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.
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 patientâ€™s situation before reporting the diagnosis codes for medical necessity.
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