Anesthesia Coding Alert
Stick with Cervical/Thoracic Code for Block to T12-L1
Question: The pain management provider administered medial branch blocks at T10 -T11 and T11-T12 to block T11-T12 and T12-L1. I know T12-L1 is considered part of the lumbar region, so should I bill 64490 with 64493 or should both blocks be reported as thoracic with 64490 and +64491? South Carolina Subscriber Answer: Because the injections were administered to thoracic areas, you should report the cervical/thoracic codes for this procedure: 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) and +64491 (… second level (List separately in addition to code for primary procedure)). Code 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) is less accurate than the cervical/thoracic code.
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