Go Back   AAPC Forum > Medical Coding > Anesthesia
Forum Rules FAQ Members List Calendar Search Today's Posts Mark Forums Read

Thread Tools
Old 12-30-2009, 03:19 PM
dhunter dhunter is offline
Join Date: Apr 2007
Posts: 18
dhunter is on a distinguished road
Question Spine hardware injection

Hi, Need some help on coding for our pain management doctor. He did a bilateral L4, L5 and S1 Hardware injection with Corticosteroid.

Patient placed prone on fluoroscopy table. Light conscious sedation was provided. The lumbosacral area was prepped and draped in the usual matter.
Landmarks were indentified using C-arm fluoroscopic image intensifier. The overlying skin and soft tissue structures were anesthetized with 1% buffered Lidocaine. A 25 gauge spinal needle was advanced to approximate the LEFT L4,L5 and S1 target screw heads. Isovue 300 contrast was thereafter injected to confirm placement and delivery of the injected solution to the appropriate target: there was no evidence of intravascular spread. 10mg Methylprednisolone Acetate PF + 2cc 0.5% Marcaine without epinephrine PF was thereafter slowly injected at each level without complications.
The above procedure was repeated at the right L4,L5,S1 hardware block.

Any help on coding this would be most helpful.
Reply With Quote
Old 12-30-2009, 03:50 PM
Walker22's Avatar
Walker22 Walker22 is offline
True Blue
Join Date: Apr 2007
Location: Athens, Ga.
Posts: 563
Walker22 is on a distinguished road

Wow.. tough one. I'd say 20552 covers the whole thing, but the reimbursement won't be very much. Anyone else have anything better?
Walker Bachman, CPC, CPPM
Reply With Quote
Old 12-30-2009, 03:53 PM
karenwebb karenwebb is offline
Join Date: Apr 2007
Posts: 18
karenwebb is on a distinguished road
Default refer to webpage below

you aren't the only person with this coding issue
Reply With Quote
Old 01-07-2010, 04:01 PM
vanessa10 vanessa10 is offline
Join Date: Apr 2007
Posts: 53
vanessa10 is on a distinguished road

A hardware injection is neither done in the joint or the muscle. It is merely in the "affected area" via flouroscopy. I have always billed them as 64472 for cervical and 64475 for lumbar. 64450 for all other areas. Billed it that way for years and have gotten paid with report.
Reply With Quote
Old 01-15-2010, 09:07 AM
brockorama01 brockorama01 is offline
Join Date: Apr 2007
Location: St. Joseph County, Indiana
Posts: 101
brockorama01 is on a distinguished road

Here's my offering:
I'm not wild about billing medical branch/facet injections 64475's (64490's) for hardware injections.

You need more info.

Think of it this way. You are not therapuetically injecting screws. You are injecting some nerve. Have physician try to explain what nerves. It might actually be medial branch nerves. If not, 64450, Other Peripheral Nerve, x 3?

Brock Berta CPC
Reply With Quote
Old 01-15-2010, 10:31 AM
coderguy1939 coderguy1939 is offline
True Blue
Join Date: Apr 2007
Posts: 643
coderguy1939 is on a distinguished road

If this is for pain management for spinal hardware, Anesthesia & Pain Management Coding Alert, 2008, Vol. 10, Number 11, recommends that 22899 or 64999 should be used unless otherwise indicated by the carrier.
Reply With Quote

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

All times are GMT -6. The time now is 10:11 PM.

Powered by vBulletin® Version 3.8.1
Copyright ©2000 - 2015, Jelsoft Enterprises Ltd.
Copyright ?2015, AAPC