Anesthesia Coding Alert
Treat Pars Defect Injection as Facet Joint
Question: What code do I use for a pars defect injection (L5) under fluoroscopy? The physician administered 1 percent Lidocaine for local anesthetic, then 1 cc of 0.5 percent Bupivacaine and 20 mg of Depo-Medrol for the actual treatment.
Delaware Subscriber
Answer: The pars interarticularis links the posterior part of the vertebrae (facet joint) to the anterior body of the vertebrae. Because of this location, a pars defect injection technique is similar to a facet joint injection. Many providers report it as a facet joint injection, with 64475 (Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve; lumbar or sacral, single level).
A pars defect may be congenital (756.11, Spondylolysis, lumbosacral region) or due to trauma, stress or sports injuries (738.4, Acquired spondylolisthesis). Verify this patient's situation before reporting the diagnosis codes for medical necessity.
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