# V64.1 vs V64.3



## mhstrauss (Mar 5, 2014)

Hi, I need help with selecting the correct diagnosis code for a discontinued procedure one of my Pain MD's performed recently.  It was intended to be a Lumbar ESI but could not be completed due to previous fusion at the same level.  My doc dictated:

...A 3.5 inch 20 gauge Tuohy spinal needle was passed through the skin wheal and advanced in a paramedian fashion, however, the epidural space could not be accessed due to posterior boney fusion.  The needle was withdrawn and gentle pressure placed over the wound for hemostasis...


Would this be considered a contraindication (V64.1)?  Or should that code only be used for medical reasons, such as reaction to anesthesia, tachycardia, etc?  If this does not fit in V64.1, the other option I'm seeing is V64.3.

Would love to get some feedback on this. TIA!!


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## MnTwins29 (Mar 5, 2014)

I would use V64.3.   I think of a contraindication as due to a medical reason or condition.   Also, the procedure could still be performed - it just has an inherent risk of a complication if a contraindication is identified.   In your case, there wasn't a risk if the procedure was carried out - it COULDN'T be carried out because of the bone structure.   Hence, why here I would use V64.3


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## mhstrauss (Mar 5, 2014)

Thanks for your reply Lance!

Just a clarification, we did use modifier 53 on the 62311...I guess I had modifiers on the brain, and posted this in Modifiers instead of Diagnosis Codes 

Thanks!


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