Neurosurgery Coding Alert
Go With Add-On for Multiple Intercostal Shots
Question: Encounter notes indicate that the provider performed a steroid injection to two levels of an intercostal nerve. I reported 64420 x 2 and the second 64420 was rejected. What did I do wrong? Illinois Subscriber Answer: You should have used an add-on code to report the second injection. Reporting the first instance of 64420 (Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level) was correct; however, you should have reported +64421 (… intercostal nerve, each additional level (List separately in addition to code for primary procedure)) for the injection to the second level. CPT® explains: In the parenthetical notes for +64421, CPT® reports “Use +64421 in conjunction with 64420.”
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