Forum - Questions & Answers
Botox Admin code
We are billing Botox admin code 64613 with MOD LT & RT & 59 MOD on one line we used to be reimbursed 100% on one CPT® & the second one @ 50%.
now we are being denied totally for the second line as duplicate & we were told its is paid once a day. any help how can we bill it & get reimbursed for both lines since the doctor injecting the patient on both sides.
re: Botox Admin code
Medicare has a limit of "1"/day but you might want to assign 64613-50, if truly bilateral
re: Botox Admin code
Modifier 50 not allawed with 64613
re: Botox Admin code
http://downloads.cms.gov/medicare-coverage-database/lcd_attachments/24280_34/CodingGuidelinesJ3CB2006.20R7.pdf
So, this has changed?
re: Botox Admin code
CMS removed these two codes from the inherently-bilateral list and added them to the conditionally-bilateral list:
64613: Chemodenervation of muscle(s): muscle(s) innervated by facial nerve
64614: Chemodenervation of muscle(s): cervical spinal muscle(s)
When a provider performs a conditionally bilateral service bilaterally, coders must append modifier -50 (bilateral procedure) to the code. If a code is inherently bilateral, coders should not append modifier -50 when the service is performed bilaterally.
re: Botox Admin code
Thank you very much for the grat help