Anesthesia Coding Alert

Question: Disks L4-5 and L5-S1 were injected with a local anesthetic and a steroid following diskography. How should the entire procedure be coded?

Idaho Subscriber
Answer: Report the diskography injections with 62290* (injection procedure for diskography, each level; lumbar) for each injection administered. Note that 62290 is a comprehensive code that includes:
 
62311 injection, single (not including indwelling catheter), not including neurolytic substances, with or without contrast (for either localization or epidurography), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), epidural or subarachnoid; lumbar, sacral (caudal)
 
62319 injection, including catheter placement, continuous infusion or intermittent bolus, not including neurolytic substances; lumbar, sacral (caudal)
 
64483 injection, anesthetic agent and/or steroid, transforaminal epidural; lumbar or sacral, single level;
 
69990 use of operating microscope
 
76005 fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures including neurolytic agent destruction.
 
Billing both codes 62290 and 62311 would violate the CCI 7.2 guidelines that were effective July 1, 2001. The procedure's supervision and interpretation may be coded as 72295 (diskography, lumbar, radiological supervision and interpretation) for each injection if the criteria for radiological supervision were met.
Reader Questions and You Be the Coder answered by Scott Groudine, MD, an anesthesiologist in Albany, N.Y.; and LaSeille Willard, CPC, lead biller with Anesthesia Consultants in Frederick, Md.