CPT^® 64495, Under Introduction/Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic Procedures on the Paravertebral Spinal Nerves and Branches

The Current Procedural Terminology (CPT^®) code 64495 as maintained by American Medical Association, is a medical procedural code under the range - Introduction/Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic Procedures on the Paravertebral Spinal Nerves and Branches.

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Summary

In this add–on procedure, the provider injects a diagnostic or therapeutic substance into a lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance (fluoroscopy or computed tomography [CT]). This code represents the service at a third facet joint level and any additional levels (on one side).

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KX modifier

Can someone explain the KX modifier for injections? Seems Medicare wants a KX modifier appended for all diagnostic injections (CPT 64633-64636 & 64490-64495) How does a hospital coder know if it is ... [ Read More ]

Anyone ever bill for pain management?

[QUOTE="Jess23009, post: 511762, member: 466434"] Hi, I am having an issuse with the dx code. DX Code M47.816 is denying for CPT 64495. Do you know which codes are acceptable? [/QUOTE] M47.816 does pr... [ Read More ]

Anyone ever bill for pain management?

[QUOTE="DGgirll20, post: 501039, member: 693252"] For CPT codes 64492 and 64495, the need for a three-level procedure may be considered under unique circumstances and with sufficient documentation of ... [ Read More ]

L4, L5, S1 Bilateral Medial Branch Blocks

64493, 64494, 64495 are the correct codes, as there are three levels. No need for a 50 modifier, because there is no reference to a bilateral procedure.... [ Read More ]

L4, L5, S1 Bilateral Medial Branch Blocks

This isn't my coding specialty, but I would have coded 64493, 64494 & 64495 for the three injections at three different levels. How are you reading this as a bilateral procedure? I don't see anythin... [ Read More ]

L4, L5, S1 Bilateral Medial Branch Blocks

I want to make sure I understand how to bill MBBs. Please help me determine the levels per this op: [I]Lying in a prone position, the patient was prepped and draped in the usual sterile fashion using... [ Read More ]

CPT update for 64492 and 64495

[URL='https://www.ama-assn.org/practice-management/cpt/cpt-errata-technical-corrections']Effective Jan. 1, 2022[/URL] the instructions that limit level 3 blocks to once a day are deleted. [QUOTE] Rem... [ Read More ]

Anyone ever bill for pain management?

In GA we get these same denials. Third level injections will be denied. Palmetto Article A58350 states, "64492 and 64495 will only be covered upon appeal if sufficient documentation of medical neces... [ Read More ]

Anyone ever bill for pain management?

[QUOTE="kellit21, post: 500975, member: 131351"] We are getting denials on our 3rd level MBB or Facet injections stating not medically necessary. Are any of you getting this? Any insight on why they w... [ Read More ]

Anyone ever bill for pain management?

For CPT codes 64492 and 64495, the need for a three-level procedure may be considered under unique circumstances and with sufficient documentation of medical necessity on appeal. The KX modifier sho... [ Read More ]

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