Neurosurgery Coding Alert

Answer: For paravertebral facet joint injections, you can bill add-on codes if your physician’s documentation supports the services. For injection at the level L1-L2, you submit the primary code 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). You then add +64494 (…second level [List separately in addition to code for primary procedure]) for the second L2-L3 level injection. Further, you report add-on code +64495 (…third and any additional level[s] [List separately in addition to code for primary procedure]). Note that you report only one unit of service for the last two facet joint levels (L3-L4 and L4-L5). It is important to note that the code descriptor for the 64495 add-on code specifies “third and any additional level[s].”