Below are 2011 descriptors for lumbar/sacral transforaminal epidural injections which have been revised and effective for dates of service on or after January 1,2011____________________________________________ _________________
Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, single level
Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional level (List separately in addition to code for primary procedure)
Due to the fact "with image guidance" is in the descriptor, 77003 would not be separately reported. The descriptor includes "sacral" and from previous posts I have seen S1 can be separately reported distinct from the L5 foramen and L4 foramen. I would watch quantity 2 with the 50 modifier, Medicare for outpatient hospitals has OCE edit that states quantity one has to be used with modifier 50, on the professional side it can also be difficult for the carrier's claim processing software to think 1 addl level 150%, 1 level addl 150% when it has to broken out from a single line.
Below is the section notes that Ignenix's Encoder pro provides:
Section Notes - 64479-64484 Transforaminal Injection - (64479-64484)
INCLUDES: Imaging guidance (fluoroscopy or CT) and contrast injection
EXCLUDES: Epidural or subarachnoid injection (62310-62319)
Nerve destruction (62280-62282, 64600-64681)
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