Outpatient Facility Coding Alert
Counting for Intra-articular Facet Nerve Blocks
Question: I’m coding for bilateral intra-articular facet nerve blocks to L1, L2, and L3 with ultrasound guidance. What is the correct way to report the procedure?
Providers can’t always append modifiers to the Category III codes, but CPT® parenthetical notes state that is the case with the 0213T – 0218T series. Each code includes the direction to report bilateral procedures with modifier 50.
Arkansas Subscriber
Answer: First, remember that coding for facet joint injections is based on the facet joint level. If your provider injected the L1, L2, and L3 medial branches, they equate to two levels: L2/L3 and L3/L4. The correct billing is 0216T (Injection[s], diagnostic or therapeutic agent, paravertebral facet [zygapophyseal] joint [or nerves innervating that joint] with ultrasound guidance, lumbar or sacral; single level) with modifier 50 (Bilateral procedure) for the first level. Then include +0217T (… second level [List separately in addition to code for primary procedure]) with modifier 50 for the second level.
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