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Wiki Dorsal rami/paravertebral blocks

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mgrimaldi

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I need help with coding this procedure.

Today we repeated dorsal rami/paravertebral blocks at C7 and T1 bilaterally. Patient was placed in the sitting position and sedated. The spinous processes were palpated and 25-gauge spinal needles were inserted 1 fingerbreadth lateral on each side of the spinous process. Each was advanced until bone was contacted and paresthesia was elicited.

No fluoroscopy was used. Thoughts??

Thanks
 
First check with the local coverage determination policy for the Medicare carrier you are billing or the policy of the private payer to make sure they cover dorsal rami/facet injection without fluoroscopy if they do not you would have to report 20552 with the GZ modifier.


Image guidance [fluoroscopy or CT] and any injection of contrast are inclusive components of 64490-64495. Imaging guidance and localization are required for the performance of paravertebral facet joint injections described by codes 64490-64495. If imaging is not used, report 20552-20553. If ultrasound guidance is used, report 0213T-0218T)

(For bilateral paravertebral facet injection procedures, use modifier 50)

(For paravertebral facet injection of the T12-L1 joint, or nerves innervating that joint, use 64490)
 
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