Billing for one mbb (1/2 a facet joint)?

[Timeoutofmind]

I did MBBs on a pt for the levels above and below a fusion (L1 and DPR L5). Did not do the MBB immediately adjacent to the pedicle with hardware, so basically I really just denervated 1/2 of two different facet joints...

How do you guys bills this?

My biller is telling me:

64493-50
64494-50

Does not seem correct?

Thanks

 

[SSdoc33]

I did MBBs on a pt for the levels above and below a fusion (L1 and DPR L5). Did not do the MBB immediately adjacent to the pedicle with hardware, so basically I really just denervated 1/2 of two different facet joints...

How do you guys bills this?

My biller is telling me:

64493-50
64494-50

Does not seem correct?

Thanks

good question. the merits of the injection aside, i think your biller is correct. you blocked 2 different joints, and should get credit for both

 

[Ducttape]

yes biller is correct.

you in fact denervated 2 different facet joints bilaterally, and some insurers will argue that the other median branch (L2 and L4) are part of the fusion element

 

[Timeoutofmind]

the merits of the injection aside,

Thanks guys.

Are you saying you would also have blocked the MBB immediately adjacent to the pedicles with hardware?

 

[cowboydoc]

Thanks guys.

Are you saying you would also have blocked the MBB immediately adjacent to the pedicles with hardware?

Sounds like you did what I'd do, and is was billed correctly.

I don't block the branches running around the pedicle screws, as I'm not going to RF there.

 

[SSdoc33]

Thanks guys.

Are you saying you would also have blocked the MBB immediately adjacent to the pedicles with hardware?

im saying i wouldnt have done the block at all. i think you will be less than impressed with the results. does he/she have pain both above AND below the fusion? thats a span of 6-8 inches. not sure what you are really going to accomplish. MAYBE an SIJ injection would help. maybe.