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Journal of Medical Practice Management


Forum Discussion Areas > Ask Us a Question > Modifiers for CPT® 64450
  Modifiers for CPT® 64450
swetha
Modifiers for CPT® 64450
Posted:
Apr 8 2013, 9:31 PM
What modifier need to be used for the CPT® 64450 for MCR insurance

 
ch76606
re: Modifiers for CPT® 64450
Posted:
Apr 9 2013, 12:56 PM
It depends on your carrier. Go to CMS.gov and go to your area's fee schedule. There is a tool on that website where you can enter the CPT® and it will give you a list of modifiers that are allowed for the procedure.

 
bsergi
re: Modifiers for CPT® 64450
Posted:
Apr 9 2013, 2:05 PM
The question is too broad.

 
tlkbilling
re: Modifiers for CPT® 64450
Posted:
Apr 10 2013, 2:33 PM
In response to correct modifer for 64450, do you bill: 64450 50 64450 50, 51 64450 50, 51

for 3 nerve branches? Receiving denial of CO236 when just using RT,LT with 64450.

Appreciate any responses, greatly?

 
tlkbilling
re: Modifiers for CPT® 64450
Posted:
Apr 10 2013, 2:34 PM
[In response to correct modifer for 64450, do you bill: 64450 50 64450 50, 51 64450 50, 51

for 3 nerve branches? Receiving denial of CO236 when just using RT,LT with 64450.

Appreciate any responses, greatly?]

 
ch76606
re: Modifiers for CPT® 64450
Posted:
Apr 10 2013, 7:00 PM
I know that modifier 50 and 51 is allowed on 64450 but LT and RT are not listed. I would recommend checking with your carrier to make sure.

When a peripheral nerve or branch block is performed for anesthesia by the surgeon, report 64450 with modifier 47. This is a unilateral procedure. If performed bilaterally, some payers require that the service be reported twice with modifier 50 appended to the second code while others require identification of the service only once with modifier 50 appended. Check with individual payers. Modifier 50 identifies a procedure performed identically on the opposite side of the body (mirror image). Some payers may allow fluoroscopic guidance to be reported separately using 77002. Medicare considers this guidance inclusive in the surgical code and will not separately reimburse for this without use of a modifier 59 and documentation in the medical record to support that modifier.

I hope this helps.

 
tlkbilling
re: Modifiers for CPT® 64450
Posted:
Apr 11 2013, 9:23 AM
Thanks so much for your reply, I did look up on CMS.gov tool page for what modifers are allowed, I was not able to identify which ones were accepted. This seems to be a battle with how to bill for these blocks. Any other suggestions?

 
bsergi
re: Modifiers for CPT® 64450
Posted:
Apr 11 2013, 12:03 PM
Stay away from LT,RT if you're trying to report being performed bilaterally. Bill it all on one line 64450-50 with 1 unit. For third one I would try mod51 and/or 59.

 

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The Field Guide to Physician Coding 2nd Edition
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