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January 29, 2025

Billing & Coding Update for Thoraco-lumbar Facet Joint Interventions

CGS revised Local Coverage Article A58364 to clarify language related to billing and coding for facet joint interventions in the thoraco-lumbar region. The revision is effective January 1, 2025.

Billing contiguous facet interventions in the thoraco-lumbar levels, T12-L1 and L1-2, during one session will be allowed and considered one spine (lumbar) region. A facet joint intervention targeting the thoraco-lumbar region will be considered and counted as one lumbar spine session.

Diagnostic and Therapeutic Procedures

For facet joint injections of the T12-L1 and L1-2 levels, or nerves innervating that joint, use 64490 and 64494 once.

Neurolytic Destruction of the Nerves (RFA)

For neurolytic destruction of the nerves innervating the T12-L1 and L1-2 paravertebral facet joints, use 64633 and 64636 once.

Reference

A58364 – Billing and Coding: Facet Joint Interventions for Pain ManagementExternal Website

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