Wiki lumbar facet injection 64475 wo fluoro

[Mary Baierl]

Is anyone doing lumbar facet injections 64475 in the office without fluoroscopic guidance? Are you then coding 64475 or is there a better code? Maybe 20610 large joint? Or is the facet considered intermediate joint 20605? Need advice and is there any documentation anywhere guiding the coding for a facet joint injection without fluoroscopic guidance.

Thank you very much, Mary

 

[RebeccaWoodward*]

The newest Orthopedic Pink Sheet (9-1-09) has an interesting article in it... here's an excerpt....

CPT codes 64470-64476 (paravertebral facet joint/facet joint nerve injections) will be deleted January 1, 2010 and replaced with new codes that clearly include fluoroscopy as a required component of the procedures."


To answer your question about 64475 w/o fluro... I found one Medicare carrier that has this policy...

Diagnostic Or Therapeutic) and AC-02-035, Paravertebral Facet Nerve Denervation state that CPT codes 64470 – 64476 and 64622 – 64627 require that a needle is placed in the proper position under fluoroscopic guidance since correct anatomic placement is essential. Effective for dates of service on or after January 1, 2008, these procedures, if billed without fluoroscopic guidance, will be considered trigger point injections and will be paid as CPT 20553: Injection(s); single or multiple trigger point(s), three or more muscle(s) Current Procedural Terminology2008 © 2007
American Medical Association. All Rights Reserved.

http://www.arkmedicare.com/provider/provnewslet/pdfformat/mcb200802.pdf

I does make you wonder if other carriers share this same view.