CPT Knowledgebase - Jun 29, 2020

Is it appropriate to report code 64451 or 64493 for the following clinical scenario? Using fluoroscopic examination, a 22-gauge spinal needle was guided into the region of the medial branch nerves from the dorsal ramus of left L4-S2. Specifically, the needle tip was inserted to the bone at the groove between the transverse process and superior articular process on lumbar vertebra, or for sacral vertebra at the lateral-superior border of the posterior sacral foramen. Needle localization was confirmed with anteroposterior and lateral radiographs. At each level, 1 cc of solution containing 2 cc 0.25% bupivacaine mixed with 125 mg methylprednisolone was injected to anesthetize the medial branch nerve.

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