1. Linda Vassallo
   Posted 4 months ago #
   

   Can we bill 64520 bilaterally? in my opinion it is a para-vertebral injection, para meaning both sides.

   Thank-you

2. SuperCoder
   Posted 4 months ago #
   

   For bilateral modifier 50, SuperCoder modifier indicator shows "0" for cpt 64520 which is explained as follows:
   Modifier Indicator 0: 150% bilateral payment adjustment doesn't apply. Payment for two sides (50 or RT/LT) is lower of (a) actual charge for both sides or (b) fee schedule amount for single code.
   So, you are right, we can't bill it bilaterally.

3. Linda Vassallo
   Posted 3 months ago #
   

   Another person at my company uses Becker's ASC Review, I took a look at this and this is what they stated:

   A sympathetic block is a unilateral procedure and can be reported with the appropriate bilateral modifier(s) when injections are performed on each side of the spine. Based on information from CPT Assistant Dec. 2010, sympathetic blocks can be reported for each level that is injected. When the physician performs "incremental" injections at L2, L3 and L4, CPT code 64520 can be reported three times and when utilized, fluoroscopic guidance would be reported with code 77003-TC.

   This is reported from AMA 2010. What should I do, I have conflicting information. I just sent out a paper stating it is not allowed bilaterally?? Do you have something more recent that I can use?

   Linda Vassallo

4. SuperCoder
   Posted 3 months ago #
   

   The information that I have given is most recent from CMS on modifier indicator status. I have confirmed it from other multiple sources.
   You can see this under the title "Modifier Guidelines" on the right hand bottom of the link given below:
   http://www.supercoder.com/code-lookup/cpt/codes/?code=64520&code_arg=feesch

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