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PAIN MANAGEMENT CODING UPDATE 2012
27096 - Sacroiliac Injection is a revised Code and includes
arthrography

Facet Nerve RF Ablation/Rhizotomy  64622, 64623, 64626, 64627
has been DELETED!
New Codes are: 64633, 64634, 64635, 64636
Read What's NEW  
from
MY BLOG

Facet Nerve RF Ablation/Rhizotomy: 64622, 64623, 64626,
64627 has been DELETED!

64622 Destruction by neurolytic agent, paravertebral facet joint nerve; lumbar or
sacral, single level

64623 Destruction by neurolytic agent, paravertebral facet joint nerve; lumbar or
sacral, each additional level (List separately in addition to code for primary
procedure)

64626 Destruction by neurolytic agent, paravertebral facet joint nerve; cervical or
thoracic, single level
64627 Destruction by neurolytic agent, paravertebral facet joint nerve; cervical or
thoracic, each additional level (List separately in addition to code for primary
procedure)


New Codes effective January 01, 2012 are:

64633
        Destruction by neurolytic agent, paravertebral facet joint nerve (s)
with imaging guidance (fluoroscopy or CT);
cervical or thoracic; single facet joint
+64634
       cervical or thoracic, each additional facet joint (List separately in
addition to code for primary procedure)

64635        Destruction by neurolytic agent, paravertebral facet joint nerve (s)
with imaging guidance (fluoroscopy or CT);
lumbar or sacral; single facet joint
+64636       lumbar or sacral, each additional facet joint (List separately in addition
to code for primary procedure)


Pointers on HOW to PROPERLY USE THESE CODES:

1. These codes are no longer billable at a service unit(s) on a per single nerve at a
single vertebral level;
2. You have to remember that there are 2 spinal nerves that inervates each single
facet joint;
3. Anatomically, there are 2 facet joints (left and right) on each vertebral level;
4. These codes are billable per facet joint; which means, if 2 facet joints were
treated on the same vertebral level, then you will report the primary code with a
modifier -50 to indicate a bilateral procedure;

Here are your number of pairs for your Spinal Nerves: There's a total of 31 pairs.
Cervical     8 pair
Thoracic    12 pair
Lumbar     5 pair
Sacral       5 pair
Coccyx     1 pair

Also note that imaging guidance is
inclusive and that per CPT guideline, fluoro or
CT (imaging guidance) is
required for the performance of these procedures.

Otherwise,  we are being further instructed that if imaging guidance (Fluoro or CT)
is
not used, it is appropriate to use the unlisted procedure code 64499
(Nervous System).


Let's move on to another changes - CPT 27096
(Injection procedure for sacroiliac joint,
arthrography and/or anesthetic/steroid)


Effective January 01, 2012:

DELETED CODE 73542 - Radiologic examination, hip, arthrography, radiological
supervision and interpretation.

REVISED 27096        Injection procedure for sacroiliac jount, anesthetic/steroid,
with image guidance (fluoroscopy or CT) including arthrography when
performed.

This means, the
imaging guidance is required for the performance of this
service,
otherwise, we are being instructed per CPT guideline that if imaging
guidance is
NOT used, it is appropriate to report this service using procedure
20552.

Append Modifier 50 for Bilateral procedure.

Reference: CPT Changes 2012, CPT Code Book 2012.
CPT is a trademark and owned by the American Medical Association (AMA)

**** For more references: Consult your CPT code books.  The National Correct
Coding Initiative (NCCI) and third pary payer payment policies and guidelines
Recommended Reference Book!