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Resolving Commons Doubts While Billing 64625

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While working with various internists, we observed lot of doubt about current procedure (CPT) code 64625. Inaccurate use of CPT code 64625 could lead to claim denials and hence lost revenue. In this article, we tried to resolve common queries and doubts while billing 64625. Let’s begin with understanding basics of the code. – PowerPoint PPT presentation

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Updated: 19 July 2023
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Title: Resolving Commons Doubts While Billing 64625


1
Resolving Commons Doubts While
Billing 64625
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Resolving Commons Doubts While Billing 64625
  • While working with various internists, we
    observed lot of doubt about current procedure
    (CPT) code 64625. Inaccurate use of CPT code
    64625 could lead to claim denials and hence lost
    revenue. In this article, we tried to resolve
    common queries and doubts while billing 64625.
    Lets begin with understanding basics of the
    code.
  • Basics of CPT Code 64625
  • CPT code 64625 refers to a nerve block injection
    of the occipital nerves. This procedure is used
    to relieve pain in the head and neck areas. The
    occipital nerves are located at the back of the
    head and can become inflamed or irritated,
    causing pain. A nerve block injection involves
    injecting medication directly into the nerves to
    reduce inflammation and relieve pain. The
    injection is typically performed in an outpatient
    setting, such as a doctors office or a hospital.
    The patient will be positioned face down on a
    table, and the injection site will be cleaned and
    numbed with a local anesthetic. The doctor will
    then use a small needle to inject a combination
    of anesthetic and steroid medication into the
    occipital nerves. The CPT code 64625 includes the
    following components
  • Pre-operative evaluation and management of the
    patient
  • Use of imaging guidance (if necessary) to locate
    the injection site
  • Injection of local anesthesia and steroid
    medication into the occipital nerves
  • Post-operative evaluation and management of the
    patient
  • It is important to note that the use of imaging
    guidance is not always necessary for this
    procedure. The decision to use imaging guidance
    will depend on the individual patients anatomy
    and the doctors preference.

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Resolving Commons Doubts While Billing 64625
Resolving Commons Doubts while Billing 64625 1.
64625 CPT Code Reimbursement The reimbursement
amount for CPT code 64625 varies depending on a
variety of factors, including the location where
the procedure is performed, the provider
performing the procedure, and the patients
insurance coverage. It is best to contact the
patients insurance company to get accurate
information on billing 64625. The insurance
company will be able to provide exact code
reimbursement, potential out-of-pocket costs for
the patient, and billing guidelines. 2. Is CPT
64625 Covered by Medicare CPT code 64625 is
covered by Medicare. However, it is important to
note that Medicare coverage and reimbursement
rates may vary depending on the specific
circumstances of the procedure, such as the
location where the procedure is performed and the
patients individual coverage plan. To determine
the specific Medicare coverage and reimbursement
amount for CPT code 64625, it is best to contact
Medicare directly. 3. 64625 vs. 64635 CPT code
64635 refers to a trigeminal nerve block
injection, which is used to treat trigeminal
neuralgia, a type of facial pain that is caused
by inflammation or compression of the trigeminal
nerve. This injection involves the injection of
local anesthetic and/or steroid medication into
the trigeminal nerve branches to relieve pain.
While both CPT codes involve nerve block
injections for pain relief, they are used to
treat different conditions and involve injections
into different nerves.
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Resolving Commons Doubts While Billing 64625
  • 4. Can You Bill 64625 and 64635 together?
  • It is possible to bill CPT code 64625 and CPT
    code 64635 together if both nerve block
    injections were performed during the same patient
    encounter and if both procedures were medically
    necessary for the treatment of the patients
    condition. However, it is important to note that
    the use of multiple CPT codes for the same
    patient encounter may be subject to certain
    billing and coding guidelines and regulations,
    which may vary depending on the payer or
    insurance plan.
  • In some cases, the use of multiple codes may
    require additional documentation and
    justification to support medical necessity and
    avoid billing errors or denials. To ensure proper
    billing and coding practices, providers and
    medical billers should be familiar with the
    specific requirements and guidelines for billing
    these codes, which may include documentation of
    the patients diagnosis, the specific nerves
    injected, and the medications used during the
    injection. You may also consult with the payer or
    insurance plan for guidance on proper coding and
    billing practices for billing 64625.
  • 5. Is CPT Code 64625 Experimental?
  • CPT code 64625 is not considered an experimental
    or investigational procedure. It is a
    well-established procedure that is recognized and
    accepted by the medical community for the
    treatment of occipital neuralgia. As discussed
    earlier, the coverage and reimbursement rates for
    CPT code 64625 may vary depending on the payer or
    insurance plan,

5
Resolving Commons Doubts While Billing 64625
it is generally recognized as a standard
procedure for the treatment of occipital
neuralgia and is not considered experimental or
investigational. 6. What CPT Code did 64625
Replace? CPT code 64625 did not replace any
specific previous code. It is a unique code that
was introduced by the American Medical
Association (AMA) in 2005. Prior to the
introduction of CPT code 64625, healthcare
providers may have used other codes to describe
similar procedures, such as codes for trigger
point injections or nerve block injections.
However, CPT code 64625 was specifically
developed to describe the injection of medication
into the occipital nerves for the treatment of
occipital neuralgia, and it is now the preferred
code for this procedure. We hope that this
article might have cleared few doubts and
provided all necessary information while billing
64625. Medisys Data Solutions is a leading
medical billing company providing complete
billing and coding services for various medical
billing specialties including internal medicine.
Our billing and coding experts are well aware of
billing guidelines to receive accurate
reimbursement for delivered services. To know
more about our internal medicine billing
services, contact us at info_at_medisysdata.com /
888-720-8884
6
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