# epidurals with transforaminal injections



## 20Hiker16 (Aug 18, 2009)

Does anyone know if an epidural at L4-L5 is performed followed by a L5 transforaminal injection at the same session can be safely billed with a 59 modifier?

I NCCI edits say that they are "Mutally Inclusive" but they also have the the 64483 with a "1" so that it can be billed separately.

I'm always a little nervous about unbundling.  Any guidance will be most appreciated.


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## bakert (Aug 19, 2009)

I am not 100% sure about the epidural and transformal....I don't believe you can bill those together. The 64483 is for the selective and won't cover what you are looking for cpt wise. ASA will be the same code for all three codes depending on position.


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