64405 has MUE-medically unlikey edit of one. If you used 64405 64405-51 with additional note which stated: procedure repeated separate encounters. They would potentially understand what you are trying to relay to them and might need the notes to pay the second one. With the Medicare carrier I am billing they will not accept 64405 64405 76 due to the fact they only want to see the 76 on diagnostic procedures not injection or surgery procedures. I don't ever have to bill the same injection procedures as separate encounters on the same day so I don't know much else add.
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