Every rheumatology practice should have the latest CPT, ICD-9, and HCPSC books in the office to make sure everyone is up to date with all code changes and to make sure procedures aren’t coded incorrectly. In addition, all super bills and charge slips should be updated to reflect the new codes in order to avoid unnecessary denials or delays in reimbursement.
Image Guidance
Whether using fluoroscopy or computed axial tomography, guidance is required to code for this procedure. If ultrasound guidance is used for the above procedures, the 2010 CPT guide states that you must report the facet joint injection as 64999. If no image is used for the procedures, you must report it as an injection code using the CPT codes 20550–20553.
Coders should note that the biggest change in the 2010 facet joint codes is that it is no longer allowable to bill separately for the image guidance.
One key point for rheumatology practices is that facet joint injections have been targeted by the Office of Inspector General as a procedure with a high error rate and are on their watch list. Also, the Centers for Medicare and Medicaid Services (CMS) released two transmittals last year on the subject of facet joints—Transmittal 526 (Change Request 6518) and Transmittal 440 (CR6317). These are available on the CMS Web site at www.cms.hhs.gov/transmittals.
It is important to stay abreast of coding guideline changes because there will be more focused audits by carriers on facet joint procedures in the coming months. If you have any questions about coding or billing in your practice, contact Melesia Tillman, CPC, CRHC, at (404) 633-3777 or at [email protected].
