News flash:
Check your usage of modifier 50 and add-ons for facets
Published on Wed Jul 01, 2009
Thank the OIG for clarified guidelines from CMS. CMS clarified its stance on correctly reporting modifier 50 (Bilateral procedure) and add-on codes for facet joint injection services with an effective date of Aug. 31, 2009 (CR Transmittal R526OTN). Here's the quick version of what you need to know: • If your physician performs facet joint injections on both sides of one level of the spine (such as right C4-C5 and left C4C5), you must append modifier 50 with the appropriate procedure code. • If your physician performs facet joint injections on multiple levels on the same side of the spine (such as right C4-C5 and right C5-C6), submit the appropriate CPT addon code to report the additional levels -- not modifier 50. When it's time to report facet joint injections, you have four coding choices: • 64470 -- Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve; cervical or [...]