I am trying to get some clarification on the frequency limitations for RFA’s. both myself and my billing supervisor are interpreting the guidelines differently than our provider. Our provider keeps ordering unilateral RFA’s if its more than one level. One side first, then two weeks later the next side. But the guidelines are stating that you cannot perform these procedures within 6 months of eachother. Our provider thinks its based off of joint levels so it shouldnt matter, but my billing supervisor says they are basing it off the codes. So regardless if they are billing 64635, then if we bill another 64635 two weeks later, then they will not pay for the 2nd even if its the same level. If anyone has any resources that they can share to clarify this.

thank you.

-Ellen