tci Outpatient Facility Coding Alert - 2016 Issue 2

Reader Question: More Than 3 Levels of Facet Joint Blocks Make Payment Difficult

Question: Our physician performed an epidural L5 nerve block and gave facet steroid injections bilaterally at the L3-L4 and L4-L5 levels. How do we report these services? North Carolina Subscriber Answer: For the epidural nerve block, you report code 64483 (Injection[s], anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance [fluoroscopy or CT]; lumbar or sacral, single level). For the facet joint steroid injection at L3-L4, you report code 64493 (Injection[s], diagnostic or therapeutic agent, paravertebral facet [zygapophysea]) joint [or nerves innervating that joint] with image guidance [fluoroscopy or CT], lumbar or sacral; single level). For the L4-L5 level...

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