What Are the 2017 Changes to Epidural Steroid Injection Coding?

epidural steroid injection coding

As of January 1, 2017, CPT codes 62310-62319 have been deleted. In their place, new codes have been added so that the use or non-use of imaging with epidural steroid injections is now reflected. If your anesthesiology practice hasn’t yet updated its systems, do so now, using the following new ESI codes.

Why Have These Changes Been Made?

The new codes exist to identify whether or not imaging guidance has been used for each type of injection and anatomic area. The change in coding is a result of a CMS (Centers for Medicare and Medicaid Services) screen that identified possibly misvalued services pertaining to the Medicare Physician Fee Schedule.

According to CMS, the injection procedures were often reported together with fluoroscopic guidance (code 77003). CMS requested that these codes be reviewed by CPT.

The American Academy of Pain Medicine, together with several other professional medical organizations, addressed the concerns brought to light by CMS by establishing a new coding scheme. These new codes went into effect January 1, 2017, at which time it became inappropriate to report codes 77003, 77012, 76942, or any other guidance codes in conjunction with epidural injections.

New ESI Codes

62320 – Injection(s), of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic, WITHOUT IMAGING GUIDANCE (previous code – 62310)

62321 – WITH IMAGING GUIDANCE (i.e., fluoroscopy or CT)

62322 – Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal), WITHOUT IMAGING GUIDANCE (previous code 62311)

62323 – WITH IMAGING GUIDANCE (i.e., fluoroscopy or CT)

62324 – Injection, including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thoracic, WITHOUT IMAGING GUIDANCE (previous code 62318)

62325 – WITH IMAGING GUIDANCE (i.e., fluoroscopy or CT)

62326 – Injection, including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (caudal), WITHOUT IMAGING GUIDANCE (previous code 62319)

62327 – WITH IMAGING GUIDANCE (i.e., fluoroscopy or CT)

Deleted ESI Codes

62310 – Injection, single, of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution) not including neurolytic substances, including needle or catheter placement, includes contrast for localization when performed, epidural or subarachnoid; cervical or thoracic

62311 – lumbar, sacral (caudal)

62318 – Injection, including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, includes contrast for localization when performed, epidural or subarachnoid, cervical or thoracic

62319 – lumbar, sacral (caudal)

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