Wiki Facet Injections

[kimberly becker]

I have a diagnosis of facet arthropathy and back pain. The procedure is a facet joint injection w/flouroscopic guidance for the left- L2-3, L3-4, L4-5 and the right - L3-4, L4-5, L5-S1. With two of the levels being bilateral and we can only have three levels, should I code the bilateral levels first and then pick the right or left for the third?

 

[Lujanwj]

If we're talking about 64483/4, CPT says use modifier -50 for bilateral procedures. I'd put your highest valued procedure 1st.

Possible coding for your scenario:
64483-50 (L3-4)
64484-50 (L4-5)
64484 (L2-3)
64484 (L5-S1)
Guidance is included in codes

Remember, LT/RT is not CPT. I'd be sure payer accepts HCPCS modifiers before I submit that way. In this case, RT/LT would be information only not unbundling.

Good Luck!

 

[kimberly becker]

Thank you for your response. I didn't know if you had to code the vertebrae in order. Just looking at what gives you the highest value first makes sense.