Medical Billing Forum

Billing => Billing => : HMGBilling August 11, 2010, 08:24:38 PM

: how to bill 20550 with 64405 for migraines
: HMGBilling August 11, 2010, 08:24:38 PM

I need to know how to bill a 20550 with 64405 for migraines, if its even possible.

: Re: how to bill 20550 with 64405 for migraines
: oneround August 12, 2010, 01:18:13 PM

Code / Description 
64405  N BLOCK INJ, OCCIPITAL M  Rel Wt: 3.72   
 
 
No bundling issues exist 
20550  INJ TENDON SHEATH/LIGAMENT M  Rel Wt: 2.56   
 
 
Code 20550 is a component of Column 1 code 64405 but a modifier is allowed in order to differentiate between the services provided.
 
 

: Re: how to bill 20550 with 64405 for migraines
: HMGBilling August 12, 2010, 05:56:37 PM

but what about when you've added on a office visit with a modifier 25 and youre getting denials on the 64405

: Re: how to bill 20550 with 64405 for migraines
: oneround August 12, 2010, 09:59:59 PM

I have ran these codes with both New PT and Est. PT codes and not getting any bundling issues except on the ten. inj whihc a mod. is allowed  Are you reporting the 64405 with LT/RT as the 150% payment adjustment for bilateral procedures does not apply.    If it's Medicare that you are billing There are several Medicare policies that you can access under Knowledge Base and Medicare B with keyword 'occipital nerve'.

The codes you are billing look correct based upon the info provided the -25 on the E/M is going to appear in the carriers database and you are going to need a modifier if this E/M was separate and distinct which you appear to be doing.

Why are they denying th 64405?