Does your carrier have an LCD for facet joint injections? That would be the place to start.
Otherwise, these should be coded with -50 for bilateral injections.
If your carrier is denying with frequency, they may want -59 for the additional levels.
By CPT if 3 levels were injected, for instance L1-L2; L2-L3; L3-L4 bilaterally, you would code 64475-50, 64476-50 x 3.
You could try 64475-50, 64476-50, 64476-50-59, 64476-50-59, but I'd check the LCD first to see how they want them.
77003 would only be coded once
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