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Thread: Coding for facet injection

  1. #11


    AAPC: Back to School
    That resource is now an online publication you can subscribe to. Here's the link: http://www.anesthesiapainanswers.com/Default.aspx

    It is published by Decision Health
    Last edited by hgolfos; 03-11-2010 at 12:26 PM. Reason: added publisher name

  2. #12
    Join Date
    Apr 2007
    Jacksonville, FL


    TY hgolfos for the link!
    Now I need something else. I'm not that great at coding pain management and need some insight if I'm correct in my thinking on the below Op Report:

    Procedure performed:
    Lumbar radiofrequency denervation L2-L3, L3-L4,
    L4-L5, and L5-S] bilateral, sacroiliac joint
    radiofrequency denervation x4 bilateral.

    The patient was identified as Bob the Builder and was brought to the operating suite. After placing appropriate monitoring devices and intravenous lines, monitored anesthesia care was induced. The patient was placed in prone position on the operating table. Care was taken to make sure all bony prominences had gentle pressure. Care was taken to make sure the brachial plexus had normal pressure. The neck was carefully flexed in all planes. The patient was then prepped and draped in the usual sterile manner in the lumbar field. Under fluorometric guidance, the L1-L2 facet joint was localized and injected with 0.5 cc of 0.5% Marcaine and then heated to 80”C for 90 seconds. This was done at L2-L3, L3-L,4, L4-L5, and L5-Sl first on the right and left and then was done at the sacroiliac joint in four locations first on the right and then on the left.

    What would this be coded as effective 01/01/2010?
    Here’s my guess:
    64493 w/ 50= 2 total
    64494 w/ 50= 2 total
    64495 w/ 50= 2 total

    Can anyone help me please?? Thanks SO much!

  3. #13


    Yes the facet joints are coded correctly, but you have also got SI nerve destruction as well, and as far as I know there is some indecision as to how to code those. Some sources direct 64640 x the number of nerves and others 64999. Your best bet on that one is to try and find out what your carrier's policy is.

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