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Thread: Lumbar/ Cervical facet injections under floroscopic guidence

  1. #1
    Join Date
    Apr 2007

    Question Lumbar/ Cervical facet injections under floroscopic guidence

    AAPC: Back to School
    I know that the Floroscopy(77003) is included in the proffessional charges for CPT codes 64490, 64491, 64492, 64493,64494, and 64495 but is it included in the facility charges? Please someone can you clarify this for me?

  2. #2
    Join Date
    Apr 2007
    Philadelphia, PA


    yes, it is included. You can no longer bill fluoro at all with these codes, prof or facility..

  3. #3


    There are new guidelines when the ASC is billing claims to National Government Services. ASC's must append modifier KX to all procedures for which fluoroscopy or CT guidance is medically necessary to attest to the use of such imaging. Procedures requiring medically necessary fluoroscopy include transforaminal epidural injections, paravertebral joint/nerve injections or denervations, and sacroiliac joint injections. Effective January 1, 2010, modifier-KX is not required for paravertebral joint/nerve injections. However, the CPT procedures codes 64490-64495 should not be reported unless fluoroscopy or CT guidance is performed.
    Because imaging is required, National Government Services is saying that they want the fluoroscopic or CT guidance code listed on the claim with modifier-KX, this gives them confirmation that all the requirements necessary for billing the pain management injection procedure have been met.
    Last edited by bethh05; 02-11-2011 at 03:07 PM. Reason: spelling

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