A common situation would be if the ED physician performed a diagnostic nerve block on a patient complaining of pain in the floor of her mouth and her bottom set of teeth. You would want to be certain that you chose 64402 (Injection, anesthetic agent; facial nerve) for facial nerve blocks, not blocks in the mouth or jaw. The determining factor is that the surgeon treated a branch of the trigeminal nerve, not the facial nerve. 

On the claim, report 64400 (… trigeminal nerve, any division or branch) for the nerve block. Other 64400 scenarios: Areas affected by the trigeminal nerve and its branches, and therefore coded with 64400 for nerve blocks, include:

• the body of the mandible and the lower portion of the ramus
• upper and lower teeth
• floor of the mouth
• anterior two-thirds of the tongue
• gingiva on the lingual surface of the mandible
• gingiva on the labial surface of the mandible
• mucosa and skin of the lower lip and chin.

To ensure proper payment, back up your medical billing claim with the proper documentation to show the reason for the facial or dental block and that will allow the carrier to see why this code was chosen along with the necessity of the procedure. This will enable you to realize reimbursements instead of rejections on these type of claims.

If you’re ready to get rid of the hassles that a rejected claim or multiple claims can cause, it might be time to consider outsourcing your medical billing claims to a third party partner that can get your claims submitted, double check your billing and get your reimbursements.

The beautiful thing about outsourcing your medical billing claims is the average return rate due to errors is less than 1%. Plus you’ll see up to 25% of your reimbursements increased due to your claims being handled in an efficient manner. Best of all, your staff will be free to help you run your practice instead of chasing paperwork for medical billing claims.