One of our providers did a lumbar facet injection, bilateral, of one level, L4-L5. Our billing department used CPT 64493 for the first site and 64493-50 for the second site. Reading the report, it looks to me as though there were two injections to L4 (each side) and two injections to L5. I am trying to figure out if this is the correct way to code this procedure. Report reads:
The L4-L5 facet joints were localized under CT. Patient's skin marked posterior to the joints. Skin prepped and draped in the usual sterile manner.
Local anesthesia was obtained using subq infiltration of 1 ml of 1% lidocaine buffered with sodium bicarbonate.
Using intermittent CT fluoroscopic guidance, 22-gauge needles were placed into the L4-L5 facets joints.
20 mg of Depo-Medrol and 2 ml of 0.25% Marcaine was injected into each joint.
Is 64493, 64493-50 correct or should it be 64493-50 twice or should it be something entirely different? Help?! Has anyone seen this before? This was done in the hospital outpatient setting. Not sure if that makes a difference
The L4-L5 facet joints were localized under CT. Patient's skin marked posterior to the joints. Skin prepped and draped in the usual sterile manner.
Local anesthesia was obtained using subq infiltration of 1 ml of 1% lidocaine buffered with sodium bicarbonate.
Using intermittent CT fluoroscopic guidance, 22-gauge needles were placed into the L4-L5 facets joints.
20 mg of Depo-Medrol and 2 ml of 0.25% Marcaine was injected into each joint.
Is 64493, 64493-50 correct or should it be 64493-50 twice or should it be something entirely different? Help?! Has anyone seen this before? This was done in the hospital outpatient setting. Not sure if that makes a difference
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