Anesthesia Coding Alert

Question: We normally report 22899 instead of facet joint codes for hardware blocks. How should I report multiple levels with this code? Our physician administered hardware blocks at left L4, L5 and S1.

Texas Subscriber

Answer: The best codes for hardware blocks are 22899 (Unlisted procedure, spine) and 64999 (Unlisted procedure, nervous system). Whichever you choose is a personal choice, but some coders opt for 64999 because they're reporting a pain management procedure.
 
Only report your unlisted-procedure code once for the entire service provided, even if your physician administers multiple injections at multiple levels (instead of reporting the code multiple times with modifier 59, Distinct procedural service).
 
Adjust your fee accordingly to reflect the multiple injections. Many groups base their fee for 64999 on the facet joint injection codes and multiply it by the number of injections performed.