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62264 or 62321

Date: Dec 5, 2019

Question:

Is the appropriate code for this procedure 62264 or 62321? "The patient was brought to the fluoroscopy suite, and monitors were applied. The patient was placed in the prone position on a carbon fiber fluoroscopy table. The skin was prepped, wiped, and draped in the usual sterile fashion. Lidocaine 1% was used for skin and subcutaneous anesthesia. A Coude needle under fluoroscopy in PA/lateral position was used to enter the caudal epidural space. No CSF, blood, or paresthesia was noted. Epidurography: 5 ml of Omnipaque 240 was injected to confirm the epidural placement of the needle with real time fluoroscopy. No intervenous or intrathecal diffusion was noted. Poor lumbar and sacral diffusion and filling defects corresponding with patient’s pain distribution were noticed. A catheter was advanced towards the L4-5 level. Following multiple gentle mechanical manipulations contrast was injected, which showed some improvement in the lumbar and sacral diffusion. Then a solution containing lidocaine mixed with betamethasone was injected without problem, needle removed."

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