Eli's Rehab Report

You Be the Coder

Multiple Epidurals During Same Session

Question: Can I bill for multiple epidurals for the same session (such as 72275)?

Michigan Subscriber

Answer: Yes, you may report multiple epidurals as long as the physiatrist performs them at different anatomic regions (cervical, thoracic, lumbar).

You can append modifier -59 (Distinct procedural service) to the second 72275 (Epidurography, radiological supervision and interpretation) on a separate line item and send documentation that clearly includes the separate radiology interpretation for both anatomic regions.

Keep in mind: If the physiatrist injected multiple levels (L2, L3 and L4 nerve roots) in a transforaminal epidural approach, this would support the coding of one unit of fluoroscopy (76005, Fluoroscopic guidance and  localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural, transforaminal epidural, subarachnoid, paravertebral facet joint, paravertebral facet joint nerve or sacroiliac joint], including neurolytic agent destruction) rather than multiple units of epidurography (72275).