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Neurology & Pain Management Coding Alert

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Coding for T12-L1 Interlaminal Epidural

Published on Mon Jul 11, 2011

Question: Our pain management specialist administered an interlaminar epidural injection to the patient's T12- L1 joint. Do we consider this a thoracic or lumbar injection for coding?Wyoming SubscriberAnswer: Consider the procedure a thoracic injection and report 62310 (Injection, single [not via 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; cervical or thoracic).Explanation: CPT® 2010 guidelines directed providers to report 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) for a facet injection to the T12-L1 joint, or nerves innervating that joint. However, the parenthetical note was revised for 2011 and now directs providers to submit 64490 (Injection[s], diagnostic or therapeutic agent, paravertebral facet [zygapophyseal] joint [or nerves innervating that joint] with [...]
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