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Wiki Medicare/Pain injections

TLVANDERPOOL

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Henderson, KY
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I am in need of some assistance please. I work at a facility that has a pain clinic. My question is when you have different types of injections (example Lesi 62311, and Sacroiliac joint G0260) cci bundles these would you add modifier 59 to 62311? since these are seperate sites?

My confusion comes from the LCD where it states "It is usually not appropritate to provide an interlaminar/epidural/intrathecal injection, a transforaminal selective epidural, facet joint/nerve block, sacroiliac joint inj, lumbar sympathetic block, or other nerve block on the same day. therefore, only one of these procedures is allowed on a given day, unless conditions are met as descibed immediately above(above info is in the lcd for pain injections) for paravertebral and sacroiliac joints or one of the following conditions occur and are documented in the medical record.

1. if more than one type of dx inj are performed on same day the anesthetic response must assessed and demonstrate incomplete relief prior to proceeding with additional injections

2. multiple pain generators are present and are clearly documented in a patient on anticoagulante, requiring the anticoagulants to be stopped for the injection.

Would simply having a separate site with a seperate diagnosis warrent adding a modifier 59.

Any addvice is greatly appreciated.
 
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