# 64483 two levels



## EricaWildinger (Jun 6, 2013)

Hi!
I'm hoping someone can help me with this.  I'm new to Pain Management and could use some experienced coding advice.
If a patient has a transforaminal epidural steroid injection (NFI), I understand the primary procedure would be 64483 and the additional level is 64484.  This is my quandary.  
If the Dr. does a 64483 on right L4 and another injection on the left L5 how would this be coded.  Can I code it as 64483-50 even though they are on two levels, but performed bilaterally?  
I would really appreciate any help! Any suggestions of Pain Management coding help books I could look into purchasing?


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## tgomez12 (Jun 6, 2013)

No you would not code 64483-50 due to the different levels. I code 64483 RT and 64484 LT. If the Dr. does Bilaterally L4 and Bilaterally L5 then you would code 64483-50 and 64484-50.

Hope this helps.


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## EricaWildinger (Jun 6, 2013)

It sure does!  Thank you!
Is it documented anywhere?  I would like to show the Dr.


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## dwaldman (Jun 11, 2013)

64483 represent a procedure performed at a single level. Then you have to know the laterality of the procedure. RT, LT, or Bilateral (50). A procedure performed at a second level would be reported with 64484. Although I am not aware off hand of AMA CPT Assistant article addressing bilateral procedures and what constitutes a bilateral procedure. Just remind the physician that 64484 is for additional levels performed, Modifier 50 is to denote a bilateral procedure performed at the same level. I don't believe you need a published source to explain this.


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