Wiki Facet injection Coding

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missyah20

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Good Morning,
I do the professional billing for a CRNA in WA who provides facet injections in an ASC. We bill the facet injections with the 64490 - 64495 codes. The ACS has been billing these codes as well and their charges have been getting denied. Can someome please clarify for me how the ASC should be billing for these charges? I do not know much about how the facility side works.

Thanks so much!
 
The one redetermination letter that we received from the facility was a medical necessity related denial. As it turns out with that patient we also had a medical necessity denial. However the facility is stating that they are not getting paid for any of the facets that they are billing - we have received payment for some of the facets we have billed for.
 
I am starting to think that it may be a diagnosis/diagnosis linking issue on the facility side since we haven't really had problems getting our charges paid.
 
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