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51/59 Nerve Block Modifiers – bundling issue

Hello-

I work for a neurology office – having some difficulty with a bundling issue.
On an extreme case I could bill for one patient:

64450
64405
20553
64615
96372

How i was trained – typically I would use:
64450 – 50, 59
64405 – 59
20553
64615
96372 – 59

BCBS – pays for all minus 20553 – UHC pays for 64615/96372 and 64405 – but not 20553/64450
We have a lot of UHC patients so i’m wondering if anyone has any advice
I’ve tried leaving 64450/64405/20553 blank as i’ve seen suggested for someone else – they bundled – i’ve tried using 51 modifier, which then 20553/64450 was paid but not 64405

Appreciate any advice – thanks so much!

Medical Billing and Coding Forum