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Neurosurgery Coding Alert

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Do Not Report Fluoroscopy with Facet Injections

Published on Tue Feb 21, 2012

Question: Our provider bills the following: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) -50 (Bilateral procedure)64494 (Injection[s], diagnostic or therapeutic agent, paravertebral facet [zygapophyseal] joint [or nerves innervating that joint] with image guidance [fluoroscopy or CT], lumbar or sacral; second level [List separately in addition to code for primary procedure]) -50 (Bilateral procedure)27096 (Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance [fluoroscopy or CT] including arthrography when performed) -59 (Distinct procedural service) RT and 27096 -59 LT77003 (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural, or subarachnoid])J1030 (Injection, methylprednisolone acetate, 40 mg) Payers are denying 64493 as being redundant to 77003. How can we get 64493 paid when billing 77003? Can a modifier be added to 77003?Tennessee SubscriberAnswer: The fluoroscopic guidance code [...]
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