**** Year 2010 - Latest Update on these codes is on my BLOG. New Pain Management
Codes for Paravertebral Facet Joint Injection(s); Nerve Block(s). Effective January 01,2010,
64470, 64472, 64475, 64476 is Deleted
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. - (useful tip: Report only 1 unit when performed on the same level - because the
modifier 50 is already indicating 2 sides (a left and a right). For example a bilateral 64470
should be billed as 64470 with modifier -50 for 1 unit.
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 AMA's 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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