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ASC billing Botulinum Toxins

DANIELLE Posted Wed 26th of October, 2016 14:28:12 PM
I have very limited billing experience with ASC. If a HCP goes to an ASC and does a botulinum toxin injection what is to be billed by the ASC and by the office? What modifiers? 64616 bilateral J0587 95874
SuperCoder Answered Thu 27th of October, 2016 01:57:16 AM

As per information given here, the codes mentioned are correct. Code 64616 is billed when injecting neck muscle for conditions such as cervical dystonia. This code can be billed bilaterally with a 50 modifier. Some insurance companies allow the addition of modifiers for bilateral injections. However it is good to check your payer preference to determine when to bill with a modifier. Typically, if a code is listed a second time on the billing sheet without a modifier, it is automatically not reimbursed as it is a duplicate. Hope this helps!! Thank you.

DANIELLE Posted Mon 31st of October, 2016 13:56:20 PM
We are trying to figure out with Ambulatory Surgical Center who bills what? I have very little experience with ASC but know that they are different then what i am used to with office injections. I completely understand the 64616 modifier 50 etc just trying to figure out the difference if being completed at an ASC. What would the HCP bill for and what does the ASC bill for? Example for a Medicare patient
DANIELLE Posted Mon 31st of October, 2016 13:56:21 PM
We are trying to figure out with Ambulatory Surgical Center who bills what? I have very little experience with ASC but know that they are different then what i am used to with office injections. I completely understand the 64616 modifier 50 etc just trying to figure out the difference if being completed at an ASC. What would the HCP bill for and what does the ASC bill for? Example for a Medicare patient
SuperCoder Answered Wed 02nd of November, 2016 07:37:46 AM

ASC are not allowed to bill for injections. HCP can bill it in office only. Thank you.

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