Radiology Coding Alert

Question: We received a denial for a claim for the following report. Which CPT codes should we use? A 22-gauge spinal needle was advanced into the epidural space at L4-L5 and L5-S1 on the left from a transforaminal approach under fluoroscopic guidance. Epidural placement was confirmed with loss of resistance technique and epidurogram with 3cc of Omnipaque 300 was performed. Spot images were obtained. Following lumbar epidurography and confirming placement of the needle within the epidural space a mixture of 80 mg of Depo-Medrol and 4 cc of 0.25 percent Marcaine was injected at each level. Texas Subscriber Answer: The radiologist documents transforaminal injections and fluoroscopic guidance. Injections: For the transforaminal anesthetic and steroid injections at the left L4-L5 and L5-S1 epidural spaces, you should report 64483 (Injection, anesthetic agent and/or steroid, transforaminal epidural; lumbar or sacral, single level) for the first lumbar injection and +64484 (... lumbar or sacral, [...]