Does Medicare cover CPT code 64405?

Does Medicare cover CPT code 64405?

Medicare does not have a National Coverage Determination (NCD) for injection, anesthetic agent, greater occipital nerve (CPT code 64405). For specific LCDs/LCAs, refer to the table for Injection, Anesthetic Agent, Greater Occipital Nerve.

Does CPT code 64400 need a modifier?

It is appropriate to report the codes (CPT codes 64400-64520) below in conjunction with an operative anesthesia service when a peripheral nerve block injection for post operative pain management is performed. Modifier -59 is required to distinguish the block from the intraoperative anesthetic technique.

Can CPT code 64405 be billed bilateral?

Medicare rules say bilateral is allowed so you would use the 50 modifier.

What does the code 64405 mean for Medicare?

For code 64405, the indicator is “1” bilateral. This means the 150% payment adjustment DOES apply. 100% allowable for first side and 50% allowable for bilateral side. Add modifier -50 to code 64405 (1 unit) (Medicare) 0 Votes – Sign in to vote or reply.

Do you add modifier-50 to code 64405?

For code 64405, the indicator is “1” bilateral. This means the 150% payment adjustment DOES apply. 100% allowable for first side and 50% allowable for bilateral side. Add modifier -50 to code 64405 (1 unit) (Medicare) 0 Votes – Sign in to vote or reply. Thank you for your time and expertise in helping to sort thru these issues.

When to use CPT code 64450 for anesthesia?

Anesthesia service included in surgical procedure. For example, when an avulsion of a nail plate (CPT code 11730) is performed, anesthesia may be provided by the surgeon using a digital nerve block (CPT code 64450).

Is the CPT code 64415 bundled to 01630-qk?

Per CCI edits, CPT code 64415 is not bundled to 01630-QK; therefore, reimbursement is recommended. 2. Per 28 Texas Administrative Code §134