Wiki 64418/20553

[DPAL924]

Can 64418 be billed along with 20553 as long as there is a 59 modifier on 20553?

 

[marvelh]

Only if the trigger point injections are performed in a different anatomic location from the suprascapular nerve injection or in a different session

 

[DPAL924]

medial branch blocks w/o guidance

Thanks Marvel. Now I have a new issue...one of our Drs is doing spinal medial branch blocks WITHOUT guidance. Should this be billed as a trigger point injection, 20553, or nerve block injections? If nerve blocks should it be coded as 64405 or 64450?

 

[marvelh]

CPT includes the following parenthetical note regarding this: "Image guidance and localization are required for the performance of paravertebral facet joint injections described by code 64490-64495. If imaging is not used, report 20552-20553"