Neurosurgery Coding Alert

Question: What is spinal hardware injection? Is there a specific code for this service?

Kentucky Subscriber

Answer: A “hardware injection” which is also called “pedicle screw block” implies that your physician injects a local anesthetic alongside the vertebral pedicle screws previously placed during spinal instrumentation surgery.

Why hardware injections? In a patient who continues to experience pain after spinal fusion with hardware placement, your physician may inject an anesthetic. The intent of this injection is diagnostic. When the patient responds and reports relief in pain, your physician will confirm the hardware to be the source of the patient’s pain.

Coding for hardware injection: You currently have no specific code for this service. You can best report the unlisted procedure code 64999 (Unlisted procedure, nervous system). You will submit a maximum of 1 unit of service regardless of the number of injections your physician provides.