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Facet joint injections

  1. Default Facet Injections
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    I believe the information you recieved for the 8 facet injections in the neck was incorrect.. I bill facet injections all the time and have no problem w/ recieving payment. CPT codes 64475 & 64476 are for facet injections to the lumbar spine, and the facet injections your Dr gave was to the C/S. The correct way to code this is:
    64470 RT
    64470 LT
    64472 RT
    64472 LT
    64472 59RT
    64472 59LT
    64472 59RT
    64472 59LT

    I Normally only bill a max of 6 injections at one time, our Dr's have never given 8 at once. Also, the correct HCPCs code for depo-medrol is J1030.

    I hope this helps

  2. #12
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    Quote Originally Posted by cdecristofaro View Post
    I believe the information you recieved for the 8 facet injections in the neck was incorrect.. I bill facet injections all the time and have no problem w/ recieving payment. CPT codes 64475 & 64476 are for facet injections to the lumbar spine, and the facet injections your Dr gave was to the C/S. The correct way to code this is:
    64470 RT
    64470 LT
    64472 RT
    64472 LT
    64472 59RT
    64472 59LT
    64472 59RT
    64472 59LT

    I Normally only bill a max of 6 injections at one time, our Dr's have never given 8 at once. Also, the correct HCPCs code for depo-medrol is J1030.

    I hope this helps
    Based on all of the recent controversy regarding payment issues with the facet injections and the OIG coming down on practices that are doing this incorrectly, I would have to disagree with breaking them out per line item (unless you code for an ASC and its a Medicare patient since those are different guidelines)

    Please see these links:

    http://www.justmypassion.com/articles-MBC-09.html

    http://www.oig.hhs.gov/oei/reports/oei-05-07-00200.pdf

    http://www.aapc.com/news/index.php/2...nt-injections/
    Last edited by mbort; 11-21-2008 at 09:46 AM. Reason: added another link

  3. #13
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    cdecristofaro - If this is how you have been billing your bilateral facet injections then you have likely been receiving incorrect payments. In addition to the links Mary posted, the Orthopedic Coder's Pink Sheet had a great article in October that broke down how to correctly bill these injections and also showed how billing them incorrectly resulted in overpayment. By splitting your injection codes on two lines using RT & LT you are not receiving the bilateral fee reduction.
    Eileen Blankenship, CPC
    Remote Coder

  4. #14
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    Albany, New York
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    Actually, I code facet joint injections on a regular basis as well.
    I do Ambulatory Surgery coding for a hospital, and don't have to code the "J" codes for injected substances because they are assigned via Chargemaster.

    However, the code ranges I provided above for the "Cervical" Facet injections are correct.
    Also, I don't think you should be using a "59" modifier, because these case can be billed with a "50".
    Karen Maloney, CPC
    Data Quality Specialist

  5. Exclamation Billing for Facet Joint Injections
    So is billing done according to how many injections were actually done, or is it by level?
    Example- Bilateral injections done at L4-L5. Would it be correct to say:
    64475 x 2 (LT AND RT)
    77003 (Flouro)

  6. #16
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    Jacksonville, FL
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    Quote Originally Posted by knevans View Post
    So is billing done according to how many injections were actually done, or is it by level?
    Example- Bilateral injections done at L4-L5. Would it be correct to say:
    64475 x 2 (LT AND RT)
    77003 (Flouro)
    Per the September 2004 CPT Assistant, it states:
    only one facet injection code should be reported at a specified level and side injected (eg, right L4-L5 facet joint) regardless of the number of needles inserted or number of drugs injected at that specific level.
    Hope that helps!

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