AHA Coding Clinic® for HCPCS - 2022 Quarter 2; Ask the Editor
Bertolotti’s joint injection
A patient with Bertolotti’s Syndrome presented for a Bertolotti’s joint injection. The skin overlying the pseudoarticulation between the L5 transverse process and sacral ala was anesthetized. The needle was advanced and wedged into the Bertolotti’s joint on the right side. Contrast was injected showing fill of the joint in the periarticular space. Lidocaine was then injected and the needle was removed. What is the correct CPT code for an injection into Bertolotti’s joint, CPT code 64493 , Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level , CPT 64999 , Unlisted procedure, nervous system , CPT code 20610 , Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance , or another CPT code? ...
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Article Overview
This article reviews a Bertolotti’s joint injection in the context of CPT coding. It is aimed at coding professionals and clinicians who need to understand how the procedure is represented, what broad anatomic and procedural factors are involved, and how the article frames the choice among reporting options.
Why This Topic Matters
Bertolotti’s syndrome can involve anatomy that does not map neatly to routine injection code families, so articles like this help readers understand the coding context and the kinds of CPT options being considered.
What You Will Learn
- The procedural context of a Bertolotti’s joint injection
- How the article frames possible CPT reporting categories for the service
- The anatomic setting and general injection approach discussed in the case scenario
- Why this procedure may raise CPT selection questions
Who Should Read This
- Medical coders
- Billing staff
- Physicians
- Advanced practice clinicians
- Coding educators
Codes Discussed
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