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Units and Frequency Report one unit per session Do not bill per spinal level Most payers allow up to 4 sessions per year per region Modifier Usage Modifier 50 for bilateral procedures when applicable Modifier 59 or X modifiers for distinct services Modifier 26 or TC for professional and technical components Place of Service 11 Office 22 Outpatient hospital 24 Ambulatory surgical center Payer Considerations Prior authorization may be required Follow payer-specific guidelines and policies Check Local Coverage Determinations for medical necessity Following these billing rules helps ensure clean claims, faster payments, and reduced denials