Anesthesia Coding Alert

Question: We have an ongoing debate in our office about the correct anesthesia code to report for 64483. We've been using 01992 because 64483 represents a transforaminal nerve block instead of a simple spinal injection. Why does the ASA's Crosswalk tell us to use 01936?

Connecticut Subscriber

Answer: Code 64483 (Injection[s], anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance [fluoroscopy or CT]; lumbar or sacral, single level) crosses to anesthesia code 01936 (Anesthesia for percutaneous image guided procedures on the spine and spinal cord; therapeutic) because the provider administers a transforaminal injection under fluoroscopic guidance. The descriptor explains exactly what happens in a transforaminal injection.

When the CPT® code descriptor for 64483 changed to include fluoroscopic guidance, the correct cross-code changed from 01992 (Anesthesia for diagnostic or therapeutic nerve blocks and injections [when block or injection is performed by a different provider]; prone position) to 01936. Note that before reporting 01936 you would need documentation that one provider administered the block and another performed the procedure.

Unit check: Both 01992 and 01936 carry a 5-unit base value, so your bottom line should remain the same regardless of the code reported. You want to always submit the more correct code for your provider's service, however, to keep your claims compliant.