Ask Dr. Z

What are the correct surgical CPT codes for lateral branch blocks in the sacrum? The orthropaedic physician says he is injecting bilaterally the lateral branches S1-S4. The radiology guidance reports seeing four needles into the SI joints; however, the physician says he is not injecting the joints, rather he is performing lateral branch blocks. The physician also confirms he used four needles for the injections, and he advises the codes for this are 64493-50, 64494-50, and 64495-50. My question is, if he is using four needles, would three levels be injected bilaterally? Also, I am seeing on some pain management websites recommendations to use code 64450 for lateral branch blocks, as they are considered peripheral nerves in the sacral area. Please advise.