I'm at a loss. Can we use 64479 or 64483 for a single cervical or lumbar (respectively) steroid injection? I interpret the coding to require floroscopic guidance to use these codes. We do not have the ability to provide the floroscoptic guidance but even so, the docs believe that their back shots do provide relief so continue to provide them.
I want to get paid for the injections. What codes can we legitimately use?
The 20550-53 are for triggerpoint injections. Are they the best I can do?
To determine which series of CPT codes to use for spinal injections you need to be able to answer the following questions:
• What is the approach or type — trigger, epidural, transforaminal, or intervertebral/facet?
• What is being injected — anesthetic, steroid, contrast, or a neurolytic agent?
• What regions are being treated — cervical, thoracic, lumbar, or sacral?
• How many levels are being treated?
• Is it a unilateral or a bilateral injection?
Injection procedures are considered unilateral and should be reported once per level per side (CPT Assistant, November 1999). Multiple injections at the same level on the same side are only reported once.
Are you doing transforaminal injections? These are administered by way of the intravertebral foramen located on each side of the vertebra where the nerve root exits the spinal column. The CPT code assignments for transforaminal injections of an anesthetic agent and/or steroid are as follows: