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Neurosurgery Coding Alert

Reader Question:

Look For Fluoroscopic Guidance with Paravertebral Injections

Published on Mon May 07, 2012

Question: Our surgeon does a right C2 parafacet and epidural steroid injections as well as right trigger point injections in the front parietal region. How do we report this?North Carolina SubscriberAnswer: You report 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) for the parvertebral injection. Note that your surgeon must have used imaging guidance and localization for the performance of paravertebral face joint injections. Procedures described by 64490-64495 require fluoroscopic or CT guidance in order to use these codes. Otherwise, if imaging is not used, you should report 20552 (Injection[s]; single or multiple trigger point[s], 1 or 2 muscle[s])-20553 (Injection[s]; single or multiple trigger point[s], 3 or more muscle[s]). If ultrasound guidance is used, report 0213T (Injection[s], diagnostic or therapeutic agent, paravertebral facet [zygapophyseal] joint [or nerves innervating that joint] with ultrasound [...]
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