Reporting of modifier 50 and Add-On codes for Facet Joint Injections

Facet joints are located on the top and bottom of each vertebra and connect the vertebrae to each other. There are two facet joints present at each spinal segment, one on the left and one on the right side. This allows the spine to bend and twist. The CPT codes used for the reporting of facet joint injections are: 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—Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that...

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Note:  The following article synopsis was NOT provided by the AHA. It was created by Find-A-Code/innoviHealth.

Article Overview

This article reviews CPT reporting for facet joint injections and discusses how bilateral procedures and additional spinal levels are represented in billing. It is intended for coding professionals, billers, and reimbursement staff who work with interventional pain management or spine-related services and need a high-level understanding of the guidance covered.

Why This Topic Matters

Facet joint injection claims can be coded differently depending on whether the service is bilateral or involves additional levels, so accurate interpretation helps support compliant claim submission and consistent reporting.

Article Sections

  1. Facet joint injection code set overview

    Introduces the procedure area and the CPT code family associated with facet joint injections. The section frames the discussion around spinal levels and image-guided injections.

  2. Reporting guidance for bilateral and additional levels

    Summarizes the article’s discussion of modifier use and add-on coding in the context of facet joint injection reporting. The section focuses on general billing distinctions related to laterality and multiple levels.

What You Will Learn

  • The CPT code family associated with facet joint injection reporting
  • How the article frames bilateral reporting in relation to spinal level coding
  • How additional levels are discussed in the context of add-on code reporting
  • The general billing issues addressed for facet joint injection claims

Who Should Read This

  • Medical coders
  • Billing specialists
  • Revenue cycle staff
  • Interventional pain management practices
  • Spine and orthopedic coding professionals

Codes Discussed

  • CPT: 64490
  • CPT: 64491
  • CPT: 64492
  • CPT: 64493
  • CPT: 64494
  • CPT: 64495

Modifiers Discussed

  • CPT: 50

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