Wiki CPT 01922 used with 64490 & 64491

[Lillian7]

I'm new to using anesthesia codes and could appreciate some feedback. The office is submitting 01922 for 64490 and 64491 nerve blocks, which is getting denied.
The payer states the patient shouldn't get billed. What would be the proper anesthesia code(s)?

 

[CBLENNIE]

01922 is anesthesia for non-invasive imaging or radiation therapy and 64490 does meet this definition since it is an 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. 64490 does include imaging services but the imaging is for guidance purposes not for imaging purposes.

 

[jkyles]

I'm new to using anesthesia codes and could appreciate some feedback. The office is submitting 01922 for 64490 and 64491 nerve blocks, which is getting denied.
The payer states the patient shouldn't get billed. What would be the proper anesthesia code(s)?

Hi there, I suspect you're getting a medical necessity denial. Have you reviewed the denial codes from the payer and the payer's policy on facet blocks? Earlier this last [edit] year all Part B Medicare carriers updated their facet joint intervention policies to state that moderate sedation and anesthesia services are not medically necessary with injections. Private payers have been following Medicare's lead on this.