Radiology Coding Alert

Visualize the procedure to take the mystery out of coding.

The more you understand about spinal structures, the more confident you can be in your transforaminal epidural injection coding. These graphics can help answer some of your anatomy questions.

Figure 1 shows the full spine. C1-C7 are cervical vertebrae, Th1-Th12 (also called T1-T12) are thoracic vertebrae, and L1-L5 are lumbar vertebrae. The sacrum is below the lumbar vertebrae.

Picturing the location of the vertebrae will help when you choose between cervical and thoracic injection codes 64479-+64480 and lumbar and sacral injection codes 64483-+64484.

Figure 2, which offers a closer view of the foramen, assists in grasping the concept of the spinal levels you have to count to properly code these injections. You can see why a single spinal level is indicated by naming two vertebrae, such as T9-T10.

Bonus tip: Review Figure 1 and the placement of T12-L1. This spinal level raises the question of whether you should report thoracic code 64479 or lumbar code 64483. CPT^® guidelines provide a definitive answer: "For transforaminal epidural injection at the T12-L1 level, use 64479."