CPT 64483 represents a transforaminal epidural injection (LESI) in the lumbar or sacral spine. It is highly audited by Medicare due to high utilization and frequent documentation errors.
Imaging is Bundled
The descriptor for 64483 explicitly states "with imaging guidance (fluoroscopy or CT)". Because of this, you cannot bill 77003 (fluoroscopic guidance) or 77012 (CT guidance) separately. It is bundled into the primary code.
Billing Additional Levels (64484)
64483 covers a single spinal level. If the physician injects a second level, you must bill the add-on code 64484. Do not append Modifier 51 to add-on codes.
NCCI Edits and Modifier 50
64483 is a unilateral code. If the physician performs bilateral transforaminal injections at the exact same spinal level, append Modifier 50 to 64483. Medicare will reimburse at 150% of the standard fee schedule.