# L45 transforaminal and S1 foramen injections



## Art111085 (Apr 20, 2010)

My Dr. has coded 64483 as L45 transforaminal injection then has listed S1 foramen injection. Upon review I have came up with 64483 and 62311. Please advise if this seems correct.

Thanks,
Amber


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## marvelh (Apr 20, 2010)

Did the physician inject the L4 and the L5 or the L4-L5 as this changes number of levels for coding, particularly transforaminal.

The S1 foraminal injection is a transforaminal injection.

IF the physician performed a transforaminal injection of the L4 spinal nerve at the L4-L5 interspace AND a transforminal injection of the L5 spinal nerve at the L5-S1 interspace, then along with the S1 foraminal injection, he would have injected a total of 3 separate levels or 64483 x 1 and 64484 x 2

IF however the physician performed a transforaminal injection of the L4 spinal nerve at the L4-L5 interspace and the S1 foraminal injection, he would have injected only 2 separate levels and would be coded as 64483 x 1 and 64484 x 1.

You may need to check with your physician if the injection procedure detail doesn't clearly identify the number of needles inserted / number of levels injected.


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## Art111085 (Apr 21, 2010)

marvelh,

He performed a transforaminal injection of the L4 at the L4-L5 interspace and the S1 foraminal injection.
I will go ahead and use the 64483, 64484 each with one level.

Thanks a bunch!
Amber


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