AMA CPT Assistant February 2011 page 8
Surgery: Nervous System, 64493 (Q&A)
Question: What CPT code is reported for a diagnostic right L5 pars injection using fluoroscopy? The patient was treated for low back pain and was under evaluation by a neurosurgeon for possible surgical intervention. The neurosurgeon requested a right L5 pars diagnostic injection to help determine pain generator. "Pars" refers to a part or portion of the anatomical structure, the spine in this case. Utilizing AP fluoroscopy, the right L5 pars was identified and a 20-gauge spinal needle was directed down to it. After careful aspiration, 0.5 cc of a 50/50 combination of 0.5% marcaine and 1% lidocaine without epinephrine were injected.
Answer: CPT code 64493, Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level, is reported for injection of a diagnostic agent into the paravertebral facet joint using fluoroscopic guidance.