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 Management