I am in TN and work in a billing company for an orthopaedic practice and a couple of our doctors do spinal injections. On some of their tickets, they bill 64493, 64494, and 64495 along with 64622, 64623 X2 or however many additional levels they injection along with 77003. I know Medicare will not pay for 64493, 64494, 64495 in TN if performed on the same visit as 64622 and 64623. My confusion comes with the 77003. I have been posting 77003 once with a 26 modifier along with the 64622 and 64623 but one of my coworkers states she does not post the 77003 with the 64622 and 64623 if they are done on the same level as the 64493, 64494, and 64495. Has anyone heard anything about this. I am really confused and would very much like to know how to code this correctly. Any written references would be extremely helpful. Per the CCI edits, 77003 is not inclusive to 64622 and it is not in the code decription for 64622. Any help would be greatly appreciated especially from other coders in TN.