Results 1 to 6 of 6

New RFA Coding

  1. Default New RFA Coding
    Medical Coding Books
    With the new codes im unsure if this is correct we received a denial from BC but they were not sure why this denied out and are suppose to be calling back.

    Procedure was Right L2-L5 RFA with Fluoro
    We coded-

    Blue Cross paid first 2 lines and denied last line as-The charge exceeds the allowable amount for this service.

    Any help would be great appreciated

  2. Default
    That is correct because that would be L3-L4, L4-L5 and L5-S1 facets.

  3. Default New RF codes & modifiers
    I'm having the same issue with Medicare. They are only paying one level of 64634 or 64636. When we called to inquire why we were told we needed to add a modifier to the 3 level but wouldn't say which one. Their system assigned modifier 51 to one of the 64636 codes. I'm thinking perhaps we need to add modifer 76 on the 3rd level.

    Any thoughts on this?

  4. #4
    I didn't think it was necessary to put a modifier on an add-on code.

  5. #5
    If you are billing only right or left side procedures for 3 levels for example

    64636-RT x 2
    additional note box 19 or electronic field stating

    2 additional levels performed on RT side

    I use additional note field every time I am billing multiple units with add on codes to confirm I am aware of the number of levels I am reporting and the note corresponds with the quantity billed on claim.

    If you are billing on separate lines as such

    They might be placing the 51 modifier on the third level in order to bypass their software from denying it as duplicate. You would need to check with the carrier you are billing regarding 76 or 59.

    For example, WPS Medicare J5 does not accept 76 modifier on non radiology procedure/surgery codes. They also do not accept 59 modifier when the codes reported are not recognized by NCCI as code pair. But these modifiers might be necessary based on the carrier's request or processing necesscities. Trying multiple ways of reporting and corresponding with their customer service to possible give a hint of "how to bill" is also sometimes necessary.

  6. Default
    We stick on a 59 modifier on the third line and it pays every time.

Similar Threads

  1. RFA Coding
    By kfrycpc in forum Anesthesia
    Replies: 2
    Last Post: 01-12-2015, 10:55 PM
  2. Coding my first RFA-Help please!
    By Jinx75 in forum Anesthesia
    Replies: 6
    Last Post: 09-12-2013, 09:56 PM
  3. Need help coding RFA's
    By xbrett82 in forum Anesthesia
    Replies: 14
    Last Post: 05-09-2013, 11:09 AM
  4. Coding an SI Joint RFA?
    By melert in forum Outpatient Facilities
    Replies: 2
    Last Post: 07-27-2010, 08:35 AM
  5. Lung mass using RFA-Jan 07 coding edge
    By username7 in forum Gastroenterology
    Replies: 1
    Last Post: 02-25-2008, 10:11 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.