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Spinal intervention coding

  1. #1
    Default Spinal intervention coding
    Medical Coding Books
    What CPT code would be appropriate to use in this case? Pt has multi-level lumbar fusion with instrumentation. Physician is performing a diagnostic injection using anesthetic via fluoro guidance into specific locations of the lumbar spine into the hardware. The purpose is to determine if the hardware is causing the pain. Thank you!

  2. #2
    North Carolina
    Could this be a discography?

    62290=This procedure is peformed to gauge the amount of damage suffered by an intervertebral disc. The injection site is determined and marked. Local anesthesia is injected. A small stab wound is made in the tissue overlying the vertebrae.

  3. #3
    Thank you for your reply. I was thinking perhaps 64493 paravertebral joint or nerves dennervating the joint (Medial branch block). Thoughts?

  4. #4
    North Carolina
    64493=Facet joint pain may is associated with post laminectomy syndrome or other spine surgery due to destabilization of the spinal joints, scar tissue formation, or recurrent disc herniation. Other causes include spondylosis, spondylolisthesis, and arthritis. Using fluoroscopic or CT guidance, a diagnostic or therapeutic facet joint injection or injection of nerves innervating the joint is performed. The skin overlying the facet joint is prepped and a local anesthetic injected. A spinal needle is directed into the facet joint space until bone or cartilage is encountered. A small amount of contrast material is injected to verify that the needle is correctly positioned. This is followed by injection of a local anesthetic and/or steroid. Diagnostic facet joint injection uses a local anesthetic to identify the specific area generating the pain. If the patient experiences pain relief for a significant period of time following a diagnostic injection, the physician will perform a therapeutic injection on a subsequent date of service using a long acting local anesthetic in conjunction with a steroid.

    With that information, this is a better fit.

  5. #5
    Wonderful! Thank you Rebecca!

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