Billing and Coding: Facet Joint Interventions for Pain Management

This billing and coding guidance covers paravertebral facet joint diagnostic and therapeutic injections and facet neurolysis in the cervical/thoracic and lumbar/sacral regions, requiring appropriate image guidance (fluoroscopy or CT) and adherence to specific CPT reporting and laterality rules. Frequency limits apply (CPT 64490–64494: up to 4 sessions/region/rolling 12 months; CPT 64633–64636: up to 2 sessions/region/rolling 12 months), ultrasound guidance and injection with unauthorized biologicals are non-covered, and thorough medical record documentation (including diagnosis, assessment, signed reports, and justification for sedation or forbeing non-candidate for RFA) is required for payment.

"Diagnostic or therapeutic injection into the paravertebral facet joint or the nerves innervating that joint for pain management is covered for cervical/thoracic and lumbar/sacral regions when consi..."