Ask Dr. Z

My provider performed an image-guided lumbar puncture at the L4-L5 level for the purposes of administration of enzyme replacement therapy for Hunter syndrome. "A 22 gauge needle was inserted into the thecal sac at the L4-L5 level. A fluoroscopic image of the needle within the spine was retained within the patient record. 10 mg of Idursulfase in 1 cc of saline was then slowly administered intrathecally." Would this procedure be coded with 62323 or 96450 with 77003? My concern is 96450 is for chemotherapy. Both procedures place the medication into the subarachnoid space.