Wiki Facet injections

[steph2355]

I have a dr that is doing facets injections, some bilateral and some not, any suggestions on how to bill this:

Facets injections of T12-L1, L1-L2, L2-L3, L3-L4, L4-L5, L5-S1 all on the right side

Facets injections of L-4-L5, L5-S1 on the left side

Does it matter which level get the bilateral charge?

Thanks for the help.

 

[jmcpolin]

64493-rt
64493-lt
64494-rt
64494-lt
64495x4

or use 50 modifier on 64493 and 64494 depending on your payer.

 

[marvelh]

Facet joint injections are limited to billing for a maximum of three facet joint levels as the 64492 and 64495 code descriptors state "third and any additional level(s)".

As well CPT includes parenthetical notes stating:
Do not report 64492 more than once per day
Do not report 64495 more than once per day

Additionally CPT has a parenthetical note:
For paravertebral facet injection of the T12-L1 joint, or nerves innervating that joint, use 64490

Depending upon how the payer wants bilateral services to be reported will vary whether you bill with modifier 50 or modifiers RT & LT. If these were intra-articular facet joint injections then

64490-RT (right T12-L1)
64493-50 (bilateral L4-L5)
64494-50 (bilateral L5-S1)
64495-RT x 1 (right L1-L2, L2-L3 and L3-L4)

If using the RT & LT modifiers instead of the 50:
64490-RT x 1
64493-RT x 1
64493-LT x 1
64494-RT x 1
64494-LT x 1
64495-RT x 1

 

[MCCONKEYT]

Thank you all of you!!! I just had a very similar question and it cleared it up for me!!!!!