sslagle
Guest
We are billing for a bilateral lumbar RFA for 3 levels and are having trouble getting the add on code to pay. It is 64635 Mod 50 and then since the add on code can no longer be coded with a mod 50 we have done 64636 with 4 separate line items (with no modifier) and it has denied. The 2021 CPT book states "for bilateral procedure, report 64636 twice. Do not report modifier 50 in conjunction with 64636." I can't seem to figure out the way it needs to be coded.
Some options we've come up with are:
64635-50
64636-RT 2 units (double charge amount)
64636-LT 2 units (double charge amount)
64635-50
64636-RT (one unit)
64636-LT (one unit)
64636-RT (one unit)
64636-LT (one unit)
We have also had trouble coding facet injections. This procedure was for bilateral lumbar facets for 3 levels. 64494 and 64495 were coded as one unit with no modifiers as follows:
64493-Mod 50
64494
64494
64495
64495
The claim paid 64493-mod 50, one line item of 64494 and one line item of 64495. They denied one of each of the 64494 and 64495 line items as duplicates.
Any insight on coding with the new bilateral guidelines would be very much appreciated!
Some options we've come up with are:
64635-50
64636-RT 2 units (double charge amount)
64636-LT 2 units (double charge amount)
64635-50
64636-RT (one unit)
64636-LT (one unit)
64636-RT (one unit)
64636-LT (one unit)
We have also had trouble coding facet injections. This procedure was for bilateral lumbar facets for 3 levels. 64494 and 64495 were coded as one unit with no modifiers as follows:
64493-Mod 50
64494
64494
64495
64495
The claim paid 64493-mod 50, one line item of 64494 and one line item of 64495. They denied one of each of the 64494 and 64495 line items as duplicates.
Any insight on coding with the new bilateral guidelines would be very much appreciated!