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cpt code 64612

  1. Default cpt code 64612
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    Hi everyone,

    I recently billed botox for headaches using 64612-50 1 line plus the j0585 to medicare and medicare denied stating the 64612 already has bilateral included. I have always billed it this way and have gotten paid but this time it was denied with an indicator 2. Does anybody know where I can find information on this? I wonder if anything changed.


  2. #2
    Everett, WA
    We know as of April 1st we can no longer append the modifier 50 to 64613 and 64614 as these codes were recently updated in the MPF but didn't see anything in their announcement concerning 64612. MCR has actually being more generous in allowing these codes to be billed bilaterally than the AMA. Not sure why you're having problems with the 64612-50 as we've been billing likewise with the 64612-50 on one line with 1 unit, and wonder if it could be one of those "glitches" when the updates go out affecting prior claims. Not sure, but if you like, will keep you updated. Glad to find someone else on here who biills for similar procedures!

    ---Suzanne E. Byrum, CPC

  3. Default thanks
    That would be great if you can keep me posted. Our pain managment office bills out alot of Botox and I'm afraid to bill anymore if it's going to get denied. Maybe it was the 64613 that got denied and not 64612 I better double check! Thanks.

    Last edited by; 04-11-2011 at 09:05 PM.

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