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GON 64405 with meds J0670

Guna Posted Thu 06th of November, 2014 09:04:18 AM

We have been used to get denials from insurance like BCBS stated as "drug J0670 (mepivacaine HCL,per 10ml) is included with nerve block code 64405 (Nerve Block, Greater Occipital Nerve) since medications is a payable code when it is billed with nerve block. Please advice is there any modifier can be unbundle this code. I have searched and found nothing from the website, your assistance in this case will be appreciated. Thank you.

SuperCoder Answered Thu 06th of November, 2014 09:40:18 AM

Thanks for your question. CCI edits bundle the use of J0670; Injection, mepivacaine hydrochloride, per 10 ml with 64405; Injection, anesthetic agent; greater occipital nerve. CCI considers J0670 as a column 2 code for 64405 but a modifier -59 (distinct procedural service) can be appended to the drug when justified. Please see the attached link for additional information. Hope this helps.

https://www.supercoder.com/coding-newsletters/my-neurosurgery-coding-alert/cci-162-double-check-before-separately-reporting-paravertebral-facet-injections-article

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