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How do we tell the MAC what type of facet joint procedure we are requesting? Do we use modifiers?
Last updated Jun 26 2023
Jurisdictions:

Ensure the Prior Authorization request is specific in stating diagnostic vs therapeutic facet joint procedure. That information can be included in the Additional Information section of the Hospital Outpatient Department (HOPD) Prior Authorization Request Form. You may also indicate modifier KX along with the CPT on the request form. The KX modifier should be appended to the line for all diagnostic injections.