CPT 64483 is transforaminal epidural injection with imaging guidance lumbar or sacral single level and 64484 is each additional level. CPT 64483 is primary code and 64484 should be listed separately in addition to code for primary procedure.

However, Medicare paid for additional code, 64484 and primary code 64483 was denied as (RAD code B15 meaning “this procedure requires that a qualifying services/procedure be received and covered. The qualifying other service/procedure has not been received/adjudicated.”)

It doesn’t make sense at all. The primary code should get paid first and then additional code get paid. Otherwise, a couple of years later Medicare will request over payment refund by the reason that if the primary code was not paid, the additional code is not payable.

To avoid future audit of refund request, the primary code, 64483 resubmitted with modifier, “XU, unusual non-overlapping service”, neither is it necessary nor requires modifier as primary procedure. Medicare paid the primary code after being resubmitted. It is not logically reasonable but the important thing in billing is to get reimbursed in a proper way.