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Multiple Nerve Blocks

Mary ann Posted Mon 24th of June, 2013 15:28:54 PM

I am coding for Neurology and we code 64450 10 times on claims for each nerve, Ex if we are coding for the hand we code 64450 6 times and if we are coding the foot we code 64450 10 using modifier RT 59 50 or LT 59 50. Insurance Humana is not paying for all nerves blocks also Medicare....Is there a better way to code so many injections....Please Help

SuperCoder Answered Mon 24th of June, 2013 23:00:44 PM

A letter of medical necessity stating the purpose of the procedure and how the blocking this many nerves in one session could accomplish greater benefit for the patient versus doing only a lower number of levels. If the explanation makes sense then the carrier will feel that this quantity is justified.

Physicians sometimes perform 64450 (Injection, anesthetic agent; other peripheral nerve or branch) bilaterally. Verify whether you're reporting a bilateral procedure and need to append modifiers accordingly. Some carriers instruct you to append modifier 50 (Bilateral procedure), but other payers prefer LT (Left side) and RT (Right side) to indicate the bilateral injection.

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