MEDAC BILLING & COMPLIANCE ALERT
December 30, 2009

By: Bellinger P. Moody RHIA,CPC, CCP
Executive Vice President of Compliance

New Facet  Injection Codes:  Base Unit Assignments

As you may or may not know, there are new CPT codes for facet injections.  The old codes were 64470, 64472 (Cervical or Thoracic) and 64475, 64475 (Lumbar or Sacral).  The base unit assignments for these codes previously were:
64470   10 base units
64472   5 base units
64475   8 base units
64476   4 base units

The new codes are 64490, 64491, 64492 (Cervical or Thoracic) and 64493, 64494, 64495 (Lumbar or Sacral).  Fluoroscopy is now bundled into these procedures and is not separately billable/payable.  Consequently, the new ASA RVG does not assign any base units to these new codes.  Rather, they have them listed as “IC” (Individual Consideration) – which means we must assign the base units ourselves.  Therefore, the base unit assignments for these codes will be as follows:

Cervical or Thoracic

64490     12 base units
64491     5 base units
64492     10 base units

Lumbar or Sacral

64493     10 base units
64494     4 base units
64495     8 base units

The information presented herein reflects general information that is current as of the date it is first published.  In light of changes that may occur in the health care regulatory and compliance environments, the author's presentation of this information and any general advice previously published might become outdated.  Please check with your individual legal and/or compliance advisor(s) prior to taking any significant actions based upon the information and advice presented.