Wiki CPT code 64490

[Cheryl Porter]

Code 64490 reads at the end cervical or thoracic; single level. If the physician documents they did bilateral paravertebral facet joint injections at C3-4, C4-5 and C5-6 and then during same visit documents bilateral paravertebral facet joint injections at T5-6, T6-7 and T7-8. Can they bill code 64490 with modifier 50 and modifier 59 for the cervical and on another line bill code 64490 with modifier 50 for the thoracic? Appreciate any insight! Thanks!

 

[pathfinder57]

Here's my interpretation: There are a total of 6 levels involved (3 cervical and 3 thoracic) on the same day. Hence, I would code as follows: 64490-50, 64491-50, 64492-50 for the first level, second level, and third and any additional level(s) respectively. The note at the bottom of 64492 says: "Do not report 64492 more than once per day". Hope this helps.

 

[OCD_coder]

Pathfinder, you nailed it perfectly. All of the facet injection codes have a MUE limit of 1 per date of service, not just the 64492.