Wiki Facet Joint Injection - Looking for feedback

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Looking for feedback on the following procedure, the physician noted

Injected the area of the left L4-L5 facet joint, provided immediate relief of pain. Depo Medrol 40 mg and 2-3 cc's of 1% lidocaine used.

The provider is billing 20600 - J1030, and J2001

I'm showing that the facet joint injection code is 64493 any feedback would be appreciated.

Thanks,
 
The code 64493 is for an epidual injection which is usually done outpatient surgery. If the procedure was done in the office it was most likely a joint injection and the code would be 20610. The code the provider gave is for a joint injection of a small joint which would be incorrect. I may be wrong but I don't think you can bill for lidocaine if it used to numb the area prior to the injection. HCPCS code J2001 in for lidocaine IV. Hope this helps
 
actually that's incorrect, 64493 is not an epidural injection, as the needle never enters the epidural space. 64493 is an injection of either the facet joint, or the nerves innervating that joint, which sounds like it would be correct. depending on where the service was performed you may or may not be able to bill the drugs. If it's in office then yes, if the procedure was done in an ASC, then no the ASC would bill the drugs normally. either way fluoroscopy is included as of 2010. hope this helps! :)
 
aaron.lucas said:
actually that's incorrect, 64493 is not an epidural injection, as the needle never enters the epidural space. 64493 is an injection of either the facet joint, or the nerves innervating that joint, which sounds like it would be correct. depending on where the service was performed you may or may not be able to bill the drugs. If it's in office then yes, if the procedure was done in an ASC, then no the ASC would bill the drugs normally. either way fluoroscopy is included as of 2010. hope this helps! :)
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I agree with this poster. Also note, these are unilateral codes so a 50 can be added if bilateral injections are performed.
 
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