAPC St Louis West Chaper

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