Is 64493 covered by Medicare?
Medicare will not cover/provide payment for CPT codes 64490 and 64493 (with or without the 50 modifier) more than five (5) times in a year. This practice is never medically reasonable or necessary.
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 …
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 CPT code 64493 need a modifier?
Paravertebral Facet Joint Injection 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.
Does 64490 need a modifier?
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).
Does CPT code 64490 need a modifier?
CPT codes 64490-64495 should only be reported once per level, per side, regardless of the number of needle placements that are required. For example, if an injection is performed on both sides of one vertebral level, providers should report the primary injection code (64490 or 64493) with modifier -50.
Is CPT 64493 a bilateral code?
Each facet joint is supplied by the medial branches of two different spinal nerves. 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.
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 to Medicare?
From AMA CPT 2020: “For bilateral paravertebral facet injection procedures, report 64490, 64493 with modifier 50. Report add-on codes 64491, 64492, 64494, 64495 twice, when performed bilaterally.
What is the difference between 64483 and 64493?
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 know which one gave the pain relief if you do both at the same time?
How do you bill CPT code 64493 bilateral?
Report 64493 for the unilateral 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.
Does 64483 require 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.