Stacey Miller: CPT 64495 (Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; third and any additional level(s) (List separately in addition to code for primary procedure)) is reported just once for third and any successive levels by virtue of the code descriptor language (CPT 2010 Professional Book).
So if a physician performs facet joint injections at the following four levels: L1-L2, L2-L3, L3-L4, and L4-L5, the appropriate codes will be: 64493 x 1, 64494 x 1 and 64495 x 1. Under no circumstances can CPT 64495 be reported more than once.
Of note, the new facet injection codes for 2010 (64490-64495) include fluoroscopic and/or CT image guidance for the needle localization.
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