What does CPT code 64490 mean?
The CPT codes 64490 and 64493 are intended to be used to report all of the nerves that innervate the first level paravertebral facet joint and not each nerve.
What is procedure code 64491?
CPT® Code 64491 in section: Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic.
Does CPT code 64490 need a modifier?
Laterality: 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 to two (2) bilateral levels per session).
How do I bill a 64490?
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.
Does 64491 need a modifier?
If the facet joint injection is performed at more than one level unilateral or bilateral CPT codes 64491, 64492, 64494 or 64495 should be used for the additional levels. For bilateral procedures Modifier 50 should be appended to the procedure codes with number of services of one. 2.
Is 64491 an add on code?
For any additional diagnostic or therapeutic procedures on the same day, use add-on codes 64491 (cervical/thoracic) or 64494 (lumbar/sacral) to report second level injections performed with image guidance (fluoroscopy or CT) in addition to the primary procedure codes 64490 or 64493.
What is LT and RT modifier?
In some instances, procedure codes do not indicate on which side of the body a procedure is performed. In those instances, the modifier LT (left) or RT (right) is used to indicate the side of the body on which a service or procedure is performed.
When do you use modifier 50 vs LT RT?
Modifier LT or RT should be used to identify which of the paired organs was operated on. Billing procedures as two lines of service using the LT and RT modifiers is not the same as identifying the procedure with modifier 50. Modifier 50 is the coding practice of choice when reporting bilateral procedures.
What is the bilateral procedure rule?
Definition: A surgical procedure is considered bilateral when the same procedure is performed on both sides of the body. Common anatomical sites for bilateral surgical procedures are extremities, eyes, ears, and breasts.
What is the correct order of modifiers?
The general order of sequencing modifiers is (1) pricing (2) payment (3) location. Location modifiers, in all coding situations, are coded “last”.