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Thread: Lumbar epidural coding

  1. #1
    Join Date
    Apr 2007
    Monmouth New Jersey

    Question Lumbar epidural coding

    AAPC: Back to School

    Which code should be first?

    64483 for an L5 (right)
    64484-50 for an S1 (bilateral)

    Does the bilateral code come first and a modifier 50 go on 64483 or is the first way the way to bill for the service?

    I'm thinking since the 64484 is an add-on code it must be coded the first way I listed but does it need to be listed twice?

    Last edited by kristin419; 10-03-2011 at 12:30 PM. Reason: wrong code

  2. #2
    Join Date
    Apr 2007
    Baton Rouge


    IMO, (without seeing the procedure note), the codes would be:


    The 64484 has to be second due to it being an add-on code.

    Hope this helps!!
    Meagan Strauss, CPC, CEMC
    Coding Coordinator
    The NeuroMedical Center
    Baton Rouge, LA

  3. #3

    Smile Kep

    I would code by 64483 Rt and 64484 50 as well. You should always code the primary code first and then the add on for the additional levels. Since L5 comes before S1 anatomically you code for the L5 level first (64483) and then the additional level (64484)with the add on code and add the modifiers appropriately for the work done at each level.

  4. #4
    Join Date
    Apr 2007
    Dallas, GA


    My only concern is 64483 and 64484 are transforminal injections. Is the procedure truly a lumbar epidural (the needle placed in the epidural space)?

  5. #5


    Correct coding sequence is-

    Rajesh Verma, CPC
    Last edited by rajeshverma607; 11-02-2011 at 06:17 AM.

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