Category III Codes Available for Facet Joint Injections Using Ultrasound Guidance

In CPT 2010, the AMA implemented new codes for facet joint injections. The CPT editorial panel clarified that facet joint injections require the use of imaging guidance and included the guidance in the code description. The new codes of 64490 to 64492 for cervical or thoracic facet joints and 64493 to 64495 for lumbar or sacral facet joint injections include fluoroscopy or CT guidance. They also clarified that if imaging is not used, codes 20550 to 20553 are to be used for these injections.

What if the physician uses ultrasound guidance in the performance of facet joint injections? The CPT editorial panel did not include ultrasound guidance in the Category I CPT codes. The panel developed Category III codes that mirror the Category I codes but include the use of ultrasound guidance rather than fluoroscopy or CT guidance. The descriptions of these new Category III codes, 0213T to 0218T, are included in the Coder’s Resource Center CPT Codebook 2010 but are not found in the printed version of AMA’s CPT 2010. 

Written by: Lynn Kuehn, MS, RHIA, CCS-P, CHAP, FAHIMA