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Pars Injection

  1. Default Pars Injection
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    I work for an Anesthesia group that also has pain management clinics. My question is, what CPT code is appropriate for a Pars Injection? We have used 22899 (Unlisted procedure, spine) and 64999 (Unlisted procedure, nervous system).

    We seldom see our doctors sending a card over for this procedure, so when they do we are all asking each other over and over again, what do you think?

    We have decided to ask what our AAPC friends what code they think is appropriate. Medicare of course denies the "Unlisted" codes.

    It looks like back on 10/21/2009 this question was raised on the discussion board. We found where 2 responses where 64490 - 64495, Facet Injections. Are these still the codes that we should be using?
    Last edited by Christine72; 09-07-2010 at 08:24 AM.

  2. #2
    Here is a Anesthesia/Pain Management Coding Alert from 2005 that list using the facet code. I don't know with the new codes if this concept has changed.

    Question: What code do I use for a pars defect injection (L5) under fluoroscopy? The physician administered 1 percent Lidocaine for local anesthetic, then 1 cc of 0.5 percent Bupivacaine and 20 mg of Depo-Medrol for the actual treatment.

    Delaware Subscriber

    Answer: The pars interarticularis links the posterior part of the vertebrae (facet joint) to the anterior body of the vertebrae. Because of this location, a pars defect injection technique is similar to a facet joint injection. Many providers report it as a facet joint injection, with 64475 (Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve; lumbar or sacral, single level).

    A pars defect may be congenital (756.11, Spondylolysis, lumbosacral region) or due to trauma, stress or sports injuries (738.4, Acquired spondylolisthesis). Verify this patient's situation before reporting the diagnosis codes for medical necessity.

  3. Default
    Thank you very much!

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