the needle placement at the L5 vertebrae is actually blocking the L4 medial branch; likewise the needle placement at the sacral ala is blocking the L5 medial branch; in the past some providers considered there to be a small communicating sensory branch from the S1 nerve to the L5-S1 facet joint. Anatomic research has found that not to be the case, however, since facet joint injection coding is based on facet joint spinal level and not necessarily the number of needles inserted, these three injections were performed to block the L5-S1 facet joint or one code as you were thinking - 64475 - LT
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