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Tara Posted Mon 16th of October, 2017 10:42:33 AM
THE PHYSICIAN SUBMITTED CHARGES FOR LUMBAR MEDICAL BRANCH BLOCKS AT L2,3 AND 4 (64493, 64494 AND 64495). TO ME THIS WOULD JUST BE 64493 AND 64494. HE HAS CHANGED HIS WORDING IN HIS DOCUMENTATION AND I WAS WONDERING IF THIS MAKES HIS CODES CORRECT: THE RIGHT L3(MB2), L4(MB3) AND L5(MB4). HE HAS NEVER PUT MB_ IN PARENTHESES BEFORE. WE HAVE HAD TROUBLE WITH THIS PHYSICIAN ON THE WAY HE COUNTS HIS MBB'S. DOES THIS MAKES A DIFFERENCE? TO ME IT WOULD STILL BE 64493 AND 64494. THANK YOU FOR YOUR HELP. TARA
SuperCoder Answered Tue 17th of October, 2017 06:21:16 AM

Hi Tara,

The L2, L3, and L4 medial branch nerves innervate the L2-L3 and L3-L4 facet joints. Since the block is given in facet joints (it will be between two vertebrae) Therefore, code 64493, Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level, is reported for the first joint injected or blocked (L2-L3). Code 64494 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (L3-L4) will be billed. Hope it helps.

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