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Facet injection

  1. Default Facet injection
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    How would you bill Medicare for 6 cervical facet joint injections? The injections were given c4-c5, c5-c6, and c6-c7 bilaterally. The procedure codes are 64470 and 64472.

    Thank you for your help!

  2. #2
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    North Carolina
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    Quote Originally Posted by MICHB010375 View Post
    How would you bill Medicare for 6 cervical facet joint injections? The injections were given c4-c5, c5-c6, and c6-c7 bilaterally. The procedure codes are 64470 and 64472.

    Thank you for your help!
    64470-50
    64472-50
    64472-50

    Now...some carriers want to see modifier 59 on the "add on" codes. Check with your carriers to see if this will be an issue.

    My Medicare carrier.....

    Multiple Level Joint Injections

    Q: How should multiple level bilateral paravertebral facet joint injections be billed?

    A: Providers may have received denials for bilateral paravertebral facet injections when more than one add-on level was billed without a modifier 59 or an electronic notepad indicating the add-on levels were distinctly different. For example, if a provider treats bilaterally three thoracic levels (such as T7-8, 8-9, and 9-10), the provider should bill 64470-50 for the first level then 64472-50 for each of the two additional levels except the last level should include a modifier 59 or a notepad explaining the three different levels treated.

  3. Default
    Do I use 2 units on each line?

  4. #4
    Location
    North Carolina
    Posts
    3,126
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    I only have one carrier that requires 2 units...BCBS. All other carriers are posted with one unit and double the fee manually.

  5. Default
    MLN
    Appropriate Use of Modifier 50 and Add-On Current Procedural Terminology Codes (CPT) for Facet Joint Injection Services

    http://www.ngsmedicare.com/ngsmedica...09_mm6518.aspx
    Anthony McCallum, CPC, CIRCC, CPC-I, CCS
    ciphermed@optonline.net

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