New facet codes would include fluoro guidance as required component

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

Article Overview

This article covers upcoming and existing coding guidance for facet joint and epidural injection services, focusing on how imaging guidance is being handled by CMS, NCCI, and the AMA CPT code set. It is aimed at coding professionals, pain management practices, and reimbursement staff who need to track changes in bundling, code replacement, and new Category III additions. The article also discusses the timing of code changes and the broader shift toward imaging being included in the procedure codes themselves.

Why This Topic Matters

The topic matters because changes in bundled services can affect how spinal injection procedures are reported and reimbursed. Readers need to understand which guidance services are being incorporated into procedure codes and where new code sets or revisions may change reporting practices.

Article Sections

  1. Current and pending fluoroscopic guidance bundling

    This section discusses existing and upcoming bundling changes involving imaging guidance for spinal injection procedures. It references CMS, NCCI, and related CPT code set updates.

  2. Looking ahead to 2011

    This section addresses anticipated future changes to epidural injection coding and the possibility of additional imaging-related bundling in later CPT updates.

  3. New Category III codes bundle ultrasound services with facets

    This section covers newly listed AMA Category III codes and the broader inclusion of ultrasound guidance with facet joint injection services.

What You Will Learn

  • How imaging guidance changes are being handled for spinal injection coding
  • Which organizations are referenced in connection with code edits and updates
  • What types of code-set changes are discussed for future reporting periods
  • How new Category III additions relate to imaging services for facet procedures

Who Should Read This

  • Medical coders
  • Pain management billing staff
  • Physician practices
  • Compliance staff
  • Reimbursement analysts

Codes Discussed

Code Ranges Discussed

  • HCPCS LEVEL II: 64470-64476
  • HCPCS LEVEL II: 64479-64484

Modifiers Discussed


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