Reader Question:
Translate 'Atlanto-Occipital' or 'Atlanto-Axial' Joint as 'Paravertebral'
Published on Thu Apr 03, 2014
Question: Our pain management specialist performed the following procedures:
-
RT C2-C3, RT C3-C4 , RT atlanto-occipital joint and RT atlanto-axial joint injections
He administered a total of four injections. I get confused with how to code the AO and AA joints because of the location. Can you please help?
North Dakota Subscriber
Answer: First, look at which joints were involved with each injection:
-
Occipito-atlantal joint/Atlanto-occipital joint (articulation between the atlas and the occipital bone) is the C0-C1
-
Atlanto-axial joint is the C1-C2
-
C2-C3
-
C3-C4.
You’re dealing with four paravertebral facet joint levels for injections. Report the encounter as:
-
64490 (Injection[s], diagnostic or therapeutic agent, paravertebral facet [zygapophyseal] joint [or nerves innervating that joint] with image guidance [fluoroscopy or CT], cervical or thoracic; single level) for C0-C1
-
+64491 (…second level [List separately in addition to code for primary procedure]) for C1-C2
-
+64492 (…third and any additional level[s] [List separately in addition to code for primary procedure]) for the C2-C3 and C3-C4 injections. Remember, since +64492 specifies “third and each additional” level, you should only bill with one unit of service for both the C2-C3 and C3-C4 injections.