Anesthesia Coding Alert

Question: How do I bill correctly for 64475 and +64476 for a total of three levels?

Oklahoma Subscriber

Answer: CPT provides one code for the first level of the procedure, and a second code for each additional level. For example, if the injections were used at the L1-L2, L2-L3, and L3-L4 joints for a total of three levels, you may report:

• 64475 (Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve; lumbar or sacra, single level) Use this for the first level (1 unit)
• +64476 (Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve; lumbar or sacral, each additional level [List separately in addition to code for primary procedure]). Use this for the second and third level. (2 units).

In short: For each additional level of the lumbar facet joint,-you should use code +64476, but for the primary level of the lumbar facet joint you should report only 64475. But watch out: Some payers have limitations on the total number of levels allowed for processing, often a maximum of three total, not four.