Orthopedic Coding Alert

Question: Please indicate the proper codes for epidural injections (e.g., right L4-5 selective translumbar epidural with myelography under fluoroscopy, where the diagnosis is L5-S1 disk herniation). Is 62289 and 62278-59 correct? And what would it be if the dye could not be used?

Billie Jo C. McCrary, CPC, CMPC
Cincinnati, Ohio

Answer: According to the Correct Coding Initiative, 62278 through 62289 are bundled as mutually exclusive procedures, which means they cannot be billed separately if in the same operating room session.

For procedures completed in 1999, you would bill 62289 (injection of substance other than anesthetic, antispasmodic, contrast, or neurolytic solutions; lumbar or caudal epidural [separate procedure]). The code applies whether an anesthetic alone or an anesthetic and a dye are used. Therefore, it does not matter if the dye cannot ultimately be used.

Things have changed in 2000, however. Codes 62288 and 62289 have been replaced with much more precise codes 62310 through 62319. Each new code clearly covers introduction of the anesthetic and the dye. Exact location and whether injection is single or not, will determine which is used.