I need clarification on how to code facet joint injections accurately along with diagnosis. I have read previous threads on this forum about this topic, but I am confused on wether to put -59 on the codes or if I need to put modifier -51 or no modifier at all? In the CPT book it states that "For paravertebral facet injection of the T12-L1 joint, or nerves innervating that joint, use 64490". Here is an example of my doctors note:

Procedure Note
Injection, lumbar facet joints, T12-L1, L1-2, L2-3, bilateral,
fluoroscopic guidance and needle localization
Procedure Details:
Position: prone
Local anesthetic: "No Sting" lidocaine 0.25% solution for skin and subcutaneous infiltration
Needle used: 27ga 3-1/2in spinal needle, at each level
Contrast: omnipaque 0.1cc at each level, (total 3cc with waste), no apparent vascular runoff
Nerves blocked: T11, T12, L1, L2, medial branches at junction of superior articulating process and transverse process, bilateral
Injectate: bupivacaine 0.75%, 0.25cc, at each level
Dye displaced after injection of local anesthetic
Needles removed
Returned to post-op area ambulating

Would I code this like:
64493 -50 M47.816
64494 -50 M47.816
64490 -50 -59 M47.814 or M47.815

OR

64490 -50 M47.814 or M47.815
64493 -50 -59 M47.816
64494 -50 -59 M47.816