CPT^® 64492, Under Introduction/Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic Procedures on the Paravertebral Spinal Nerves and Branches

The Current Procedural Terminology (CPT^®) code 64492 as maintained by American Medical Association, is a medical procedural code under the range - Introduction/Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic Procedures on the Paravertebral Spinal Nerves and Branches.

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Summary

In this add–on procedure, the provider injects a diagnostic or therapeutic agent into a facet joint, the joint connecting two spinal vertebrae together, at the cervical or thoracic level. Or he may perform the injection for nerves innervating that joint. He uses imaging guidance of either fluoroscopy or CT scan. The provider injects the third additional level, after two initial separately reportable injections. The goal of this procedure is to treat spinal pain or to identify the exact source of pain.

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Forum

Have a question about CPT Code 64492 ? Start a discussion here

Anyone ever bill for pain management?

[QUOTE="Jess23009, post: 511762, member: 466434"] Hi, I am having an issuse with the dx code. DX Code M47.816 is denying for CPT 64495. Do you know which codes are acceptable? [/QUOTE] M47.816 does pr... [ Read More ]

Anyone ever bill for pain management?

[QUOTE="DGgirll20, post: 501039, member: 693252"] For CPT codes 64492 and 64495, the need for a three-level procedure may be considered under unique circumstances and with sufficient documentation of ... [ Read More ]

CPT update for 64492 and 64495

[URL='https://www.ama-assn.org/practice-management/cpt/cpt-errata-technical-corrections']Effective Jan. 1, 2022[/URL] the instructions that limit level 3 blocks to once a day are deleted. [QUOTE] Rem... [ Read More ]

Medial Nerve Block

If the method of anesthesia is documented as MAC with this block, you would bill the ASA code with REGIONAL anesthesia. This means you would not bill the block separately. If the method of anesthesi... [ Read More ]

Anyone ever bill for pain management?

In GA we get these same denials. Third level injections will be denied. Palmetto Article A58350 states, "64492 and 64495 will only be covered upon appeal if sufficient documentation of medical neces... [ Read More ]

Anyone ever bill for pain management?

[QUOTE="kellit21, post: 500975, member: 131351"] We are getting denials on our 3rd level MBB or Facet injections stating not medically necessary. Are any of you getting this? Any insight on why they w... [ Read More ]

Anyone ever bill for pain management?

For CPT codes 64492 and 64495, the need for a three-level procedure may be considered under unique circumstances and with sufficient documentation of medical necessity on appeal. The KX modifier sho... [ Read More ]

Anyone ever bill for pain management?

Hi there, Medicare administrative contractors recently implemented a uniform policy that auto-denies 3rd level blocks, but you can appeal. Private payers may have followed suit or adopted a similar po... [ Read More ]

Anyone ever bill for pain management?

We are getting denials on our 3rd level MBB or Facet injections stating not medically necessary. Are any of you getting this? Any insight on why they would pay for the 1st 2 levels but not the 3rd? cp... [ Read More ]

Facet/MBB new guidelines KX mod

[QUOTE="DGgirll20, post: 494969, member: 693252"] I did attend a CMS webinar , the 1st 2 Diagnostic injections will apply the KX modifier , not 100 % sure is on all lines or just the 1st code dependi... [ Read More ]

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