Eli's Rehab Report

Published on Mon Nov 14, 2005 PDF

Question: What are the possible CPT Codes for selective nerve root blocks?


Iowa Subscriber

Answer: Many physiatrists consider a selective nerve root block to be synonymous with a transforaminal epidural injection and use the terms interchangeably. You should choose your code from the following code series:

• 64479--Injection, anesthetic agent and/or steroid, transforaminal epidural; cervical or thoracic, single level

• +64480--…cervical or thoracic, each additional level (list separately in addition to code for primary procedure)

• 64483--…lumbar or sacral, single level

• +64484--…lumbar or sacral, each additional level (list separately in addition to code for primary procedure).

Other physiatrists may not agree. In that case, you’ll have to look to the unlisted-procedure code (64999, Unlisted procedure, nervous system).

Remember: Whenever you report an unlisted- procedure code, you should prepare additional documentation. Typically, you should have a letter of explanation along with the documentation of your physiatrist’s services. In the letter of explanation (which is preferably a single page), be sure to include a brief summation as to why you are using the unlisted- procedure code and why the procedure(s) or service(s) was necessary for the patient.

You should select a valid CPT code to base your fees on, due to the comparable work, malpractice and relative value unit expenses.

Moral of the story: Verify with your physiatrist what he truly performed, and proceed from there.