Radiology Coding Alert

You Be the Coder:

Face Facet Joint Coding Head On

Published on Thu Sep 06, 2012

Question: The physician advanced a 25 gauge spinal needle into the posterior aspect of the right T12-L1 facet joint. Needle aspiration was found to be negative for blood or cerebrospinal fluid (CSF). 0.25 cc of Isovue 200 was then injected into the facet joint confirming an intra-articular facet joint placement. He then injected 1 cc of 4% Lidocaine and 0.5 cc of Depo-Medrol 80 mg/ml into the joint. How should we code the injection?

New Hampshire Subscriber

Answer: The correct choice for injections to the T12-L1 joint or nerves innervating that joint is 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). Providers must use image guidance to complete the procedure, but you don't report guidance separately because the descriptor states "with image guidance."

Explanation: CPT® parenthetical notes changed in 2011 to direct providers to report the cervical/thoracic choice for a T12-L1 facet injection rather than the lumbar/sacral facet joint injection code.

Radiology Coding Alert

Ultrasound:
76506-76999 Authoritative Guidelines Clear the Way to Cleaner Claims
Know where to look for nationally non-covered ultrasound services. When you report diagnostic ultrasound, be [...]

ICD-10-CM:
568.0 and K66.0 Are Similar, But There's a Twist
News alert: The implementation date for the new code set is now official.Oct. 1, 2014, [...]

Biopsy:
10022 or 19102? Decide Whether to Report 1 or Both for This Case
CCI offers guidance to protect you from unexpected payback requests. Breast biopsies may not always [...]

Term Tips:
Take Your Ultrasound Coding Up a Notch Using This Glossary
Apply definitions direct from CPT®.Successfully connecting your radiology report to codes and coverage policies requires [...]

You Be the Coder:
Face Facet Joint Coding Head On
Question: The physician advanced a 25 gauge spinal needle into the posterior aspect of the [...]

Reader Question:
74000 Is Your Go-To KUB Code
Question: Which code applies to a KUB interpretation following ESWL?Texas SubscriberAnswer: Code 74000 (Radiological examination, abdomen; [...]

Reader Question:
174.x Is Just the Start for This Case
Question: How should we code malignant breast cancer with metastasis to liver and bone?Tennessee SubscriberAnswer: [...]

Reader Question:
Modifier PD: Verify Hospital Ownership
Question: If we perform a diagnostic X-ray for a Medicare patient at our office and [...]

Reader Question:
38221 and G0364 Can Pair Up
Question: For private payers, should I report G0364 or 38220 for aspiration and biopsy at [...]

View All