#Ode to reasonable doubt zippy code#
Whether a transforaminal epidural injection is performed unilaterally or bilaterally at one vertebral level, use CPT code 64479 or 64483 for the first level injected. Only one (1) unit of service should be submitted for a transforaminal epidural injection for a unilateral or bilateral injection at the same level. When injecting a nerve root unilaterally, file the appropriate anatomic modifier –LT or –RT.
When injecting a nerve root bilaterally, file with modifier –50. The CPT codes 64479-64484 (transforaminal epidurals) have a bilateral surgery indicator of “1.” Thus, they are considered “unilateral” procedures and the 150% payment adjustment for bilateral procedures applies. The CPT codes 62310, 62311, 62318, and 62319 each have a bilateral surgery indicator of “0.” Modifier -50 and/or the anatomic modifiers, -LT/-RT should not be used. Only one (1) unit of 62310, 62311, 62318 or 62319 should be billed and allowed per spinal region, no matter how many injections are made in that region. 62310 – Injection(s), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, includes contrast for localization when performed, epidural or subarachnoid cervical or thoracic – Average fee amount $230 – 260Ħ2311 – Injection(s), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, includes contrast for localization when performed, epidural or subarachnoid lumbar or sacral (caudal) Average fee amount $230 – 260Ħ2318 – Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, includes contrast for localization when performed, epidural or subarachnoid cervical or thoracicĦ2319 – Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, includes contrast for localization when performed, epidural or subarachnoid lumbar or sacral (caudal) – average fee payment – $150 – $180