# C4 & C5 medial branch block One or Two levels??



## MTrujillo (Mar 25, 2011)

Would an injection to the C4/C5 medial branch block be considered one or two levels?  Can I bill 64490 and 64491 for this procedure?  Any help is greatly appreciated!


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## marvelh (Mar 25, 2011)

64490 is to be reported for either an intra-articular facet joint injection OR blocking BOTH  medial branches that provide sensory innervation to that joint.  So if the physician injection into the C4-C5 joint itself OR blocked both the C4 and the C5 medial branches it would still only be 64490.  

Check the code descriptor "Injection, diagnostic or therapeutic agent, paravertebral facet joint (zygapophyseal) joint (OR NERVES INNERVATING THAT JOINT) with image guidance (fluoroscopy or CT), ...


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