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2010 CPT changes/facet injection codes

  1. #1
    Default 2010 CPT changes/facet injection codes
    Medical Coding Books
    Does any one have explanation for this;
    Per the CPT changes for 2010, the new facet injection codes are;
    94490 - cervical or thoracic, first level 64493 - lumbar, first l
    64491 - second level 64494 - second level
    64492 - third and any additional level 64495 - third and any add

    It also states that the CPT code 64492 and 64495 are only reproted once per day. This is ok if there were only three levels involved. What heppens if the facet injection is performed to more then three levels? How can we report the forth or the fifth level?

    Thank you for your help

    Jesenka Ratkovic, CPC

  2. #2
    When you bill 64492 it's understood that you are doing three or more levels. You must remember that these are diagnostic injections intended to determine which levels are the pain generators. If you do ALL the levels at the same time, how do you know which one was causing the pain?
    Walker Bachman, CPC, CPPM

  3. #3
    Most of the time we do two or three levels, but in some instances we might do more then three levels.

    I undeestand that the CPT codes; 64492 and 64495 are billed for the third or any additional level, but it also states that you do not bill these codes more then once per day. So, if you are billing facet injections for four levels how do you bill for the forth level if you can only bill these code once per day?
    Do you bill 64492 or 64495 with two units?
    How do you bill these codes if you are billing for right and left sides? Do you bill 64492 or 64495 with modifier 50 and 4 units?

    I appriciate your help

  4. #4
    It's my understanding that the reimbursement you get for 64492/64495 is meant to cover ALL levels done beyond the second one. Yes, that means you get paid the same amount for 4 levels as you do for 3 levels. Fair? No, but that's the way it is.
    Walker Bachman, CPC, CPPM

  5. #5
    No it's not fair, and I was afraid that this will be the answer, but at least we know now.

    Thank you for your help

  6. #6
    Providence, RI
    Default CPT changes for 2009 & 2010
    I have a 2008 CPT book and looking for th list of changes for 2009 and 2010, does anyone have these changes or the link to them..please email me at

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