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Radiology Coding Alert

Reader Question:
Use Multiple Codes for Same-Day SI and Facet Injections

Question: Which codes should we report for a sacroiliac (SI) injection with three different lumbar facet injections and imaging? Idaho Subscriber Answer: If you perform unilateral facet injections to three different levels and document a separate SI injection procedure with radiologic imaging to confirm needle placement, you should report the following codes:
64475 Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve; lumbar or sacral, single level
+64476 x 2 ... lumbar or sacral, each additional level (list separately in addition to code for primary procedure)
27096-59 Injection procedure for sacroiliac joint, arthrography and/or anesthetic/steroid; Distinct procedural service
76005-26 Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural, transforaminal epidural, subarachnoid, paravertebral facet joint, paravertebral facet joint nerve or sacroiliac joint), including neurolytic agent destruction; Professional component (one unit) for the professional portion of the radiologic imaging. Reader Questions were reviewed by Cindy C. Parman, CPC, CPC-H, RCC, co-owner of Coding Strategies Inc. in Dallas, Ga; and Gary S. Dorfman, MD, FACR, FSIR, representative to the AMA's CPT Advisory Committee.  


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