If you are anything like me, just looking at pain management codes can be pretty stressful. Especially the codes relating to the spine, spinal nerves, and joints! These codes all seem similar, so how are you supposed to know which code is the right one? What in the world does transforaminal mean and how is a transforaminal epidural different from an interlaminar epidural?!

While I thought I understood the basic anatomy of the spine and nervous system, I realized I didn’t fully grasp how they work together, which is so critical to understanding pain management coding. Once I put in the extra effort towards learning how these systems work together…Voila!  The code descriptions were no longer confusing, and my confidence grew when coding these types of procedures!

Here are some details that I found helpful when coding these scenarios!

The foramen is an opening between each vertebra where the spinal nerve branches break off the spinal cord and exit the spinal column. So, a transforaminal epidural means the epidural space was accessed via this specific opening.  Look to codes 66479-64484 for transforaminal epidurals.

The lamina is a flattened structure forming part of the vertebral arch on the posterior side of each vertebra.  In an interlaminar epidural procedure, the needle accesses the epidural space between the laminae of two vertebrae.  The code set for interlaminar epidural procedures is 62320-62327.

Taking the time to better understand spinal anatomy can be very helpful when it comes to figuring out the correct epidural codes.

If you are curious about anatomy as it relates to pain management codes or wondering about things like which codes include imaging guidance or how to report bilateral injections, be sure to check out Haugen's Pain Management Webinar!

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