Common Errors When Coding Facet Injections

Common Errors When Coding Facet Injections

Mistake #1:

Not Using Imaging

Imaging guidance and localization for facet injections is included in the code descriptors and is required. Fluoroscopy and CT guidance are not separately billable. If ultrasound guidance is used, use category three codes.

Mistake #2:

Reporting bilateral injection rather than an add on code for unilateral multi-level procedures

When you report these codes, remember to append the 50 modifiers when the physician injects both the right and left side at the SAME spinal level.

Mistake #3:

Billing multiple units of 64492 or 64495.

These codes are only billable once per day, regardless if more than three levels were performed.

Mistake #4:

Coding 64494 for L2-L3 since that is the second facet joint in the lumbar region or second block for the patient.

64493 is the first code to report, 64494 and 64495 are merely add on codes for additional levels performed. 64491, 64492 must be billed in conjunction with 64490. 64494, 64495 must be billed in conjunction with 64493.

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*Disclaimer: Information provided in this presentation was accurate at the time of release in October 2016.  Due to constant coding changes, it is recommended to verify the information at time of use.

Melissa Billman

About the author: Melissa Billman is the billing director for C E Medical Group, a nation-wide medical billing firm that specializes in working with pain management, sport medicine, family practice, and orthopedic surgery. In addition to managing her large team of medical billers and coders, she speaks nationally at various billing and coding conferences. Melissa resides in Salt Lake City, Utah with her husband and two children.