CPT code 64495 is an add-on CPT code for image-guided diagnostic or therapeutic injections targeting lumbar or sacral paravertebral facet (zygapophyseal) joints or the nerves supplying those joints, representing the third treated facet joint level and any additional levels on one side. This procedure is clinically important for evaluation and management of axial low back pain where targeted diagnostic blocks or therapeutic injections guide further treatment decisions. Nationally, use of this code reflects patterns in interventional pain management and imaging utilization for spine care.

Key payers in the coverage landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent and typical sites of service, comparisons of payer coverage approaches and billing requirements, and benchmarks for documentation and coding practices tied to image-guided lumbar/sacral facet interventions. The publication also highlights common modifier usage and coding considerations when reporting multiple levels, and outlines where data is limited or varies by payer.

This summary is intended for billing managers, interventional pain clinicians, and policy analysts seeking a national-level briefing on coding and coverage issues related to image-guided lumbar/sacral facet joint injections at multiple levels.