How to code MBB - Block from Lumbar L5 to S3? CPT 64451 versus CPT 64493

HOW TO CODE MBB - BLOCK FROM LUMBAR L5 TO S3? CPT 64451 VERSUS CPT 64493

Does this sound familiar? - ​BILLING CODING L5 DORSAL RAMUS AND S1, S2, S3 LATERAL BRANCH BLOCK

HOW TO CODE MBB - BLOCK FROM LUMBAR L5 TO S3? CPT 64451 VERSUS CPT 64493

​When CPT code 64451 is performed from L5 to S3, it should be reported as a single unit of service regardless of the number of sacroiliac joints injected. Each sacroiliac joint should not be counted as a separate injection. This is because the injection is being performed at the sacral plexus, which is located near the sacroiliac joint but is a different structure.
This information is supported by the American Medical Association's CPT Assistant, which states that "when injection of the sacral plexus is performed at multiple levels (e.g., L4, L5, and S1), each level should be separately identified and reported with the -59 modifier appended to the additional levels beyond the first level." However, in the scenario you described, since the injection is being performed from L5 to S3, it should be reported as a single unit of service using code 64451 without any modifiers.
It is important to review the payer's specific coding and billing guidelines to ensure compliance with their policies. The Centers for Medicare & Medicaid Services (CMS) has also published guidelines on the appropriate use of CPT code 64451.
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Source: American Medical Association. CPT Assistant. May 2013 Volume 23, Issue 5, Page 9. CMS National Correct Coding Initiative Policy Manual for Medicare Services, Chapter 11, Section H (available on the CMS website).