Anesthesia Coding Alert
Reader Question:
Multi-Level Transforaminal Injections Get Separate Line Units
Published on Tue Aug 13, 2013
Question: The pain management specialist administered three transforaminal epidural injections at the S1, S2, and S3 nerve branches. He confirmed needle tip placement with fluoroscopic views. How do I code this?
Indiana Subscriber
Answer: There are four levels involved with this procedure. Code so that the payer clearly understands that your provider injected separate and distinct nerves:
- 64483 (Injection[s], anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance [fluoroscopy or CT]; lumbar or sacral, single level) for the L5 foramen
- +64484 (… lumbar or sacral, each additional level [List separately in addition to code for primary procedure]) for the S1 injection
- +64484-59 (Distinct procedural service) for the S2 injection
- +64484-59 for the S3 injection.
Other Articles in this issue of
Anesthesia Coding Alert
- Diagnosis Coding:
Let V Codes Help You Gain Higher Reimbursement
Build your diagnosis codes by starting with subterms. Thinking that V code diagnoses might not [...] - 2014 Physician Fee Schedule:
Proposed Changes Could Benefit You Next Year
Other news: Don’t miss your chance at $39,000 if you still haven’t joined the EHR [...] - ICD-10:
Continue to Focus on Gangrene and Obstruction to Untangle Umbilical Hernia Diagnoses
ICD-10 keeps 3 code choices for you. When your anesthesiologist is involved with a case [...] - Compliance:
Are You Reporting the Correct Group Practice Designation?
Brush up on the definitions to be sure. If you’re reporting quality data using the [...] - You Be the Coder:
Anesthesia During Kyphoplasty
Question: Our providers offer kyphoplasty in the office setting. One physician performs the kyphoplasty and [...] - Reader Question:
Report Failed Sedation With 995.24
Question: What diagnosis should we assign when our physician documents "failed sedation based on the [...] - Reader Question:
3 Documented Nerve Blocks Leads to 64450 x 3
Question: Three blocks were given during a patient’s wrist procedure (listed in the notes as [...] - Reader Question:
CABG Case That Crosses from Off Pump to On Pump
Question: My anesthesiologist began a bypass case without the pump oxygenator, then went on pump [...] - Reader Question:
Multi-Level Transforaminal Injections Get Separate Line Units
Question: The pain management specialist administered three transforaminal epidural injections at the S1, S2, and [...] - Reader Question:
Moderate Sedation Is Allowed With Discogram
Question: Our physician sometimes provides anesthesia while performing a discogram. Is this legitimate, and can [...] - Reader Question:
Get the Scoop on Sending Unencrypted Emails
Question: I recently heard that the HIPAA privacy rule was changed and it now prohibits [...] - Reader Question:
Choose 64999 for US Guidance With Paravertebral Facet Joint Nerve Destruction
Question: Our physician used ultrasound guidance during destruction of paravertebral facet joint nerves. How do [...]
View All
