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Jennifer Posted 5 Year(s) ago

OUR DOCTOR CODED A FACET INJECTION FOR T11/12, T12-L1, L1-L2 AS THORACIC FACET INJECTIONS. HOW DO I CORRECTLY BILL?

SuperCoder Posted 5 Year(s) ago

Code it as:

T12-L1 facet injection: 64490 (as per CPT guidelines instruction)
T11/12: +64491
L1-L2: 64493

Use the above codes if image guidance of any type (fluoroscopy / CT) was used, but do not code the image guidance separately.

If no image guidance was used, code 20552-20553.

If US was used, bill 0213T-0218T

Jennifer Posted 5 Year(s) ago

Are you considering T12-L1 to be thoracic (64490) instead of lumbar. Please explain.

SuperCoder Posted 5 Year(s) ago

In this case, Yes.

See the CPT guideline just above code 64490 in CPT manual. It says: "For paravertebral facet injection of the T12-L1 joint, or nerves innervating that joint, use 64490"

This is the reason I chose 64490 for T12-L1, and after that have taken +64491 for T11/12.

It's the other way around of usual billing. Anyway, you can bill 1 unit of 64490 and 1 unit of 64491 only. You cannot bill any single code with 2 units.

Posted by Jennifer, 5 Year(s). There are 4 posts. The latest reply is from SuperCoder.

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