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Neurosurgery Coding Alert

Reader Questions:

Master Diagnoses for Facet Joint Injections

Published on Mon Jun 20, 2005

Question: Will I have trouble receiving reimbursement for facet joint injections (64470-64476) with the diagnosis of facet syndrome (724.8)?

Oregon Subscriber Answer: In some states, such as Oregon, you may have trouble being reimbursed by Medicare with a diagnosis of 724.8 (Other symptoms referable to back). But offices in other geographic areas, such as Northern California, won't have a problem. Carriers differ greatly regarding the acceptable ICD-9 codes for facet joint injections - some even require 721.3 (Lumbosacral spondylosis without myelopathy).
 
Best strategy: Visit your Medicare carrier's Web site for its local coverage determination (LCD) to review the diagnoses your payer will allow to support medical necessity for facet joint injections. Remember that you should only report what the medical record will support.
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