Caudal epidural steroid injections involve injecting a steroid into the epidural space, where the irritated nerve roots are located. The caudal injection is performed through the sacral opening and is used to treat low back pain. This injection includes both a long-lasting steroid and an anesthetic (lidocaine, bupivacaine). The steroid reduces inflammation and irritation, while the anesthetic interrupts the pain-spasm cycle and nociceptor transmission (Boswell 2007). The medicines spread to the most painful levels of the spine, reducing inflammation and irritation. The entire procedure usually takes less than 15 minutes.
8. CPT codes 64400-64530 describe injection of anesthetic agent for diagnostic or therapeutic purposes, the codes being distinguished from one another by the named nerve and whether a single or continuous infusion by catheter is utilized. All injections into the nerve including branches described (named) by the code descriptor at a single patient encounter constitute a single unit of service(UOS). For example:
(1) If a physician injects an anesthetic agent into multiple areas around the sciatic nerve at a single patient encounter, only one UOS of CPT code 64445 (injection, anesthetic agent; sciatic nerve, single) may be reported.
(2) If a physician injects the superior medial and lateral branches and inferior medial branches of the left genicular nerve, only one UOS of CPT code 64450 (Injection, anesthetic agent; other peripheral nerve or branch) may be reported regardless of the number of injections needed to block this nerve and its branches.
I had three injections all of which worked for a few days to two weeks then stopped. The excruciating pain returned and only Vicoden 5 mg 3-4 times a day controlled the pain. Vicoden at that dose is the lowest dose prescribed. it worked perfectly for several years and doctors refused to prescribed opioids for fear of losing their license. My sister recently died of throat cancer and she complained constantly of pain. She died with unrelieved pain. As a cancer patient she was prescribed Morphine 2 mg. every 6 hours. That is beyond ridiculous but keeps our doctor’s license safe. Our doctors are violating their Hippocratic oath – Do No Harm. They had added a caveat “except when the government is breathing down your neck. Then the patient be damned. I am glad this helped you Randy. I don’t know your clinical status but I am sure it differs from mine. Do you have severe and crippling arthritis?