Results 1 to 2 of 2

Thread: Modifier 76 and CPT code 64450

  1. #1

    Default Modifier 76 and CPT code 64450

    Is it appropriate to use modifier 76 on CPT code 64450? My provider is doing a diagnostic bilateral L5, S1, S2, & S3 dorsal primary ramus injection under fluoroscooic visualization. Claim was billed 64450-507659
    64450-507659
    64450-507659
    Medicare is denying the second and third line as duplicates. Please help.
    As always Thanks

  2. #2
    Join Date
    Apr 2007
    Posts
    1,423

    Default

    I assume you are describing the lateral branches w/ 3 levels performed bilateral. When billing WPS Medicare J5, I would not be able use 76 modifier on a surgical procedure code and I would not be able to use the 59 modifier on code pairs that are not subject to NCCI edits. So if I was billing this I would have to bill as such

    64450-50
    64450-50 51 additional note two additional levels performed Bilateral
    64450-50 51

    The additional note on the claim is important, but this might be the type of procedure that requires an anticipated denial with planned appeal for review that this a per level procedure and not a duplicate.

Similar Threads

  1. Cpt 64450
    By vonzilla35 in forum Podiatry
    Replies: 4
    Last Post: 08-20-2015, 09:35 AM
  2. Does cpt code 64450 include cpt s0020?
    By micki127 in forum Anesthesia
    Replies: 1
    Last Post: 04-23-2014, 10:40 AM
  3. Cpt 64450
    By karras in forum Anesthesia
    Replies: 4
    Last Post: 03-16-2014, 06:16 PM
  4. Modifier 76 and CPT code 64450
    By NESmith in forum Modifiers
    Replies: 1
    Last Post: 07-06-2011, 03:11 PM
  5. cpt code 64450
    By grasshopper4716 in forum Pediatrics
    Replies: 2
    Last Post: 05-25-2011, 06:39 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •