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.
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.
Billing multiple units of 64492 or 64495.
These codes are only billable once per day, regardless if more than three levels were performed.
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.
*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.