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64405 as a bilateral

  1. Default 64405 as a bilateral
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    Can anyone help me with this....the Dr. performed a bilateral occipital nerve block and I am not sure what modifiers to use. The payer is Medicare. Do I use 64405 twice and use modifiers LT and RT? Do I use 64405 once and use a 50 modifier? Does Medicare pay for bilateral?

  2. #2
    Location
    Tacoma, WA
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    1,087
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    Quote Originally Posted by kimmerham View Post
    Can anyone help me with this....the Dr. performed a bilateral occipital nerve block and I am not sure what modifiers to use. The payer is Medicare. Do I use 64405 twice and use modifiers LT and RT? Do I use 64405 once and use a 50 modifier? Does Medicare pay for bilateral?
    Medicare rules say bilateral is allowed so you would use the 50 modifier.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

  3. #3
    Location
    Everett, WA
    Posts
    886
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    Our doctor provides this service and we bill out on one line as Arlene stated above, 64405-50 for our Palmetto GBA MCR patients.
    ---Suzanne E. Byrum CPC

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