Question: Will I have trouble receiving reimbursement for facet joint injections 64470-64476 with the diagnosis of facet syndrome, 724.8 ? You Be the Coder and Reader Questions were reviewed by Marvel Hammer, RN, CPC, CCS-P, CHCO, owner of MJH Consulting in Denver.
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 correct ICD-9 codes for facet joint injections - some even require 721.3 (Lumbosacral spondylosis without myelopathy). So go to your Medicare carrier's website and pull up the LCD to review the diagnoses that support medical necessity.