Both patients and doctors struggle to treat chronic pain effectively. To treat pain and aid patients in coping with the issue as effectively as possible, doctors use a variety of modalities, including non-invasive methods and interventional treatments.
Providers must apply proper codes to claims to define the patient’s condition for which the services were provided as they execute comprehensive pain treatment programs.
This is a complex undertaking because state and federal laws, billing regulations, and codes constantly change. In this regard, RCM Matter is committed to assisting doctors in staying informed of these developments and submitting claim submissions free of mistakes. Let’s check through the various pain management CPT codes and their explanations.
List of CPT codes used for Pain Management
- 64479
Transforaminal epidural injections with anesthesia and steroid; cervical or thoracic, single level:
In this treatment, an anesthetic and steroid are injected into one level (cervical or thoracic) using a transforaminal epidural needle.
- 64483
Transforaminal epidural injection(s), lumbar or sacral, single level, anesthetic, and steroid:
This method involves injecting a steroid or anesthesia into the lumbar or sacral region at a single level using a transforaminal epidural needle.
- 64635
The destruction of the nerve(s) in the paravertebral facet joint with a neurolytic chemical under imaging guidance (fluoroscopy or CT); either a sacral or lumbar single facet joint:
The doctor injects a chemical into a lower back joint to kill nerve tissue while guided by fluoroscopic or CT imaging.
- 64450 – a local anesthetic injection; a different peripheral nerve or branch:
The doctor injects a steroid, an anesthetic drug, or both to numb a peripheral nerve or branch not covered by another code. This code should be used for one or more injections within a single procedure.
- 62270 – lumbar, diagnostic spinal puncture:
The medical professional collects a sample of cerebrospinal fluid (CSF) during this diagnostic procedure for analysis. The doctor will frequently carry out this treatment to rule out meningitis.
- 62272 – therapeutic spinal puncture to drain cerebrospinal fluid with a needle or catheter:
The doctor reduces brain CSF pressure with this medication. He withdraws CSF by placing a hollow needle or catheter into the subarachnoid space, usually in the lower back. This method is also called “spinal tap.”
- 64493 – Paravertebral Spinal Nerves and Branches: Introduction/Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic Procedures:
In this procedure, a medical professional administers an injection into the facet joint, which connects the lumbar or sacral levels of two spinal vertebrae, as a diagnostic or therapeutic tool. Or the doctor could administer the injection to the nerves that supply that joint’s innervation. He makes use of CT or fluoroscopy imaging guidance. This procedure aims to either alleviate back discomfort or pinpoint its precise cause.
- 64633 – Destruction of Neurolytic Agents on the Somatic Nerves (such as Chemical, Thermal, Electrical, or Radiofrequency):
During this treatment, a cervical or thoracic spinal segment’s facet joint nerve is destroyed utilizing neurolytic agents such as heat, electricity, or a chemical substance. He employs fluoroscopy or a CT scan for imaging guidance. On just one facet joint, does he administer the injection?
- 64640 – Under Neurolytic Agent Procedures on the Somatic Nerves, such as Chemical, Thermal, Electrical, or Radiofrequency:
Nerves that transmit pain signals are destroyed through a process called neurolysis. Radiofrequency, chemical, and thermal methods may be used in the destruction.
- 64520 – Procedures on the Autonomic Nerves That Involve the Introduction/Injection of an Anesthetic Agent (Nerve Block), Diagnostic, or Therapeutic:
In this treatment, a sympathetic nerve block is applied to the sympathetic division of the autonomic nervous system’s lumbar or thoracic paravertebral sympathetic nerves. Treatment for painful disorders of the thorax, abdomen, and lower extremities that involve paravertebral sympathetic nerve blockade is beneficial.
Additionally, it serves as an anesthetic for various abdominal and thoracic procedures.
- 64415 – Brachial plexus, single injection; anesthetic agent:
The brachial plexus, a nexus of nerves in the arm that starts in the neck, is where the doctor administers one or more anesthetics and steroids. For one or more shots during a single process, report this code.
- 62321 – Procedures Using Injection, Drainage, or Aspiration on the Spine and Spinal Cord:
The doctor administers an injection of diagnostic or therapeutic material, such as a steroid or painkiller, into the area surrounding the cervical (neck) or thoracic (upper and middle back) spinal nerves. The doctor inserts a needle or catheter (tube) to make the injection more manageable.
- 77003 – Fluoroscopic guidance
To undertake operations to determine the severity or origin of a condition or to treat an injury or disease, the doctor places a needle or catheter under fluoroscopic guidance in the spine or a region close to the spinal column. The procedure’s objective is to determine the level and strategy for initial needle implantation.
Injections
Trigger point injections are also known as injections given into the tendon sheath or ligament. When a muscle is overworked or injured, trigger points, which are uncomfortable knots in the muscle, develop.
For example:
- A steroid injection is frequently used to treat carpal tunnel syndrome (G56.00).
- An anesthetic or corticosteroid injection given therapeutically (20526) is done to treat carpal tunnel syndrome.
Joint Aspiration
Joint aspiration involves inserting a needle into a joint or bursa through the skin and removing fluid using the syringe attachment on the hand.
A medication is injected into the joint during a joint injection for medicinal purposes. Without the use of ultrasound guidance, this treatment is carried out.
Example:
- These techniques are frequently used to treat osteoarthritis (M19.90).
- Major joint/bursa: 20610 (Osteoarthritis is typically treated by arthrocentesis, aspiration, and injection, major joints, or bursa.
Nerve Blockages
A local anesthetic and steroid injection used for nerve blocks causes the area the nerve supplies to become anesthetized. An example of a condition that can be managed with a nerve block is occipital neuralgia (M54.81).
Example:
- The strong nerve-related headache pain known as greater occipital neuralgia (M54.81) is frequently brought on by cervicogenic headaches or trauma to the back of the head’s nerves.
- Significant occipital block (64405) By injecting a steroid or anesthetic into the more significant occipital nerve, the medical professional can treat occipital neuralgia.
Conclusion
Injections, nerve blocks, and neurolytic destruction are all covered by CPT codes, which are essential in pain management processes. The precise coding of these codes, which are particular to anatomical locations, necessitates using trustworthy resources and collaboration with medical practitioners. Following correct coding procedures enables accurate invoicing and documentation, resulting in effective pain management procedures.