Pain Management Coding Update: Facet Joint Injection CPT Changes for 2010

Posted on 29. Oct, 2009 by .

Pain management, anesthesia, orthopedic, physiatry & neurology coders get ready for a facet joint codes shift that preps for ICD-10.

The 2010 version of CPT attempts to organize the facet joint injection codes by deleting 64470-64476 and debuting 64490- 64495 in their place, as follows:

• 64490 — Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level

• 64491 — … second level

• 64492 — … third and any additional level(s)

• 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

• 64494 — … second level

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MAC Auditors Will Stick It To Facet Joint Injection Claims

Posted on 26. Aug, 2009 by .

We hook you up with CMS instructions for when to use +64472, +64476 and when to use modifier 50.

Thanks to a 2006 OIG audit, MACs are on the lookout for incorrectly-billed facet joint injections, so it’s time to scrutinize your claims. Medicare guidelines are very strict about when you can append modifier 50 (Bilateral procedure) to a facet joint injection code — so you should know when to report this modifier versus when you must bill add-on codes instead.

CMS revised MLN Matters article MM6518 (effective date August 31). In the article, CMS clarifies that you should append modifier 50 to your facet joint injection code (64470, 64475) if the doctor injects the patient “on both the right and left sides of one level of the spine.”

If, however, the doctor performs facet joint injections on multiple levels on the same side of the spine, you should use the appropriate add-on codes (+64472, +64476) instead of modifier 50.

A 2006 OIG audit found that doctors incorrectly reported facet joint add-on codes to bill bilateral injections, when they should have appended modifier 50, the MLN Matters article notes.

You can access the article online here. If you’d like to read the OIG’s report on facet joint injections, visit here.

AUDIO: ICD-9 Coding Essentials for Pain Management Coders, with Marvel Hammer.

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Save Time Coding Facet Injections With This Coding Tool

Posted on 19. Mar, 2009 by .

Hint: Location, number and substance are key.

Several factors come into play when you’re successfully coding facet joint injections – spinal level, the number of injections, unilateral versus bilateral, and even the type of substance injected.

Use this handy chart to help pinpoint the correct codes for each case.

Pain-Free CEU on CD: Must-Know Anatomy Coding Tips for Office-Based Injections, with Marvel Hammer.

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Audit Hot Spot: Facet Joint Injection Claims

Posted on 12. Feb, 2009 by .

Here’s why the OIG wants to stick it to facet joint injection claims: Auditors found errors in 71 percent of physician office claims submitted to Medicare in 2006, resulting in $96 million in improper payments, according to a report released last year.

Get your injection coding right on target with Marvel Hammer.

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