The spinal injection procedures are UNILATERAL procedures. Therefore, these codes are reported once per level, per site regardless of the number or type of injection performed per level, per side.
It is inappropriate to report injection on the spine procedures for each injection performed at a particular level and side.
If both sides of the same joint level/site/side are injected, then modifier –50 must be appended to the specific injection procedure code to indicate that bilateral procedures were performed.
Fluoroscopic Guidance - for Needle Localization and Guidance you must report CPT 77003 in Conjuction with 64470~64475; 64622~64626.
Append modifier –26 if it is done at POS: 22 or POS: 24 which means using facility owned equipment. Otherwise, do not append a modifier if done at the office and if you owned the equipments.
FACET NERVE BLOCK/PARAVERTEBRAL JOINT NERVE BLOCK/PARAVERTEBRAL JOINT NERVE BLOCK INJECTION:
64470 Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve; cervical or thoracic, single level 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). *** This code is not a stand alone code! Use 64470 as the primary code. Mod –51 is not allowed for 64472.
64475 Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve; lumbar or sacral, single level 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) . *** This code is not a stand alone code! Use 64475 as the primary code. Mod –51 is not allowed for 64476.
Example:
PARAVERTEBRAL Facet Joint Nerve Block performed at: L2-L3-L4 should be reported:
64475 x 1 Unit (at L2-L3; 1st level; L2 Medial Branch; L3 Pedicle) 64476 x 1 Unit (at L3-L4; 2nd level; L3 Medial Branch; L4 Pedicle)
Fluoroscopic Guidance, report CPT 77003 in conjuction with 64470~64475.
**** For more references: Consult your CPT code books. The National Correct Coding Initiative (NCCI) and third pary payer payment policies and guidelines *** Always consult your local carrier's local LCDs
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