Surgery: Nervous System (Q&A) (October 2012)

October 2012 page 15 Surgery: Nervous System Question: Is it appropriate to always report code 64491 in conjunction with code 64492, since the first code is for the second level and the latter is for third or additional level(s). Seeing that there is an instruction for always reporting the second level (64491) with the initial level (64490), it seems logical that the third or additional level(s) (64492) should always be reported with the second level (64491) as well. The same issue applies to the parallel codes for reporting the injections on the lumbar or sacral levels (64493-64495). Answer: Yes...

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

Article Overview

This article explains a coding question-and-answer discussion from CPT Assistant focused on surgery of the nervous system. It addresses how a family of facet joint injection codes is structured across spinal regions, with related guidance on unilateral reporting and the use of a bilateral modifier. The piece is intended for coders, billers, and reimbursement staff who work with interventional pain and spine-related procedure coding.

Why This Topic Matters

Accurate reporting of multi-level spinal injection services depends on understanding how related CPT codes and modifiers are organized within the code family. This article helps readers evaluate whether the topic applies to their workflow without exposing the full premium guidance.

Article Sections

  1. October 2012 page 15

    Introductory publication reference for the Q&A content and its placement within the issue.

  2. Surgery: Nervous System

    A coding question-and-answer discussion centered on nervous system surgery topics and facet injection reporting.

What You Will Learn

  • The general structure of a spinal injection code family across regions
  • How a coding Q&A explains reporting for successive levels of a procedure
  • What broad modifier guidance is discussed for bilateral procedures
  • How the article frames the topic within CPT Assistant and nervous system surgery

Who Should Read This

  • Medical coders
  • Coding auditors
  • Billing staff
  • Compliance teams
  • Revenue cycle professionals

Codes Discussed

Code Ranges Discussed

Modifiers Discussed


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