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Anesthesia Coding Alert

Reader Question:

T12-L1 and L1-L2 Call for Multiple Codes

Published on Mon Jan 04, 2010

Question: The pain management doctor administered facet joint injections at the T11-L2 levels. Should we code this as both thoracic and lumbar facet injections, or only report the thoracic injection codes? Mississippi Subscriber Answer: Your physician injected a total of three spinal levels: T11-T12, T12-L1, and L1-L2. For the thoracic facet joint injection (T11-T12), report 64490 (Injection[s], diagnostic or therapeutic agent, paravertebral facet [zygapophyseal] joint [or nerves innervating that joint] with image guidance [fluoroscopy or CT], cervical or thoracic; single level). Per the CPT parenthetical note preceding 64490, report 64493 (Injection[s], diagnostic or therapeutic agent, paravertebral facet [zygapophyseal] joint [for nerves innervating that joint] with image guidance [fluoroscopy or CT], lumbar or sacral; single level) for the T12-L1 injection. For the L1-L2 facet injection, use the lumbar/sacral add-on code: +64494 (... second level [List separately in addition to code for primary procedure]). Don't miss: Many payers, including Medicare, follow a [...]
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