CPC

30 Jan 2016

how to code Epidural steroid injection

     

Epidural steroid injection is performed to reduce the inflammation and pain associated with nerve root compression. Nerve roots can be compressed by a disc herniation/bulge, Lumbar or cervical spinal stenosis, and other spine-related conditions which lead to nerve compression.

 

A needle is inserted into the epidural space (The epidural space is the outermost part of the spinal canal, located outside the dural membrane) under imaging guidance (CT or fluoroscopy) to administer steroid.

 

Cervical epidural injection is performed in the neck provide relief to nerve roots in the neck. 

 

Thoracic epidural injection is performed in the thoracic provide relief to nerve roots in the Thoracic.

 

Lumbar epidural injection is performed at the lower back provide relief to nerve roots in lumbar.  

 

A Radiologist will perform the epidural injection; however orthopaedic surgeon or neurosurgeons may also administer it.

 

Any imaging that is performed during the epidural steroid injection procedure itself will conclude with the procedure, no follow-up image interpretation is required.


Interlaminar epidural or subarachnoid Injection:

 

Single Injection – Injecting substances at one or more levels and then removing the catheter.

 

§  Cervical or Thoracic  

    62320 – without imaging guidance  

    62321 - with imaging guidance

 

§  Lumbar or Sacral  

   62322 – without imaging guidance  

   62323 - with imaging guidance

 

Infusion (Continuous)The catheter is left in place to deliver substances over a prolonged period.

 

§  Cervical or Thoracic

   62324 - without imaging guidance  

   62325 - with imaging guidance

 

§  Lumbar or Sacral

    62326 - without imaging guidance

    62327 - with imaging guidance

 

 

Billing Guidelines:

 

1.     Guidance included.

 

2.     Coded only once based on region at which the needle entered the body.

 


Transforaminal Epidural Injections:

CPT 64479 - Injection(s), anesthetic agent and/or steroid, Transforaminal epidural, with imaging guidance (fluoroscopy or CT); cervical or thoracic, single level

CPT +64480 - each additional level


CPT 64483 - Injection(s), anesthetic agent and/or steroid, Transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, single level

CPT +64484 - each additional level

Billing Guidelines:

 

1.     Guidance included.

 

2.     For Transforaminal epidural injection under ultrasound guidance – 0228T – 0231T

 

3.     For bilateral procedure:  CPT 64479 / 64483 – add modifier 50, But not with add on codes (64480 or 64484) instead bill it twice.