What is the CPT code for medial branch block?

According to the AMA, the code series for medial branch blocks and the facet joint injections are the same (i.e., CPT series 64490-64495), with reporting based on the number of facet joints injected, not the number of nerves injected.

What is the CPT code 64491?

CPT 64491 – Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; second level.

Does Medicare pay for medial branch blocks?

Medicare Coverage for Lumbar Medial Branch Blocks Lumbar medial branch blocks refer to a diagnostic procedure where injection of an anesthetic “tests” the joint’s nerve endings. This is done to verify the pain relief response and receives coverage when medically necessary.

What does CPT code 64494 mean?

CPT® 64494 in section: Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral.

What is a medial branch block?

A medial branch block is a treatment for pain that has developed due to a damaged or inflamed facet joint in the spine. A facet joint is a bony structure that connects spinal vertebrae together. Facet joints help control the movement of the spine and provide extra support and stability for the vertebrae.

Does CPT code 64483 need a modifier?

Answer: If you perform a bilateral transforaminal epidural injection (64483) you can report CPT 64483 with Modifier 50 (bilateral procedure). Some payors require CPT 64483-single level (1 side) and 64483-50 (the other side) whereas some payors may require RT/LT.

Is 64491 an add on code?

Note that the multiple procedures modifier 51 should not be appended to the add-on codes 64491, 64492, 64494 or 64495 because these are add-on codes and exempt from multiple procedure concept.

Is CPT 64493 a surgical code?

The Current Procedural Terminology (CPT®) code 64493 as maintained by American Medical Association, is a medical procedural code under the range – Introduction/Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic Procedures on the Paravertebral Spinal Nerves and Branches.

Does insurance cover nerve ablation?

Radiofrequency ablation is usually covered by insurance, and for those experiencing chronic neck or back pain, RFA can be a welcomed relief.

Can nerve ablation make pain worse?

You may even experience a small amount of increased pain in the days immediately following the procedure, due to the nerves being irritated; but that is a normal will decrease with time.

What are the CPT codes for medial branch block?

The L3, L4 and L5 medial branch nerves innervate the L4-L5 and L5-S1 facet joint. We would report two CPT codes (64493 and 64494 provided the injections were performed with fluoroscopic guidance or CT guidance) for two facet joint injections despite having injected three nerves.

Is the code for medial and lateral nerve blocks the same?

Coding Billing for Medial and Lateral Nerve Blocks. According to the AMA, the code series for medial branch blocks and the facet joint injections are the same (i.e., CPT series 64490-64495), with reporting based on the number of facet joints injected, not the number of nerves injected.

When to report incorrect medial branch block reporting?

To reiterate, according to the AMA, when reporting medial branch blocks, if a physician states he intends to inject three medial branch nerves and he injects the L3, L4 and L5 medial branch nerves, we would only report two facet joint injection codes despite three nerves being injected. Remember, two nerves anatomically innervate each facet joint.

How are medial branch blocks and facet joint injections alike?

According to the AMA, the code series for medial branch blocks and the facet joint injections are the same (i.e., CPT series 64490-64495), with reporting based on the number of facet joints injected, not the number of nerves injected.