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Help Needed for 64493,64494,&64495 Bilateral

  1. #1
    Default Help Needed for 64493,64494,&64495 Bilateral
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    We are suddenly receiving clearinghouse edits on use of 64493-50,64494-50,64495-50. These codes appear to be billable as bilateral procedures. The rejection that we are receiving states ....Add-on code 64492/64495 may only be billed once daily.
    Can anyone offer any insight into what is going on with this sets of codes? Thanks!

  2. #2
    Lightbulb 64491,64492,64494,64495 (add on codes per seg.)
    I have run into this on several back procedures: the add on codes specify the additional segments treated. So if for ex: L5 bilateral then you would code: two segments being treated. One on each side. 64493 and 64494 and so forth.

  3. #3
    Thank you for your response, but I am still confused on this. If we performed 64493-50, 64494-50, & 64495-50, how would we bill this correctly, since it is rejecting in CCI edits as only being allowed once per day. According to the CPT 50 is allowed, and multiple levels are to be billed. I am not understanding what they mean by once a day.

  4. Question
    I think they mean only once per person/patient daily

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