Wiki Facet Blocks

[Ami Denney]

I want to get everyone's opinion on this situation. Here is the op note:

Diagnostic Right T7-8, Left T7-8, Right T8-9, Left T8-9, Right T9-10, Left T9-10, Right T10-11, and Left T10-11 Facet Block via injection of medial branch nerves under fluoroscopic guidance.

In the CPT-2013 edition there is a note that states "do not report 64492 more than once per day". According the to note this is how I coded this:

64490 RT
64490 LT
64491 RT
64491 LT
64492 RT
64492 LT
64492 RT 59
64492 LT 59

But the problem lies in the fact that we cannot code 64492 more than once per level in a day. So what do we do? Not report for the last level and leave out the additional 64492 RT 59/64492 LT 59?

 

[LLynn29]

It should be coded this way:
64490-50
64491-50
64492-50

64492 is for third and any addtional levels. The additional levels are included in this code.
Hope that makes sense.

 

[Ami Denney]

Thank you! We usualy explode the codes instead of using mod 50 simply because Medicare guidlines have requested it that way for some reason. Seems all one on the same to me. Thank you for your help!