# paracoccyx steroid injection



## MNovoselatz (Nov 12, 2010)

Hi- Looking for some suggestion on how to code a paracoccyx injection:

A 22 gauge 3 1/2 inch needle was passed through the skin wheal and advanced toward the mid point of coccyx under periodical radiographic guidance until bony structure contacted. About 80mg of depo-medrol mixed with 2 cc of 0.25% bupivacaine was injected into the paracoccyx area with the tip of the needle redirected several times to achieve maximal infiltration.

I don't believe he is in the joint by this documentation- but I really cannot tell where he is (muscle, tendon, etc)- any thoughts?

Thank you!


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## dwaldman (Nov 12, 2010)

Like you said, muscle, joint, tendon, or nerve? You would query the physician. I typically see coccygeal nerve block. I don't see the other structures being injected in that region. I use 64450 which is not the best, but do  feel the RVUs are being met by the work involved to do the injection compare to other procedure you bill with 64450 if the nerve was injected.


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