Anesthesia Coding Alert
Look to 01935 or 01936 for Anesthesia During Paravertebral Joint Block
Question: I know that anesthesia is "typically not required" with the services of 64490 or 64493, but what happens if the patient does need anesthesia with these procedures? We have varying opinions in our office of which anesthesia code would be appropriate (01992, 01935, 01936, or 00600 or 00630). What's the right answer? Washington Subscriber Answer: You're correct in noting that anesthesia is not typically needed for 64490 (Injection[s], diagnostic or therapeutic agent, paravertebral facet [zygapophyseal] joint [or nerves innervating that joint] with image guidance [fluoroscopy or CT], cervical or thoracic; single level) or 64493 (Injection[s], diagnostic or therapeutic agent, paravertebral facet [zygapophyseal] joint [or nerves innervating that joint] with image guidance [fluoroscopy or CT], lumbar or sacral; single level). The descriptors for facet blocks and transforaminal injections state "with image guidance," which means the provider is required to use image guidance to perform these injections. The closest anesthesia codes representing the services would be 01935 (Anesthesia for percutaneous image guided procedures on the spine and spinal cord; diagnostic) or 01936 (... therapeutic) since their code descriptors include image guidance. Anesthesia codes 00600 (Anesthesia for procedures on cervical spine and cord; not otherwise specified) and 00630 (Anesthesia for procedures in lumbar region; not otherwise specified) are incorrect for this situation.
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