CPT 64493 can be used for a paravertebral facet (zygapophyseal) joint injection procedure using image guidance to inject a diagnostic or therapeutic agent at a single level of the lumbar or sacral spine.
What Is CPT Code 64493?
CPT code 64493 describes a procedure known as a paravertebral facet (zygapophyseal) joint injection.
The procedure is performed under image guidance (fluoroscopy or CT scan) to help ensure accuracy.
The injection is given into the lumbar or sacral level of the patient’s spine on a single level.
The injection is either a diagnostic or therapeutic agent, such as a steroid or anesthetic mixture.
The 64493 CPT code procedure aims to treat spinal pain, identify the source of pain, or diagnose a specific condition related to the facet joints or the nerves innervating the joints.
The CPT book describes CPT code 64493 as: “Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level.”
Tthe provider utilizes imaging guidance to accurately position a needle at the lumbar or sacral level facet joint or the nerves innervating the joint. The patient is first prepped and anesthetized.
Once the needle is in the correct position, the provider injects a diagnostic or therapeutic agent, such as a steroid or anesthetic mixture.
The needle is then removed, and the injection site is checked for bleeding. The goal of the 64493 procedure is to alleviate spinal pain or pinpoint the source of pain.
How To Use CPT 64493
Multiple injections at the same spinal level should not be coded separately. Instead, report CPT code 64493 once for the first level (e.g., L3 to L4) and use add-on code CPT 64494 once for the second level (e.g., L4 to L5) and report add-on code CPT 64495 for each additional level.
Also, it is unnecessary to report imaging guidance such as fluoroscopy or CT separately. If the injection is for the anesthetic agent, nerves innervating the sacroiliac joint, use CPT code 64451.