Medical Billing Forum

General Category => General Questions => Topic started by: rzepeda on January 26, 2011, 02:56:47 PM

Title: Medicaid Question
Post by: rzepeda on January 26, 2011, 02:56:47 PM
How many Radiofrequency denervation procedures can a pt have for medicaid in a lifetime? The codes I'm using are 64622, 64623, 64626, & 64627. I was told one in a lifetime. But this pt has already had a Cervical RFD and needs to come in for a Lumbar RFD.   Thanks..
Title: Re: Medicaid Question
Post by: tlewis on January 26, 2011, 07:25:51 PM
I would recommend the guidelines for your state. Even the guidelines for what medicaid program they are on in your state. I would call the provider rep for the medicaid program and ask them. If you are still don't like the answer I would look at your state medicaid guidelines and see if there is any possible exceptions and appeal. Pain managements weren't covered on oregon medicaid than they were covered and now they aren't covered again. So check frequently as the guidelines could change.
Title: Re: Medicaid Question
Post by: rzepeda on January 27, 2011, 09:01:16 AM
I have contacted the rep for our area here in Mississippi. She said she's not a coder and would have to forward the question to someone else. Then I got an email from her this morning explaining how to bill the procedures. That was not my question to her. So I emailed her again and explained my question as to how many a patient can have in a lifetime. Maybe she will find the answer I'm looking for.
Thanks for your help.