Wiki How would could L3-L5?

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pandorarose3

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How would this be coded L3-L5?

I was just working with a facility whom coded this in a particular way, but never mentioned it to me. I was wondering if this is the actual way to code it.

The patient would come in for a transforaminal epidural injection L3-L5.

Which way should it be coded?

EX 1

One for each part L3, L4, L5

64483
64484
64484

EX2

Or each space L3/L4, L4/L5

64483
64484

After I get a few answers I will say how the facility wanted it. I am just curious at this point.
 
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The L3 nerve root exits the L3-L4 foramen this would be the first level (66483)
The L4 nerve root exits the L4-L5 foramen this would be the second level (64484)

What is being described does not state to S1 so the L5-S1 level was not included.
 
I saw this on a internet search to describe the anatomy from Coding Strageries

_____________________________________________________

"Transforaminal injection is performed by passing the needle into the intervertebral foramen, also called the neuroforamen. There are intervertebral foramina on the right and left sides between each pair of adjacent vertebrae. The spinal nerves pass through these foramina, and narrowing of the opening can result in pain caused by irritation of the nerve roots. Transforaminal injection allows the medication to be delivered directly into the tissue surrounding the spinal nerve root."
 
So you are counting number of intervertebral foramen (eg, L3 foramen corresponding to L3-L4, L5 foramen corresponding to L4-L5, not vertebral segments that are spanned (L3-L5)
 
You did not indicate if they were unilateral or bilateral, from your question I would say 2 levels 64483, 64484. If bilateral would need to add modifier 50.
 
Hi,

In the documentation, if L3, L4 and L5 indicate the nerve roots, then the correct coding would be 64483 and 64484 X 2.
If L3, L4 and L5 indicate the vertebrae, then the correct coding would be 64483 (for L3-L4 intervertebral foramen) and 64484 (for L4-L5 intervertebral foramen)

Thanks,
Vernon Kreiss
 
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