Ask Dr. Z

When RF ablation (64635 and 64636) and medial branch nerve blocks (64493 to 64495) are done, what is the best documentation to determine the number of levels dealt with? We have a new provider, and I am confused on if there are two or three levels in this documentation. "Needle placed at L2 medial branch nerve location at the junction of the right L3 transverse and superior articulating processes. Bupivacain was injected. Same procedure then repeated for right L3 medial branch at the junction of right L4 transverse and superior articular process and for the right L4 medial nerve at the right L5 transverse and superior articular processes. This was then repeated for left L2, L3, and L4 medial branch nerves." Would this be two or three BILATERAL levels for nerve block? What if for radiofreqency procedure?

I am used to documentation stating L2-3, L3-4, L4-5,  and this documentation is confusing me.