Forum - Questions & Answers

Jun 14th, 2016 - scantie1


We keep getting denials for CPT® code 64405 stating it is investigational and experimental. is there a reason why no one is paying this code?

Jun 14th, 2016 - AWASKEY 17 

re: 64405

I know Aetna and United HC do not pay for headaches and occipital neuralgia. it is experimental. Aetna's policy is "Headaches:Invasive procedures" Number 0707. The policy for United HC is "Occipital Neuralgia and Headache Treatment". Policy number 2015T0080Q.
Not sure your diagnosis or insurance company in question.

Jun 23rd, 2016 - LBAROGIANIS 250 

re: 64405

Check out your LCD. This will tell you what diagnosis codes are needed and what conservative treatment was needed prior to using this injection code. Also, some payers require authorization.

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