Wiki Spinal Injections


Wheatland , WY
Best answers
One of my surgeons performed two spinal injections in one day and I was hoping for some help on how to submit this properly to insurance..

The patient came in for right T11, T12, L1, and L2 Medial branch anesthetic injections (anesthetic only). A few hours later, the patient was brought back into the OR with no relief from the medial branch blocks. He them performed a right T12 costovertebral joint injection.

Is it possible to bill for both of these procedures in the same day, and if so what would be the appropriate CPT code/modifiers?

I really appreciate any help and so does my physician!

Thank you,

Maybe this will help
64490 (T11-T12)
64491 (T12-L1)
64493 (L1-L2)
20600 XS,78

If they used fluoro with the costovertebral joint injection code 77002-26,XS-78
coding combinations

In order to correctly code, we would have to see the note, but, with the information provided- you would code 64490, 64491 and 64493 - you would append the appropriate 59 or X code on 64493 as this is for a different region. These codes include CT or fluoroscopy and 20600 is a smaller component of 64490 - so it would not be coded unless it was for a separate region. If the latter was the case, append the appropriate modifier. Payers sometimes require different modifiers. :cool: