Anesthesia Coding Alert

Question: When a physician performs an epidural injection at T12-L1 level, a thoracic facet injection at T12-L1 and a lumbar facet injection at L1-2, which codes would you use?

Wisconsin Subscriber

Answer: Codes 64470-6448 (injection, anesthetic agent and/or steroid, paravertebral facet, joint or facet joint nerve; cervical or thoracic; single level) are the better codes because they are intended for facet injections. It is indicated that the primary injection was the T12 level and the additional level was L1. Because of that, it is suggested to use codes 64470 and 64476 (lumbar or sacral, each additional level [list separately in addition to code for primary procedure]). This would stand an audit (with documentation, of course) better than 64470 and 64475 (lumbar or sacral, single level) unless 64475 was modified with modifier -51 (multiple procedures).