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Thread: Bilateral Lumbar/Cervical facet

  1. #11
    Join Date
    Apr 2007
    Jacksonville Beach, FL


    AAPC: Back to School
    I have found that some carriers want one line with a modifier 50, others want 2 lines with the modifier 50 on the second line. It all depends on the carrier and your contract, I have to bill both ways for our facility. I forgot that the fluro is inclusive to these procedures again.

  2. #12

    Default I think this is how it is meant to be reported....

    Quote Originally Posted by cronicizo View Post
    The proper way to bill bilateral cervical/Lumbar injections on four levels is:

    CPT Code Units Modifier
    64490/64493 2 50
    64491/64494 2 50
    64492/64495 4 50

    This is how I see it:

    64490 50 x1
    64491 50 x1
    64492 50 x1

    64493 50 x1
    64494 50 x1
    64495 50 x1

    Not sure why you would report 64490 on one line, then 64490-50 on the next.
    64490 = first level, 50 = both sides.
    That appears to be incorrect, but as someone above said, every carrier is different.
    Last edited by ctpepenelli; 04-06-2011 at 01:04 PM. Reason: forgot to add something

  3. #13


    Quote Originally Posted by brockorama01 View Post
    I completely disagree.

    The 64492 and 64495 expressly state they are to be used for "third and add'l levels". How can you jusitify billing them two times? Four levels should be just 64490, 64491 and 64492 with no fluoro. Bilateral should just be 64490-50, 64494-50 and 64492-50.

    If your 59 modifier actually works, I have 300 MBB's to fix from 2010.

    I agree with you here. We bill these mulitple times during a week and I would bill them just as you have described above. 64490-50, 64491-50, 64492-50 & 64493-50, 64494-50, 64495-50. Hope that helps whoever is trying to bill these.

    Kelsey, CPC

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