# Medial Branch Nerve Blocks



## missyah20 (May 5, 2010)

How would you code the below procedure? 

Bilateral T12, L1, L2, L3, and L4 Medial Branch Nerve Block Steroid Injection and Bilateral L5 Dorsal primary Ramus nerve block steroid injection

Thanks!


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## dwaldman (May 5, 2010)

Bilateral T12, L1, L2, L3, and L4 Medial Branch Nerve Block Steroid Injection and Bilateral L5 Dorsal primary Ramus nerve block steroid injection

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According to the CPT book T12-L1 should be billed lumbar.

You would want to inquire from the physician if these are the medial branch nerves or the anatomical locations of the injections. Whether he is referring anatomical locations of the injections or the medial branch facet nerves this would be 64493 50 64494 50 64495 50

If he is referring to T12,L1 etc as medial branch/facet joint nerves then you would have 

T12,L1 for the  facet joint L1-2 64493 50
L1,L2 for the facet joint L2-L3 64494 50
L2,L3 for the facet joint L3-L4 64495 50
L3,L4 for the facet joint L4-L5 included in the above code 
L4,L5 for the facet joint L5-S1 included in the above code

If he says these are the anatomical locations

T11, T12  blocked at T12 and L1 for facet joint T12-L1 64493 50
T12,L1 blocked  at L1 and L2 for L1-L2 facet joint       64494 50
L1,L2 blocked at L2 and L3 or L2-L3 facet joint        64495 50
The other levels would be included in 64495.


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