64483 nerve root selective epidural

[ASC CODER]

DESCRIPTION OF PROCEDURE:
The patient was then taken to the procedure room, placed in the prone position. The left low back was prepped with Betadine x3 and allowed to dry. Under AP and oblique views, the left L5 pedicle was observed. Endplates were flattened out. Skin local was performed with a 27 gauge needle and approximately 3 cc of 0.5% lidocaine, at which time a 4.5 inch 22 gauge needle was placed towards the caudal aspect of the left L5 pedicle in the oblique position. The anterior placement was checked on lateral view. Then, in the AP view appropriate position of the needle was identified. Approximately 0.75 cc of dye was injected under live fluoroscopy without vascular uptake. The left L5 epidural space seemed to be entered, and the left L5 nerve root was outlined. The patient had no pain down the left leg during injection of the dye. Then, approximately 1 cc of 10 mg of preservative-free Decadron, along with 1 cc of 0.5% lidocaine was injected slowly without difficulty. The patient tolerated the procedure well without complication and without sedation.

Ok I am having a questionable moment. My understanding is if it is selective and they are going into a nerve root it would be 64483 and not 62311 Correct?????? Help

[rkmcoder]

(These are my opinions and should not be construed as being the final authority. Other opinions may vary.)

Don't fret over the terminology, because your physician could get that wrong. That said, your case above is a 64483 - Selective Nerve Root Block. For a 62311, the needle must be placed into the spinal canal in a manner other than through the foramen. If the needle is placed into the foramen, or located near the foramen (as in your case above), then use code 64483.

Richard Mann, your pain management coder
rkmcoder@yahoo.com

[ASC CODER]

Thank you