CPT Coding for Tarnforaminal ESI

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It's similar to the coding of a right L3, left L4 and right L5 TFESI
 
Second level is 64484
 
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that is interesting.

i thought it should be a -50 modifier because it is a bilateral TFESI. however, it is also at an additional level.

it seems to me this is ambiguous, and could be accurately coded either way. 64483 + 64484 would theoretically pay more and also generate more RVUs.
 
2 different levels, not the same procedure each side, so 64483&64484 is more appropriate, especially if you have different levels of disc herniation or NF stenosis (as an example).

If it were L4 TF left and right, then 64483 mod 50 seems more appropriate.

I will confirm with my coder.


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