# Dorsal rami/paravertebral blocks - coding this procedure.



## mgrimaldi (Feb 20, 2013)

I need help with coding this procedure.

Today we repeated dorsal rami/paravertebral blocks at C7 and T1 bilaterally.  Patient was placed in the sitting position and sedated.  The spinous processes were palpated and 25-gauge spinal needles were inserted 1 fingerbreadth lateral on each side of the spinous process.  Each was advanced until bone was contacted and paresthesia was elicited.  

No fluoroscopy was used.  Thoughts?? 

Thanks


----------



## stonecm (Feb 21, 2013)

Per CPT, you would use 20552.

If image guiadance was used, it'd be considered a facet block as the dorsal rami would fall under "nerves innervating the facet joint", however, per CPT when image guidance isn't used it says to see CPT codes 20552-20553. Depending on the ICD-9 codes, Medicare probably won't pay the 20552-20553. You could try billing with unlisted CPT code and state it's similar to CPT code 64490, that's what we do for SI joint injections done with ultrasound because it's the same situation.


----------

