Author Topic: how to bill 20550 with 64405 for migraines  (Read 1214 times)

HMGBilling

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how to bill 20550 with 64405 for migraines
« on: August 11, 2010, 05:24:38 PM »
I need to know how to bill a 20550 with 64405 for migraines, if its even possible.

oneround

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Re: how to bill 20550 with 64405 for migraines
« Reply #1 on: August 12, 2010, 10:18:13 AM »
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.
 
 
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

HMGBilling

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Re: how to bill 20550 with 64405 for migraines
« Reply #2 on: August 12, 2010, 02:56:37 PM »
but what about when you've added on a office visit with a modifier 25 and youre getting denials on the 64405

oneround

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Re: how to bill 20550 with 64405 for migraines
« Reply #3 on: August 12, 2010, 06:59:59 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?
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare