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New Pain Management Codes for Paravertebral Facet Joint Injection(s) or
Nerve Block(s)
Effective January 01,2010
64470, 64472, 64475, 64476 is now Deleted
Effective January 01, 2010. Your Paravertebral Facet Injection(s) Codes 64470-64472 &
Deleted 64470 Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint
nerve; cervical or thoracic, single level

- to report; use new code is 64490 - Injection(s), diagnostic or therapeutic agent, paravertebral
facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or
CT), cervical or thoracic; single level

Deleted 64472 Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint
nerve; cervical or thoracic, each additional level (List separately in addition to code for primary
procedure)

-
to report; use new code is 64490 Injection(s), diagnostic or therapeutic agent, paravertebral
facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or
CT), cervical or thoracic;
first level (List separately in addition to code for primary procedure)

+64491 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint
(or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic;
second level (List separately in addition to code for primary procedure)

+64492 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint
(or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic;
third and any additional level(s) (List separately in addition to code for primary procedure)

Deleted 64475 Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint
nerve; lumbar or sacral, single level

- to report; use new code is 64493 Injection(s), diagnostic or therapeutic agent, paravertebral
facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or
CT), lumbar or sacral;
single level

Deleted 64476
Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint
nerve; lumbar or sacral, each additional level (List separately in addition to code for primary
procedure)

- to report; use new code is 64494 Injection(s), diagnostic or therapeutic agent, paravertebral
facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or
CT), lumbar or sacral;
second level (List separately in addition to code for primary procedure)

+64495 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint
(or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral;
third
and any additional level(s)
(List separately in addition to code for primary procedure)

Keypoints to remember:

1. These codes additionally describes zygapophyseal joint or the nerves innervating that joint;
2. These codes is inclusive with image guidance; eg. fluoroscopy or CT;
3. These codes requires Imaging and Localization for proper needle placement;
4. If imaging is NOT used, report using 20550-20553 or 64999 if ultrasound guidance is used.
5. Append modifier 50 for bilateral procedures.
6. These codes are already on Medicare's 2010 Fee Schedule.


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source: consult your CPT Code book for 2010.
CPT is a trademark and owned by the American Medical Association.