Neurology & Pain Management Coding Alert

Question: Can you explain how to bill 64622? Do we report the code per level or per nerve destruction?

Answer: You report 64622 (Destruction of neurolytic agent, paravertebral facet joint nerve; lumbar or sacral, single level) per destruction of each nerve.

Facet nerve destruction codes 64622-64627 refer to individual nerve destruction. Facet joint nerve injection codes 64490-64495, by contrast, describe facet joint injections and are based on facet joint level.

Example: Your provider performs an injection of the left L3 and L4 medial branch (facet joint) nerve; report 64493 (Injection[s], diagnostic or therapeutic agent, paravertebral facet [zygapophyseal] joint [or nerves innervating that joint] with image guidance [fluoroscopy or CT], lumbar or sacral; single level). If your provider performs a radiofrequency destruction of the L3 and L4 medial branch nerves, however, you would report 64622 and +64623 (... lumbar or sacral, each additional level [List separately in addition to code for primary procedure]).