AHA Coding Clinic® for HCPCS - 2022 Issue 2; Ask the Editor

Bertolotti’s joint injection

A patient with Bertolotti’s Syndrome presented for a Bertolotti’s joint injection. The skin overlying the pseudoarticulation between the L5 transverse process and sacral ala was anesthetized. The needle was advanced and wedged into the Bertolotti’s joint on the right side. Contrast was injected showing fill of the joint in the periarticular space. Lidocaine was then injected and the needle was removed. What is the correct CPT code for an injection into Bertolotti’s joint, 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, CPT 64999, Unlisted procedure, nervous system, CPT code 20610, Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance, or another CPT code? ...

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