Practice Management and Prior Authorization for Interventional Pain and Orthopedic Spine Surgery. Patients Access and Healthcare Financial Management Consulting Company | GoHealthcare Practice Solutions
  • About
  • Services
    • Prior Authorization Services
    • Patient Access Services
    • Medical Scribe Services
    • Coding and Documentation Audit Review
    • ​E/M & Surgical Coding Education and Training
    • RCM FULL SERVICES
  • READ OUR BLOG
  • Let's Meet in Person
    • 2023 ORTHOPEDIC VALUE BASED CARE CONFERENCE
    • 2023 AAOS Annual Meeting of the American Academy of Orthopaedic Surgeons
    • 2023 ASIPP 25th Annual Meeting of the American Society of Interventional Pain Management
    • 2023 Becker's 20th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference
    • 2023 FSIPP Annual Conference by FSIPP FSPMR Florida Society Of Interventional Pain Physicians
    • 2023 New York and New Jersey Pain Medicine Symposium
  • Testimonials
  • Frequently Asked Questions and Answers - GoHealthcare Practice Solutions
  • FREE ASSESSMENT
  • Readers Questions

Blog Posts

How to code MBB - Block from Lumbar L5 to S3? CPT 64451 versus CPT 64493

3/6/2023

0 Comments

 
HOW TO CODE MBB - BLOCK FROM LUMBAR L5 TO S3? CPT 64451 VERSUS CPT 64493
Does this sound familiar? - ​BILLING CODING L5 DORSAL RAMUS AND S1, S2, S3 LATERAL BRANCH BLOCK
HOW TO CODE MBB - BLOCK FROM LUMBAR L5 TO S3? CPT 64451 VERSUS CPT 64493
HOW TO CODE MBB - BLOCK FROM LUMBAR L5 TO S3? CPT 64451 VERSUS CPT 64493
​When CPT code 64451 is performed from L5 to S3, it should be reported as a single unit of service regardless of the number of sacroiliac joints injected. Each sacroiliac joint should not be counted as a separate injection. This is because the injection is being performed at the sacral plexus, which is located near the sacroiliac joint but is a different structure.
This information is supported by the American Medical Association's CPT Assistant, which states that "when injection of the sacral plexus is performed at multiple levels (e.g., L4, L5, and S1), each level should be separately identified and reported with the -59 modifier appended to the additional levels beyond the first level." However, in the scenario you described, since the injection is being performed from L5 to S3, it should be reported as a single unit of service using code 64451 without any modifiers.
It is important to review the payer's specific coding and billing guidelines to ensure compliance with their policies. The Centers for Medicare & Medicaid Services (CMS) has also published guidelines on the appropriate use of CPT code 64451.
​
Source: American Medical Association. CPT Assistant. May 2013 Volume 23, Issue 5, Page 9. CMS National Correct Coding Initiative Policy Manual for Medicare Services, Chapter 11, Section H (available on the CMS website).
0 Comments

Your comment will be posted after it is approved.


Leave a Reply.

    Picture
    ABOUT THE AUTHOR:
    Ms. Pinky Maniri-Pescasio is the Founder of GoHealthcare Consulting. She is a National Speaker on Practice Reimbursement and a Physician Advocate. She has served the Medical Practice Industry for more than 25 years as a Professional Medical Practice Consultant.

    View my Profile on Linkedin
    View my profile on LinkedIn
    READERS QUESTIONS
    Picture
    Ad: Immune Shield is the breakthrough new, doctor-approved supplement for quickly strengthening and protecting your immune system. Check it out!
    Picture
    Ad: Make Dinner in 15 Minutes

    search here

    Medical Billing and Coding Webinars
    Learn from the EXPERTS in the Industry

    RSS Feed

    Archives

    March 2023
    February 2023
    January 2023
    November 2022
    September 2022
    July 2022
    June 2022
    May 2022
    April 2022
    March 2022
    February 2022
    October 2021
    July 2021
    June 2021
    February 2021
    January 2021
    October 2020
    September 2020
    August 2020
    July 2020
    June 2020
    April 2020
    March 2020
    December 2019
    February 2019
    September 2018
    August 2018
    February 2018
    January 2018
    December 2017
    September 2017
    August 2017
    June 2017
    May 2017
    February 2017
    October 2016


    Categories

    All
    10 Common Reasons Claims Gets Denied And Reject
    2019 New CPT Codes Medicare Payments For Virtual Services Remote Monitoring Interprofessional Consultation
    Chronic Care Management In 2017 Changes
    Events
    Medical Modifiers
    Pain Management Billing
    Pain Management Billing Codes
    Practice Management
    READER'S QUESTION
    Revenue Cycle
    Spinal Fusion Billing And Coding
    When To Use Medicare's ABN Advanced Beneficiary Notice Claim Reporting Modifiers
    You Be The Biller
    Your Be The Coder

    RSS Feed


    BROWSE HERE

    All
    10 Common Reasons Claims Gets Denied And Reject
    2019 New CPT Codes Medicare Payments For Virtual Services Remote Monitoring Interprofessional Consultation
    Chronic Care Management In 2017 Changes
    Events
    Medical Modifiers
    Pain Management Billing
    Pain Management Billing Codes
    Practice Management
    READER'S QUESTION
    Revenue Cycle
    Spinal Fusion Billing And Coding
    When To Use Medicare's ABN Advanced Beneficiary Notice Claim Reporting Modifiers
    You Be The Biller
    Your Be The Coder


© COPYRIGHT 2019 GoHealthcare Consulting and Business Development LLC. ALL RIGHTS RESERVED.
  • About
  • Services
    • Prior Authorization Services
    • Patient Access Services
    • Medical Scribe Services
    • Coding and Documentation Audit Review
    • ​E/M & Surgical Coding Education and Training
    • RCM FULL SERVICES
  • READ OUR BLOG
  • Let's Meet in Person
    • 2023 ORTHOPEDIC VALUE BASED CARE CONFERENCE
    • 2023 AAOS Annual Meeting of the American Academy of Orthopaedic Surgeons
    • 2023 ASIPP 25th Annual Meeting of the American Society of Interventional Pain Management
    • 2023 Becker's 20th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference
    • 2023 FSIPP Annual Conference by FSIPP FSPMR Florida Society Of Interventional Pain Physicians
    • 2023 New York and New Jersey Pain Medicine Symposium
  • Testimonials
  • Frequently Asked Questions and Answers - GoHealthcare Practice Solutions
  • FREE ASSESSMENT
  • Readers Questions