CPT 64494 is an add-on code and can be the injections of the diagnostic or therapeutic agent into the facet joint at the second additional level.
1. What Is CPT Code 64494?
The 64494 CPT code procedure aims to identify the source of spinal pain or treat it.
This code is an add-on procedure and can be billed if a surgeon injects a therapeutic or diagnostic agent into the patient’s facet joint. The facet joint connects two spinal vertebrae at the sacral or lumbar level.
They can also inject for the nerves innervating the joint. This add-on procedure is performed with a CT scan or fluoroscopy guidance.
TIP: You can find the billing guide for the primary procedure CPT 64493 here.
CPT code 64494 is an add-on procedure and is defined by the CPT book 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; second level.”
CPT 64494 is an add-on procedure and is performed during a primary procedure. First, the provider administered facet injections at an initial spinal level.
Then, they anesthetize and prep the patient for a second lumbar or sacral-level facet joint injection. Next, the health provider uses a needle, inserts it through the patient’s skin, and positions it within the joint with the help of CT or fluoroscopy guidance.
Finally, the diagnostic or therapeutic is injected. This can be an anesthetic mixture or a steroid.
They end the procedure by removing the needle and ensuring that the site obtains hemostasis.
4. Billing Guidelines
You can use CPT 64494 as an add-on code for CPT 64493.
Do not report imaging guidance separately. It is included in the 64494 CPT code.
CPT 64494 can only be reported once per day.
You can not bill CPT 64494 without a primary surgical code. CPT 64493 may be used for the initial lumbar or sacral level, and CPT 64494 for the second level. The third level or more can be billed with the add-on code CPT 64494.