![]() ![]() Spinal stenosis creates a lot of pressure on the spinal cord and nerves in the spine. More conservative treatments such as pain relievers and physical therapy are preferred and are usually tried before surgery is considered. The laminectomy procedure is done as a last resort to treat back problems such as spinal stenosis, a condition in which the spine narrows, and herniated disc when other treatment has not been effective, and the condition is severe. This surgery will enlarge the spinal canal to relieve pressure. ![]() The lamina is part of the vertebra that covers the spinal canal. What is PLS? Laminectomy is a surgical procedure that removes the lamina from the back. The term “post-laminectomy syndrome” is used by some doctors to indicate the same condition as failed back syndrome. Abnormal sensibility may include sharp, pricking, and stabbing pain in the extremities. Therefore, it would be appropriate to report CPT code 64493, Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapohphyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral, single level, for the L5 medial branch block.įor the 4 lateral branch block injections at S1, S2, S3, and S4, report 4 units of CPT code 64450, Injection, anesthetic agent other peripheral nerve or branch.Post laminectomy syndrome (PLS) or sometimes called failed back syndrome is a condition characterized by chronic pain following back surgeries.Ĭommon symptoms associated with PLS include diffuse, dull and aching pain involving the back or legs. based on the operative report a medial branch nerve block was performed at the L5 and a lateral branch nerve block was performed at the S1, S2, S3 and S4 What are the correct codes for a lateral nerve block?" "A patient was seen at our facility and underwent a left-sided L5 and S1, S2, S3, and S4 lateral branch nerve block for diagnostic purpose with C-arm fluoroscopy. Report multiple units of the injection for the four lateral branch block injections performed, modifier 59 would not be appended in this case. Therefore, for the four lateral branch block injections at S1, S2, S3, and S4, report 4 units of CPT code 64450, Injection, anesthetic agent other peripheral nerve or branch. The lateral branches of the dorsal sacral nerve plexus are considered peripheral nerves. Are we correct in reporting lateral branch nerve block(s) to the peripheral nerve CPT code?" Yes, you are correct. Our Pain Center wants to use facet injection for the medial branch block and other peripheral nerve for the lateral branch block. "We are getting conflicting information regarding coding medial and lateral branch blocks S1, S2, and S3, Medial 64493, 64494, Lateral 64493, and 64494. The right CPT code 64450, Injection, anesthetic agent other peripheral nerve or branch, would be appropriately reported only once in this case since all 3 nerve blocks were administered to the same nerve or branch. "What are the appropriate code assignments when a patient receives 3 separate nerve blocks into the same lateral branch nerve? Would it be appropriate to report 3 units of this service?" Let's Review at the following Reader's Questions again: Please note: CPT code 64450 should only be reported per nerve or branch and not per injection.ĬPT code 76942, Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation, would be additionally reported when utilizing ultrasound guidance for certain nerve block procedures when it is not inherent in the primary procedure code. Looking at the lateral branch nerve is a peripheral nerve and would be reported with CPT code 64450, Injection, anesthetic agent other peripheral nerve or branch, when a lateral branch nerve block is performed.
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