Wiki hardware injection

[paula f3]

I have a question in reference to symptomatic hardware injection. Patient had spinal fusion Mar 2012, Nov 2012 confirmed CAT scan loose screw in back. Patient to have injection of S1 screw. My choice would be 64999 but, pt is Medicare and being that Medicare does not take kindly to unlisted codes, is there another appropriate code that I may use? The physician is using the code 64493.
Ordinarily I would not have a problem using an unlisted code and including the op note, but this is a Medicare patient, which is my dilemma.
Any input is appreciated.

Thank you
Paula

 

[marvelh]

Compliant coding for any payer is 64999 unless directed otherwise in writing from the payer.