Summary & Overview
CPT 64483: Lumbar or Sacral Transforaminal Epidural Injection with Imaging
CPT code 64483 is a widely utilized billing code for transforaminal epidural injections in the lumbar or sacral region, performed with imaging guidance. This procedure is a cornerstone in the management of chronic low back pain and radiculopathy, providing targeted relief for patients suffering from nerve root inflammation. The code is relevant across the United States, reflecting its importance in both clinical practice and medical billing.
Major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare, recognize and reimburse for this service, underscoring its broad acceptance and clinical value. The procedure is typically performed in ambulatory surgical centers, aligning with current trends toward outpatient pain management.
Readers will gain insight into the clinical context of 64483, including its role in pain medicine and anesthesiology, typical sites of service, and associated billing practices. The publication also covers related codes, common modifiers, and ICD-10 diagnoses frequently linked to this procedure. Policy updates, payer coverage details, and benchmarks are provided to inform stakeholders about current reimbursement and utilization patterns. This summary offers a comprehensive overview for clinicians, administrators, and policy analysts seeking to understand the national landscape for lumbar and sacral transforaminal epidural injections.
CPT Code Overview
CPT code 64483 describes the injection of anesthetic agent(s) and/or steroid into the transforaminal epidural space of the lumbar or sacral region at a single level, performed with imaging guidance such as fluoroscopy or CT. This procedure is commonly used in the management of pain related to nerve root irritation or inflammation in the lower back. The service falls under Anesthesiology and is typically performed in an Ambulatory Surgical Center (POS 24), offering patients a minimally invasive option for pain relief in an outpatient setting.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult presenting with persistent low back pain and/or radicular symptoms such as sciatica, often due to intervertebral disc disorders or lumbar radiculopathy. The patient has not responded adequately to conservative treatments like physical therapy or oral medications. The provider, typically an anesthesiologist, pain medicine physician, or spine surgeon, evaluates the patient and determines that a transforaminal epidural injection with imaging guidance is appropriate to deliver anesthetic and/or steroid medication directly to the affected nerve root. The procedure is performed in an ambulatory surgical center (Place of Service 24), using fluoroscopy or CT imaging to ensure accurate needle placement at a single lumbar or sacral level.
Coding Specifications
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Modifiers:
Modifier Code Description When Used 50Bilateral Procedure When the injection is performed on both sides 59Distinct Procedural Service When a separate and distinct procedure is performed in addition to the primary service