Anesthesia Coding Alert

Reader Question:

Bilateral Lumbar Facet Injections

Question: How should I bill Medicare to get full payment for lumbar facet block injections from L3-L5 bilaterally? Should I add any modifiers to indicate left or right side and which level received injections?

New York Subscriber  
Answer: Your scenario describes two levels of injections (L3-L4 and L4-L5), bilaterally. The correct way to code the procedure would be 64475-RT (injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve; lumbar or sacral, single level) (right side), 64475-50-LT (bilateral procedure) (left side), and 64476 ( lumbar or sacral, each additional level [list separately in addition to code for primary procedure]) twice to show injections on both the right and left sides.
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