What code are you all using for this injection? Thanks in advance!
coding for pars injection
- Thread starter gecko
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I use the code for MBB, unless someone has a better idea...
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coding for pars injection What code are you all using for this injection? Thanks in advance!
spondy14 said:
If you are not injecting/blocking the facet joint/medial branches innervating the facet joint, I DO NOT recommend using that code. You are misrepresenting (though unintentionally) what you are actually doing, if what you are doing is a pars injection. The claim will probably get paid if submitted with 64475, but if they ask for notes or audit you later in the year, you will be asked to refund the money.
If this happened to be a Medicare patient whose claim you misrepresented, it could be construed as fraud and subject to a $5,000 fine...
Unfortunately, the AMA has not developed a code for this procedure- at least not one that I could find. That leaves the dreaded 64999, unlisted code. List on Line 19 that it is similar to a 64483, send your op note and cross your fingers.
I know everyone hates to use 64999, but I have almost always been paid something on these claims. Not usually what I asked for, but pretty close. It does take some savvy and persistence though...
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Absolutely gecko, sorry to be out of touch. We gotta get together soon!
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If you are not injecting/blocking the facet joint/medial branches innervating the facet joint, I DO NOT recommend using that code. You are misrepresenting (though unintentionally) what you are actually doing, if what you are doing is a pars injection. The claim will probably get paid if submitted with 64475, but if they ask for notes or audit you later in the year, you will be asked to refund the money.
If this happened to be a Medicare patient whose claim you misrepresented, it could be construed as fraud and subject to a $5,000 fine...
Unfortunately, the AMA has not developed a code for this procedure- at least not one that I could find. That leaves the dreaded 64999, unlisted code. List on Line 19 that it is similar to a 64483, send your op note and cross your fingers.
I know everyone hates to use 64999, but I have almost always been paid something on these claims. Not usually what I asked for, but pretty close. It does take some savvy and persistence though...
So is there any consensus yet on a code to use for pars injection..I can't even find 64999 in the spinal coding manual...
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Ligament is right on target...64999 is your only option at this point.
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2008 CPT
64999: Unlisted procedure, nervous system
Claim will require a copy of your op note, so make it pretty
Since it is similar to facet joint block, list on Line 19 of the claim
"64999 Pars Inject similar to 64475 Facet Joint Inject"
This will put the bureaucrat at the insurance company in the ball park of how to price it.
Hey Ligament...
On that same note, do you use this code for a piriformis injection and add that it is similar to the code for a sciatic nerve block? I'm getting paid peanuts for using 64999 on the piriformis injection.
On that same note, do you use this code for a piriformis injection and add that it is similar to the code for a sciatic nerve block? I'm getting paid peanuts for using 64999 on the piriformis injection.
