Wiki Transforaminal or Translaminal injection

[dragonflye]

Hello I am not sure which injection code to use for this procedure.

The L5 transverse prcess, medial port, was located and the needle tip was walked onto the medial portion, walked off medially and inferiroly, taken to be the 12 0'clock positon; vis-avis the pedicle. Once this was achieved, patient was injected with dye. Intermittent aspirations were negative. The patient was injected then with a Kenalog lidocaide mixture.

His title says Right transforaminal epidural steroid injection, L5-S1

Is it 64483 or 62311?

 

[dwaldman]

Lumbar transforaminal epidural injection at L4/5 and L5/S1 levels. The tip of the 22 G needle is positioned below the pedicle lateral to the 6º clock position of the L4 pedicle. Contrast injection shows the dye spreading into the epidural space and along the L4 nerve root. (B) Lumbar transforaminal epidural injection at L4/5 and L5/S1 levels. Contrast spread is seen on the right side of the epidural space and along the right L4 and L5 nerve roots

http://www.medscape.com/viewarticle/717826_5

Above they describe a transforaminal block with the 6 o'clock position. The procedure heading nor does the procedure note describe the use of fluoroscopy which should be in the documentation. The location of the final needle tip might also be required for carriers. I have seen where Humana has denied a caudal approach because they don't describe the needle final location before administration as in the epidural space. Maybe you could request the physician to add an addendum that fluoroscopy was performed and final needle location prior to delivery of drug.