Neurosurgery Coding Alert

Reader Questions:

Dial Into This Injection Scenario

Question: My neurosurgeon injected an anesthetic agent into the nerves innervating the patient’s sacroiliac joint. He injected five nerves and used CT guidance to perform this procedure. Which CPT® code should I report?

Texas Subscriber

Answer: You should report 64451 for this procedure.

Don’t miss: With 64451, you should report one unit for any number of nerves innervating the sacroiliac joint inject, regardless of the number of injections. Also, since imaging guidance is included is an inclusive component of 64451, you cannot report the CT guidance separately. This is a different procedure from injecting the sacroiliac joint itself, which is reported with code 27096 (Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT) including arthrography when performed), which requires image guidance and includes arthrogram, when performed.

Caution: You should never report 64451 in conjunction with 64493-+64495, +77002, +77003, 77012, +95873, or +95874, according to CPT® guidelines.