Updated: Jul 14
A guide into pain management coding from Revmedi healthcare Services. Book a free consultation with our expert team and see how we helped to save 30000$ to 40000$ annually on your expenses.
CPT codes 62320, 62321 (cervical or thoracic) and 62322, 62322 (lumbar) describe a single injection of a diagnostic or therapeutic substance, not including neurolytic substances, directly into the subarachnoid or epidural space. This type of spinal injection is often described as an interlaminar epidural injection. This procedure typically cannot be described as unilateral or bilateral, as can other spinal injection procedures. However, epidural injection codes should be reported once per spinal level
Facet joint or Medial branch block injection
CPT codes for injections into the paravertebral facet joints or facet nerves are coded with 64490-64495 Facet joint or facet nerve injections are performed as therapy for pain control. The cervical facet injection codes (64490-64492). Report 64490 for a single level, 64491 for a second level, and 64492 for the third and any additional levels The Lumbar facet injection codes (64493-64495). Report 64493 for a single level, 64494 for a second level, and 64495 for the third and any additional level These codes are unilateral and when performed on both sides of the spine, should be reported as a bilateral procedure. For Facet joint injection under ultrasound guidance, see (0213T-0218T)
Transformational epidural injection:
Codes 64479- 64484 describe both diagnostic and therapeutic nerve root injections that involve needle entry into the epidural space through the intervertebral foramen. This technique differs from interlaminar epidural injection technique (62310- 62311), and from facet joint nerve injection technique (64490-64495), in that it is more difficult to perform. It involves a more lateral approach with the needle right next to the foramen the transformational epidural injection may often be termed a "nerve block." Like those spinal injection codes described previously, 64479 – 64484 are unilateral codes, and are performed with fluoroscopic or CT guidance. Coding conventions are the same with respect to bilateral injections at the same level, and for add-on codes for additional levels. As well, codes for each level treated are to be reported one time per level regardless of the number of injections performed at that specific level. For transformational epidural injections under ultrasound guidance, see 0228T-0231T
The use of ultrasound guidance for epidural steroid injection(s) and facet joint injection(s)is unproven and not medically necessary.