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CPT codes 64633 and 64634

  1. #1
    Default CPT codes 64633 and 64634
    Medical Coding Books
    I am aware of the new changes for 2012 for these CPT codes but Medicare is denying our claims when we bill the add-on code 64634 with 4 units. We are being told to bill each 64634 on individual lines. I never knew that an add-on code needed to be billed this way. Give me your thoughts on this matter. Thank You as always for your help.

  2. #2
    Default Add on codes
    You need to break them out - the add-on codes generally are not billed as units for these procedures. What can also help is putting the levels of the spine in the narrative (based on experience and payors).

  3. Default
    Each of the add on codes need to be listed on separate lines. I don't ever change quantity. Always list separate.

  4. #4
    it can also depend on the insurance carrier, some want multiple line items, some want one line with multiple units, based on how their software calculates fees. just make sure you know what the payor wants before hand. as long as it all adds up correctly, that's the part that counts.

  5. #5
    Were they stating to put it on separate lines with no modifiers (59 or 76) that sometimes are required to designate separate levels?

    With the Medicare carrier (WPS), I am billing we can not use 76 modifier with "surgery" procedures but only radiology codes such as an MRI of the right knee and right hip. And can only use 59 when there is CCI bundling issue between the code pair that is being reported. If it has to be on separate lines I would put an additional note on the claim such as

    4 addtional levels performed on LT side

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