The BELIEVE IT OR NOT with Pain Management Coding
Got this information on google
2011
2012 CPT Changes
. The code set that Id like to discuss is 62310-62319 and the reason for that is a revision to the CPT code definitions and clarification of the coding guidelines when an injection is performed utilizing a catheter instead of a needle.
Previously, code 62310-62311 read Injection, single (not via indwelling catheter) ..This code was revised in 2012 and now reads Injection(s), of diagnostic or therapeutic substances .Note that the 2011 code was for a single injection and the revision being made for 2012 is adding the plural alternative to the term injection meaning that the code now represents one or more injections at the lumbar or sacral level. This seems to be in keeping with CPT Assistant Nov. 08 which stated that 62311 would not be reported more than once on a given date of service because any injected substance(s) would diffuse into the entire area - therefore it would not be necessary to inject both sides or multiple levels.
When it came to a catheter based procedure for epidural injections there was always a difference of opinion with some physician practices coding the 62318-62319 codes while the ASCs were reporting the 62310-62311 codes.
When a catheter is placed for the purpose of administering a single injection or injecting substance(s) at more than one level and then the catheter is removed the injection procedure should be treated in the same manner as if a needle had been used with the correct code being either 62310 or 62311 depending on where the needle or catheter is inserted into the body. 62318 or 62319 should only be reported when the catheter is left is place (more than a calendar day) to continuously deliver substance(s) or to deliver substance(s) by intermittent bolus
- Epidural injections are only reported one time per date of service for a given region, it would not be appropriate to append modifier 50 for a bilateral procedure nor modifier 59 for multiple levels.
- An epidural injection at T12-L1 is reported with the cervical epidural injection code, but a facet joint injection at T12-L1 is reported with a lumbar facet injection code.
- A facet injection code is reported as one level when 2 medial branch nerves are injected but destruction codes are reported for two levels when 2 medial branch nerves are destroyed.
- Facet injections that are performed without the use of fluoroscopy are reported with trigger point injection codes.
- Facet joint injections performed using ultrasound are reported with Category III codes 0213T-0218T and as of July 1, 2010 Transforaminal injections using ultrasound will be reported with Category III codes 0228T-0231T.
- An L3-L4 transforaminal injection is reported as one level, but injections into the L3, L4 foramen are reported as two levels.
- Radiofrequency nerve ablation is reported with the appropriate CPT code, Pulsed Radiofrequency is reported with Unlisted CPT code 64999.
- Destruction of lateral branch nerves S1-S4 using the Simplicity III probe is reported with Unlisted CPT one time for each nerve. code 64999, but when each lateral branch nerve is individually destroyed CPT code 64040 is reported.
- SI joint injections that are performed without the use of fluoroscopy are reported with the large joint injection code 20610.
- Sympathetic nerve blocks performed using fluoroscopy are reported with CPT code 77002 rather than 77003.
Got this information on google
2011
- The transforaminal injection codes have been revised and now take on the same look as the facet injection codes. Image guidance (fluoroscopy or CT) is required when performing the injection procedure, but the CPT code definitions for 64479-64484 now include fluoroscopic or
- CT imagining as an inclusive component of the procedure, so 77003 is no longer reported for fluoroscopy in addition to the transforaminal CPT code.
- Category III codes should be reported when transforaminal or facet injections are performed using ultrasound guidance.
- Epidural, transforaminal or facet injection(s) performed at theT12-L1 interspace/facet would be reported with the appropriate CPT code for the cervical or thoracic level and not a code from the lumbar or sacral level series of codes.
2012 CPT Changes
. The code set that Id like to discuss is 62310-62319 and the reason for that is a revision to the CPT code definitions and clarification of the coding guidelines when an injection is performed utilizing a catheter instead of a needle.
Previously, code 62310-62311 read Injection, single (not via indwelling catheter) ..This code was revised in 2012 and now reads Injection(s), of diagnostic or therapeutic substances .Note that the 2011 code was for a single injection and the revision being made for 2012 is adding the plural alternative to the term injection meaning that the code now represents one or more injections at the lumbar or sacral level. This seems to be in keeping with CPT Assistant Nov. 08 which stated that 62311 would not be reported more than once on a given date of service because any injected substance(s) would diffuse into the entire area - therefore it would not be necessary to inject both sides or multiple levels.
When it came to a catheter based procedure for epidural injections there was always a difference of opinion with some physician practices coding the 62318-62319 codes while the ASCs were reporting the 62310-62311 codes.
When a catheter is placed for the purpose of administering a single injection or injecting substance(s) at more than one level and then the catheter is removed the injection procedure should be treated in the same manner as if a needle had been used with the correct code being either 62310 or 62311 depending on where the needle or catheter is inserted into the body. 62318 or 62319 should only be reported when the catheter is left is place (more than a calendar day) to continuously deliver substance(s) or to deliver substance(s) by intermittent bolus
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