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64450 billing help

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cardinal:
Hi
I am looking for help with billing a 64450 nerve block.  I have billed this with various podiatry procedures and am getting denials saying that it is included in another service.  Should I be appending a modifier 51?  Or is another modifier appropriate?

Thanks
Have a wonderful day!

Michele:
You can't just add the modifier to get the service paid.  You need to check with the provider.  Explain that the insurance carriers state it is included in the other service.  If the provider doesn't feel that it should be and feels a modifier is appropriate, they must advise you of that. 

The 51 modifier is basically letting the carrier know there are more than one procedure (multiple procedures performed).

The 59 modifier is to let the carrier know its a separately identifiable procedure.

Michele

cardinal:
Thanks Michele!  Your input is greatly appreciated!

thelakeshow2k:
my (worker's comp) provider bills nerve block.  sometimes it gets paid, sometimes not.  i checked the code in the OMFS and it is listed, so i'm appealing with the argument that the code is covered by the W/C guidelines. i hope my thinking is correct.

Michele:
If it is paid sometimes I would definitely at least call to get an explanation as to why it was denied.  If they cannot give you a reason that makes sense, or their reason is not correct, then definitely appeal.

Michele

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