thoracic/lumbar MBB

[Drd105]

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If I bill 64490, 64491 (crv/thrc) and also 64493 (lumb/sac) (for T11-12, T12-L1, L1-2 facets) will that cause confusion for insurance? I have never billed crv/thrc and lumb/sac in the same encounter before...

 

[Ferrismonk]

You are billing correctly, but this should not be done. Many insurances will deny because you are treating more than one region. I would recommend doing the lumbars and then thoracic separately.

 

[Drd105]

You are billing correctly, but this should not be done. Many insurances will deny because you are treating more than one region. I would recommend doing the lumbars and then thoracic separately.

SHOOT!!! head smack emoji. should have asked before injecting. thank you!

 

[hiyaman]

In this case just bill for the thoracic and take the lumbar region as a loss if you've already done the procedure.

 

[chibadriver]

If I bill 64490, 64491 (crv/thrc) and also 64493 (lumb/sac) (for T11-12, T12-L1, L1-2 facets) will that cause confusion for insurance? I have never billed crv/thrc and lumb/sac in the same encounter before...

Is this a new Medicare patient? You may not be able to do three levels anyway. I agree, take the hit or see them in a separate encounter.

 

[pmrmd]

Last year you would have been be able to do this. I used to do this for a cervical and lumbar complaint on the same day to speed things up. Patients were appreciative. No more. One region only.

 

[painfree23]

Last year you would have been be able to do this. I used to do this for a cervical and lumbar complaint on the same day to speed things up. Patients were appreciative. No more. One region only.

U used to inject the lumbar and cervical spine at the same time?

 

[pmrmd]

U used to inject the lumbar and cervical spine at the same time?

For Medicare people sure. It paid without problems and patients were appreciative.

 

[paindoc007]

For Medicare people sure. It paid without problems and patients were appreciative.

Wtf? Medicare has been clear forever about one site per dos. How in the world were you getting paid for that

 

[RoloTomassi]

Wtf? Medicare has been clear forever about one site per dos. How in the world were you getting paid for that

-59 modifier? But doesn't that pay less for one of them?

 

[TIVAndy]

not sure what you guys to but i use T12-L1 facet as either thoracic or lumbar facet depending on if i'm treating higher or lower. (T11-T12, T12-L1 as thoracic billing and T12-L1, L1-L2 as lumbar billing)

 

[paindoctor2014]

The new Medicare guidelines state two levels at a time? Can you do bilateral?

 

[p1at0]

You are billing correctly, but this should not be done. Many insurances will deny because you are treating more than one region. I would recommend doing the lumbars and then thoracic separately.

Agree.