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multi level facet injection question

  1. Default multi level facet injection question
    Clearnace Sale
    Hello everyone, I need help billing Facet injections. Here is the senario - the Dr. injected at levels C6, C7, T1, T2 then lumbar levels L1, L2. I have had a hard time getting reimbursed by different carriers. I have 2 ways that I have been told to bill, if anyone can provide additional info please share or indicate which senario you would go with:

    senario #1
    64472 x2 units
    senario #2
    64475(59 mod)

  2. #2
    Duluth, Minnesota
    the way I read the scenario - 3 different levels - T/C/L - when my provider does these he marks (and I agree)
    no need for modifier .59 (as 64475 is a different level than 64470 and 64472 is an add on code) per CCI guidelines also
    Also, linking the dx's to cpt's very important because of the 3 different levels.
    we haven't had any payment issues on this to my knowledge.
    {that's my opinion on the posted matter}
    Last edited by dmaec; 09-17-2008 at 01:43 PM.
    Donna, CPC, CPC-H

  3. Default
    i would use your scenerio #2 I was taught to use mod 59 to show the levels the physician has entered. I, myself use mod and the second procedure all the way down.

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