Wiki 64493 and 77003

[richelle25]

Hi
My doc performed an 64493, injection paravertebral facet with fluoroscopic guidance, 77003, Medicare is denying stating inclusive, can I add a 59 modifier for this?

Thanks

 

[smcbroom]

as per CPT book it states 64493 is with image guidance (fluoroscopy or CT) so it is not separately reported like the old facet codes were for 2009.

Sorry, Medicare is correct!

Susan

 

[RebeccaWoodward*]

Hi
My doc performed an 64493, injection paravertebral facet with fluoroscopic guidance, 77003, Medicare is denying stating inclusive, can I add a 59 modifier for this?

Thanks

The description for facet injections changed in 2010; now including fluoro. Adding modifier 59 would indicate that separate encounters took place or two separate anatomic locations were involved and this would be inappropriate for the scenario you presented.

 

[richelle25]

Thank you!!

 

[r.alexandrou@hio.org.cy]

Can we bill 64493 with 77003 or 77012?

 

[jkyles]

Hi there, here is the full descriptor for the block.

Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level

 

[r.alexandrou@hio.org.cy]

Is there a code for spinal CTA?
CT, angiography, spine, w iv contrast