Question: Can 64622 (Destruction by neurolytic agent, paravertebral facet joint nerve; lumbar or sacral, single level) be billed using modifier -50 (Bilateral procedure)? Ohio Subscriber Answer: Both 64622 and the add-on code +64623 ( lumbar or sacral, each additional level [list separately in addition to code for primary procedure]) can be billed bilaterally with modifier -50. However, if you add the modifier, it is likely that carriers will reduce their payment. It may be more advantageous to bill additional levels without the modifier. Most contractors' local medical review policies (LMRP) will provide reimbursement for these procedures, but it is always wise to check with the contractor in your state.