Anesthesia Coding Alert

Question: Our pain specialist shot a single-view lumbar x-ray on the same day she administered the patient's paravertebral facet injection. Can we code both services?

Oregon Subscriber

Answer: Yes, you can report both services because the Correct Coding Initiative (CCI) does not bundle the procedures together, but certain conditions apply.

Assuming your provider administered injections to the lumbar area, code the appropriate number of injections from:

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

+64494 -- ... second level (List separately in addition to code for primary procedure)

+64495 -- ... third and any additional level(s) (List separately in addition to code for primary procedure).

For the single-view lumbar x-ray, you should also report 72020 (Radiologic examination, spine, single view, specify level).

Caveat: While you may be tempted to "carve out" the permanent image portion in these situations, remember that if you report 72020, you must be able to prove separate and distinct medical necessity for the diagnostic study, not the permanent storage of the needle guidance.