My pain specialist does Occipital Block in the office. And I used to
bill and code for it using CPT Code 64405 (INJECTION, ANESTHETIC
AGENT; GREATER OCCIPITAL NERVE) - when he does bilateral
(which means Left & Right), I used LT-RT or 2 Units of 64405. But
Medicare would only pay for 1 unit and so are the other commercial
insurance payors (some will not even pay for it!).
I called one of the biggest insurance companies and told me this
code can not be billed unilateral. No Left or No Right Side.
Now, here is the good news, CMS now had made the changes
(retroactive to January 1, 2008).
Many of your pain specialist's Somatic Nerve Injections are Now
Billable for Bilateral with an indicator "1".
Here are some of the codes that has been included in the new
changes and updates:
64402 (INJECTION, ANESTHETIC AGENT; FACIAL NERVE)
64405 (INJECTION, ANESTHETIC AGENT; GREATER OCCIPITAL
NERVE)
64410 (INJECTION, ANESTHETIC AGENT; PHRENIC NERVE)
64417 (INJECTION, ANESTHETIC AGENT; AXILLARY NERVE)
64445 (INJECTION, ANESTHETIC AGENT; SCIATIC NERVE, SINGLE)
64430 (INJECTION, ANESTHETIC AGENT; PUDENDAL NERVE)
64435 (INJECTION, ANESTHETIC AGENT; PARACERVICAL
(UTERINE) NERVE)
64445 (INJECTION, ANESTHETIC AGENT; SCIATIC NERVE, SINGLE)
64446 (INJECTION, ANESTHETIC AGENT; SCIATIC NERVE,
CONTINUOUS INFUSION BY CATHETER, (INCLUDING CATHETER
PLACEMENT)
considering medicare's changes and new updates on coding and
considering medicare's changes and new updates on coding and
billing guidelines/policies.
billing guidelines/policies.
Read more on MLN Matters - Transmittal 1482 / CR5980
**** For more references: Consult your CPT code books. The National
Correct Coding Initiative (NCCI) and third pary payer payment policies
and guidelines
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