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Anesthesia Coding Alert

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Paravertebral Nerve Root Block

Published on Wed May 01, 2002

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: What is a paravertebral nerve root block and the correct code for it? Is it truly a transforaminal epidural steroid injection?

Texas Subscriber   Answer: Transforaminal epidural steroid injections occasionally are called selective nerve root blocks, but they are different from paravertebral facet joint or paravertebral facet joint nerve injections. The codes for transforaminal epidural steroid injections are 64479 (Injection, anesthetic agent and/or steroid, transforaminal epidural; cervical or thoracic, single level) and +CPT 64480 ( cervical or thoracic, each additional level [list separately in addition to code for primary procedure]) for cervical/thoracic injections, and 64475 (Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve; lumbar or sacral, single level) and +64476 ( lumbar or sacral, each additional level [list separately in addition to code for primary procedure]) for lumbar or sacral injections.
 
The facet joint nerve injections are also sometimes called medial branch blocks. The codes for those are 64470 (Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve; cervical or thoracic, single level) and +64472 ( cervical or thoracic, each additional level [list separately in addition to code for primary procedure]) for cervical/thoracic injections, and 64475 or 64476 for lumbar/sacral injections. Physicians can be vague regarding which procedure was performed. If you are in doubt about the service, verify it with the physician before coding.
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