Anesthesia Coding Alert

Question: Our office was coding CPT® codes 64635, 64636, and the J code with the anesthesia series 00600-00670. Could you please advice are these codes appropriate for place of service 49? 

Oklahoma Subscriber

Answer: POS 49 (Independent clinic) represents “A location, not part of a hospital and not described by any other Place of Service code, that is organized and operated to provide preventive, diagnostic, therapeutic, rehabilitative, or palliative services to outpatients only.”

CPT® includes two codes that might be reported for facet joint injections performed in an outpatient setting: 

• 64635 – [Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint]
• 64636 – [Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to code for primary procedure)]

However, 00600 (Anesthesia for procedures on cervical spine and cord; not otherwise specified) and 00670 (Anesthesia for extensive spine and spinal cord procedures (eg, spinal instrumentation or vascular procedures)) are general anesthesia codes and are not usually seen as appropriate for billing at an independent clinic level. It might attract denial from the payer.