# Facet Joint



## lump2009 (Apr 8, 2010)

Doctor performed the Right C2-C3 and C3-C4 C4-C5 and C6-C7 median branch block I billed 64490, 64491, 64492 and 64492 did I bill correctly


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## rkmcoder (Apr 8, 2010)

(These are my opinions and should not be construed as being the final authority.  Other opinions may vary.)

Look in your CPT book at the parenthetical note under 64492; "(Do not report 64492 more than once per day)".  You have billed 64492 twice in your example above.  What CMS/AMA are doing is not allowing billing for more than three facet injections per session (or six if bilateral).  If your doc does additional level(s), he will not be reimbursed for those level(s).  In your example above, he gave the patient a free injection at C6/7.

Richard Mann, your pain management coder
rkmcoder@yahoo.com


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## hgolfos (Apr 8, 2010)

I agree only 3 levels are billable, you may also want to append a modifier to indicate which side the injections were done on.  

64490-RT
64491-RT
64492-RT


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