What is a paravertebral facet joint?

A paravertebral facet joint represents the articulation of the posterior elements of one vertebra with its neighboring vertebra. For the purposes of this Local Coverage Determination (LCD), the facet joint is noted at a specific level, by the vertebrae that form it (e.g., C4-5 or L2-3).

What is procedure code 64493?

CPT code 64493 is defined as an “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.” CPT code 64494 is the “second level (list separately in addition to code for primary …

What is procedure code 64491?

CPT® Code 64491 – Introduction/Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic Procedures on the Paravertebral Spinal Nerves and Branches – Codify by AAPC.

What is a Paravertebral?

A paravertebral block is essentially a unilateral block of the spinal nerve, including the dorsal and ventral rami, as well as the sympathetic chain ganglion. These blocks can be performed at any vertebral level. However, they are most commonly performed at the thoracic level because of anatomic considerations.

What is the difference between facet injection and epidural injection?

Although both treatments are utilized for pain relief, they’re used for different underlying conditions. Epidural injections are for the back pain that radiates to the arm or legs. On the other hand, facet injections are injected into the facet joints for patients that suffer from degenerative conditions.

Can 64483 and 64493 be billed together?

The two procedures should not be performed together at the same time because 64493 is a diagnostic procedure and the 64483 may interfere with the results.

How do you bill CPT code 64493 bilateral?

1. Each CPT code listed (single level, second level, third and any additional levels) may be billed with a Modifier 50 when injecting a level bilaterally. For one level unilateral or bilateral CPT codes 64490 or 64493 should be used.

What is procedure code 77003?

77003 – Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (List separately in addition to code for primary procedure)

Where is the paravertebral region?

They’re known collectively as the paravertebral muscles. The highest of them are attached to the base of the skull, the lowest ones arise from the sacrum and iliac crest, some in between are attached to the backs of the ribs, and many are attached to the transverse and spinous processes of the vertebrae.

What is the CPT code for paravertebral facet block?

An anatomic spinal region for paravertebral facet joint block (diagnostic or therapeutic), is defined as cervical horacic (CPT codes 64490, 64491, 64492) or lumbar\\sacral (CPT codes 64493, 64494, 64495) per the AMA CPT Manual.

What is the modifier for bilateral paravertebral facet injection?

Bilateral paravertebral facet injection procedures 64490 through 64495 should be reported with modifier 50. One to two levels, either unilateral or bilateral, are allowed per session per spine region (i.e., two (2) unilateral or two (2) bilateral levels per session). For services performed in the ASC, do not use modifier 50.

What is the CPT code for bilateral facet injection?

Example: Under fluoroscopic guidance, a physician performs bilateral facet joint injections at L3-4 and L4-5. Report code 64493-50 for the bilateral injection at L3-4 and 64494-50 for the bilateral injection at L4-5.

What is the CPT code for vertebral injection?

Report 64490-64495 once per level, per side, regardless of the number of needle placements that are required. For instance, for injections performed on both sides of one vertebral level, report the base injection code (64490 or 64493) with modifier 50 Bilateral procedure.