AMA Clinical Examples in Radiology - 2009 Bulletin 2
Bilateral Facet Joint Injection Coding
Bilateral Facet Joint Injection Coding The Centers for Medicare and Medicaid Services (CMS) issued Transmittal 526 providing instructions to appropriately report bilateral facet joint injections. The Office of Inspector General (OIG) reported that physicians are incorrectly using add-on codes 66472 and 66476 to report bilateral facet joint injection procedures instead of using Modifier 50. The CMS requires that Modifier 50 be appended to the appropriate CPT code ( 64470 - 64476 ) to identify bilateral (left and right) facet joint injection procedures when performed at the same operative session. For multiple bilateral injections, Modifier 50 should accompany each CPT...
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Article Overview
This article reviews Medicare guidance on reporting bilateral facet joint injection procedures, including CMS instructions, an OIG correction issue, and the transition from earlier CPT codes to later ones. It is aimed at coders, billing staff, and clinical documentation professionals who need to understand the general reporting framework for these procedures and the related policy update context.
Why This Topic Matters
Accurate reporting for facet joint injection procedures affects compliance, claims processing, and correct use of bilateral procedure indicators. The article is relevant because it addresses a common reporting error and notes a later CPT code revision that changed how these procedures are categorized.
What You Will Learn
- The CMS and OIG context behind bilateral facet joint injection reporting
- How the article frames the transition from earlier CPT code groupings to later revisions
- The general reporting considerations for bilateral versus additional-level facet joint injection procedures
- Where the article points readers for additional CMS reference material
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Radiology documentation staff
- Pain management coding professionals
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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