62310-62319) are also referred to as translaminar injections (don't
confuse these procedures with transforaminal ESI procedures,
which we'll cover next). These injections are done midline. Because
you place the injection in the middle of the back, you can only bill
them once per case. Don't use LT or RT modifiers.
• 62310. cervical or thoracic epidural injections (not via indwelling
catheter) are for patients with pain in the arms, neck, chest or high
back area.
• 62311. lumbar or caudal epidural injections are for patients with
pain in the legs and/or lower back/buttock(s) area.
• 62318. ESI continuous infusion or bolus, including catheter place-
ment, by continuous infusion or intermittent bolus.
• 62319. ESI continuous infusion or bolus (lumbar or sacral [caudal]).
For codes 62310 or 62311, ESI procedures can be done using a nee-
dle or a catheter. However, don't bill codes 62318 or 62319 unless the
patient leaves with the catheter still in place.
Imaging is not separately billable on most pain procedures, which
now include the fluoroscopy, so don't unbundle them. Another rule: If
you previously billed for fluoroscopic guidance, most of the time you
can no longer use CPT code 77003-TC to bill the fluoroscopy separate-
ly.
Transforaminal epidural injections
Transforaminal ESIs, also called selective nerve root blocks, are more
difficult to perform, due to the close proximity of the nerve root to the
vertebral artery and spinal cord. They're performed under fluoroscopy
for precise anatomic localization, to avoid injury to the vertebral artery.
The contrast will be in either the foramen into the epidural space, or it
will be in a fascial plane or epidural vein.
These codes are unilateral procedure codes. The procedure is per-
Coding & Billing
CB
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