Part B Coding Coach: The Difference Between Nerve Block and Destruction May Be Greater Than You Think

Why This Topic Matters

Facet joint injection claims can be affected by how the procedure is documented, how levels are counted, whether both sides are involved, and whether imaging guidance is separately reportable. Understanding the distinction helps support accurate CPT-based reporting and alignment with payer guidance.

Article Sections

1. Report only destruction with same-session block

   Introduces the main documentation issue and the relationship between blocking and destruction when both occur at the same location on the same date. References payer guidance and a local coverage example.

2. Count joints for nerve blocks

   Explains the general approach to counting facet joint levels for nerve block reporting and contrasts nerves versus levels in cervical, thoracic, lumbar, and sacral regions.

3. Multiple injections won't mean multiple code units

   Describes how repeated injections at the same level are treated for reporting purposes and clarifies how a single level is interpreted in the context of nerve block services.

4. Call on bilateral modifiers

   Covers bilateral reporting concepts for unilateral facet joint procedures and notes the use of modifier options for payer-specific billing conventions.

5. For destruction, count individual nerves

   Explains the contrasting counting approach for nerve destruction services and discusses how multiple injections to the same nerve are treated.

6. Report only destruction with same-session block

   Summarizes the instruction to report only the destruction service when blocking and destruction occur at the same site on the same date, and mentions related imaging guidance reporting.